Sleep disturbances can trigger migraine headaches, according to the largest prospective study using objective measures of sleep to evaluate its relationship with the neurological disease, an advance that may lead to new interventions for treating the condition.
The study, published in the journal Neurology, revealed that sleep fragmentation -- time spent in bed, but not asleep -- was linked to migraine onset not on the next day, but rather the day after that.
The researchers, including those from Brigham and Women's Hospital in the US, did not find that sleep duration or self-reported low sleep quality was associated with higher risk of migraine over the next day or day after.
"When it comes to sleep and migraines, there's a lot that we don't know. I became interested in this topic because migraine patients are frequently referred to me in the sleep clinic for help with treating their insomnia," said study co-author Suzanne Bertisch from Brigham and Women's Hospital.
"Anyone treating these patients wants to be able to counsel them on what to do to decrease their risk of a migraine, but the literature is unclear on what kind of sleep interventions may be helpful," Bertisch added.
The researchers conducted a prospective study of 98 adults with episodic migraines, who reported at least two headaches, but had fewer than 15 days each month with a headache. The participants made entries in electronic diaries twice a day, recording details about their sleep, headaches and health habits for six weeks.
They also wore a device called a wrist actigraph to bed which objectively captured their sleep patterns. The researchers adjusted data for other migraine triggers such as daily caffeine intake, alcohol intake, physical activity, and stress.
The participants reported 870 headaches over the course of six weeks. According to the study, nightly sleep duration of 6.5 hours or less, and poor sleep quality were not associated with migraine the day immediately following (Day 0) or the day after that (Day 1).
However, the study said sleep fragmentation measured by both diary, and actigraphy were associated with higher odds of having a migraine on Day 1.
"Sleep is multi-dimensional, and when we look at certain aspects such as sleep, we found that low sleep efficiency, which is the amount of time you're awake in bed when you're trying to sleep, was associated with migraines not on the day immediately following, but on the day after that," said Bertisch.
However, she said the team found no observable relationship between short nightly sleep duration (under 6.5 hours) or reported sleep quality and risk of migraine.