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Sleep Symptoms and Disorders in Episodic Migraine: Assessment and Management

  • Episodic Migraine (S Parikh, Section Editor)
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Abstract

Purpose of Review

We review research on sleep symptoms and disorders in patients with episodic migraine and propose a framework for evaluating sleep symptoms in this patient population.

Recent Findings

Patients with episodic migraine consistently report poorer sleep on validated self-reports compared to those without migraine. In polysomnographic studies, children with migraine have objectively shorter sleep duration and lower percentage of REM sleep interictally. Prospective actigraphy studies in adults and children suggest that there are no significant changes in sleep duration, efficiency, or quality in the night before or after a migraine attack.

Summary

The relationship between sleep and migraine is multifaceted. Patients with episodic migraine report poorer sleep and have higher risk of some sleep disorders, including insomnia, sleep-related bruxism, and restless legs syndrome. Sleep screening questions may be incorporated into headache evaluations. Care should be taken to avoid headache medications that may exacerbate sleep symptoms. Evidence-based treatments for insomnia may be initiated while patients await CBT-I. Further studies are needed to assess whether treatment of comorbid sleep disorders results in improvement in migraine-related burden in those with episodic migraine.

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Authors and Affiliations

  1. Division of Headache Medicine, Department of Neurology, John R. Graham Headache Center, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Angeliki Vgontzas

  2. Montefiore Headache Center, Department of Neurology, Albert Einstein College of Medicine, NY, Bronx, USA

    Jelena Pavlović

  3. Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Suzanne Bertisch

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  1. Angeliki Vgontzas
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  3. Suzanne Bertisch
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Correspondence to Angeliki Vgontzas.

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Dr. Vgontzas has no conflicts of interest. Dr. Pavlović has received consulting honoraria from Abbvie, Lundbeck, and Biohaven. Dr. Bertisch has received consulting fees from Idorsia Pharmaceuticals, Merck, ResMed, and Eisai.

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Vgontzas, A., Pavlović, J. & Bertisch, S. Sleep Symptoms and Disorders in Episodic Migraine: Assessment and Management. Curr Pain Headache Rep 27, 511–520 (2023). https://doi.org/10.1007/s11916-023-01160-z

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