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Sleep and Quality of Life in Headache and Migraine

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Sleep and Quality of Life in Clinical Medicine

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Summary

Headache and sleep disorders are prevalent, comorbid conditions that challenge physical as well as psychosocial well-being. Headache is the most common pain-related complaint and the seventh leading ailment seen in medical practice, accounting for 18 million physician visits annually in the USA alone (1). Though historically headache often has been trivialized (perhaps because pain is not easily quantified and headache does not generally compromise life expectancy), headache is in a major quality of life (QOL) concern. In fact, migraine headache is among the 20 leading causes of “years lived with disability” according the World Health Report (2). The burden of headache is increasingly appreciated in psychological, family and interpersonal, vocational, and economic realms. Headache, particularly in its more chronic and severe forms, has been linked to sleep disorders. Interestingly, the sleep disorders associated with headache are varied in nature, including obstructive sleep apnea, periodic limb movement disorder, circadian rhythm disorder, insomnia, and hypersomnia. General symptom patterns, particularly morning headache and chronic daily headache, are suggestive of and aid in recognition of a sleep disorder. Management of the sleep disorder may improve or resolve the headache; sleep-disordered breathing is the most empirically supported example of this relationship. Although pure sleep-related headaches, such as hypoxemia-related headache, are less prevalent and more easily recognized, primary headaches as well are often impacted to some degree by sleep. Irrespective of sleep disorders, variation in the sleep/wake schedule is one of the most common acute headache precipitants while sleeping is one of the most common palliative responses to headache. Insomnia is the sleep disorder most often cited by clinical headache populations. Despite an emerging literature supporting the interdependence of sleep and headache, our understanding of the underlying mechanisms remains speculative. Few well-controlled studies are available, and it is difficult to generalize results across sleep and headache literatures due to inconsistencies in diagnostic nosologies, lack of standardized outcome measures, and varied populations. Future research with improved methods is needed to identify mediating factors between sleep and headache. This chapter reviews the co-morbidity of headache and sleep disorders, prevalence, diagnostic considerations, societal and individual burden of headache, clinical implications, and considerations for future directions.

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Authors
  1. Jeanetta C. Rains
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  2. Donald B. Penzien
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Editor information

Editors and Affiliations

  1. Section Psychopharmacology Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3508TB, PoBox 80082, Utrecht, The Netherlands

    Joris C. Verster

  2. Divison of Clinical Pharmacology and Experimental Therapeutics Department of Medicine, College of Physicians and Surgeons of Columbia University, 630 West 168th Street - Rm # BB813, New York, NY 10032, USA

    S. R. Pandi-Perumal

  3. Department of Psychiatry, Kunin-Lunenfeld Applied Research Unit (KLARU), 3560 Bathurst St., Toronto, M6A 2E1, Canada

    David L. Streiner

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© 2008 Humana Press, Totowa, NJ

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Rains, J.C., Penzien, D.B. (2008). Sleep and Quality of Life in Headache and Migraine. In: Verster, J.C., Pandi-Perumal, S.R., Streiner, D.L. (eds) Sleep and Quality of Life in Clinical Medicine. Humana Press. https://doi.org/10.1007/978-1-60327-343-5_19

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  • DOI: https://doi.org/10.1007/978-1-60327-343-5_19

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60327-340-4

  • Online ISBN: 978-1-60327-343-5

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