People with migraines have less REM sleep, study finds

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By Kristen Rogers, CNN

According to new research, people with migraines may benefit from a reduced sleep phase, which is crucial for thinking and memory.

Rapid eye movement, or REM, sleep is the perfect place of our sleep cycles, characterized by more dreams, body movements, and faster heart rate and breathing than in other stages of sleep.

In a meta-analysis of 32 studies, adults and children with migraines were less likely than healthy people without migraines to have both subjectively and objectively poorer quality sleep. The results of the meta-analysis published Wednesday in the journal Neurology, the medical journal of the American Academy of Neurology.

The research comes from experts who wonder if migraines cause poor sleep quality or if poor sleep leads to migraines.

“We wanted to analyze recent research to get a clearer picture of how migraines affect people’s sleep patterns and the severity of their headaches,” said one of the study’s authors, Dr. Jan Hoffman, Clinical Lecturer in Neurology at King’s College London, in A declaration.

“This way clinicians can better support people with migraines and provide more effective sleep treatments,” added Hoffman, member of the American Academy of Neurology. Hoffman consults, sits on advisory boards, and has received honoraria from several drug companies, but those activities are unrelated to the submitted work, according to the authors.

Previously observed associations between sleep disturbances and migraines have been difficult for researchers to disentangle, as the alterations in sleep can be a trigger, treatment, or symptom of migraines, the authors wrote.

Although migraines affect approximately 1 billion people and are one of the leading causes of disability worldwide, according to a 2018 studyThere hasn’t been a lot of conclusive research into what migraine patients think about the quality of their sleep – and whether objective lab tests match those perceptions, the study found.

The new meta-analysis included more than 10,000 adults and children who had participated in previous studies. Adults with migraines performed worse than healthy participants on the Pittsburgh Sleep Quality Index, a questionnaire on the quality of sleep, the duration of sleep, the duration and efficiency of sleep, sleep disorders, the use of sleeping pills and daytime dysfunction. This finding was more common in adults with chronic than episodic migraines.

Many participants had suffered overnight polysomnography, a sleep study that records certain bodily functions while participants sleep and is used to diagnose sleep disorders. These tests showed that adults and children with migraines had a lower percentage of REM sleep than the control groups. Children with migraines also took less time to fall asleep, had less total sleep time, and more time awake.

“This study was an association study. It was not a causal study, which will always have limits, ”said Dr. Raj Dasgupta, assistant professor of clinical medicine at the Keck School of Medicine at the University of Southern California, who was not involved in study. “It would be nice to know what they see in terms of other sleep disorders like obstructive sleep apnea and stuff.”

Headaches and migraines have been associated with insomnia, sleepwalking, bruxism, restless leg syndrome and narcolepsy, Dasgupta added, some of which could involve a genetic factor.

The studies included in the meta-analysis did not report whether migraine patients experienced migraines during sleep itself, and six studies did not include an extra night for participants to adjust to the sleep lab. which can affect REM sleep. And the authors couldn’t fully explain potential mental health diagnoses or drug use, both of which could influence sleep, according to the study.

But their research is starting to provide “a better understanding of migraines and how they affect sleep patterns,” Hoffman said.

Underlying factors and tips for sleep and pain

Previous research has reported a reduction in REM sleep the night before a migraine attack, the authors wrote. A symptom of migraine that got worse after REM sleep deprivation is cutaneous allodynia, when someone experiences pain after their skin has been touched in a way that usually doesn’t produce pain, according to the study. This suggests a possible dysfunction of REM sleep processes that could cause migraines.

Children with migraines who fell asleep faster than children without migraines might have done so because they might be sleep deprived, the authors said.

Both adults and children can try to alleviate migraine sleep problems or migraine sleep problems.

For children, the American Academy of Pediatrics recommends maintain sleep hygiene – including eight to 10 hours a night and turn off technology an hour before bed – and healthy eating. If your child has trouble sleeping, a pediatrician might recommend testing for snoring or sleep disturbances, which have been linked to migraines, suggests the AAP. Eating three meals at regular times a day, staying hydrated, and avoiding heavily processed foods, which typically contain more migraine triggers – including sweeteners, additives, and artificial colors – can help.

The advice for adults is similar. “Sleep can improve headaches,” Dasgupta said, so it’s “important to get the right amount and quality of sleep. Remember that too much sleep can also trigger headaches such as migraines.

Try to go to bed and wake up at the same time each day to regulate your circadian cycle, spend more time in natural light during the day, and avoid alcohol and tobacco, suggests The Migraine Trust, a UK migraine charity that helped support this study.

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