The role of sleep in migraine attacks

Inamorato, Elaine; Minatti-Hannuch, Suzanmeire N.; Zukerman, Eliova

doi:10.1590/S0004-282X1993000400001

Abstracts

Migraine attacks may be precipitated by sleep deprivation or excessive sleep and sleep is also associated with relief of migraine attacks. In view of this variable relationship we studied the records of 159 consecutive outpatients of our Headache Unit. In 121 records there was reference to sleep involvement, in 55% by a single form and in 45% by more than one form. When only one form was related, relief was most common (70%). 30% of that group of patients had the migraine attack precipitated by sleep, 24% by deprivation and 6% by sleep excess. When the effects of sleep were multiple, these effects were as expected logically in 65%: «in accordance» group (e.g attack precipitated by sleep deprivation and relieved by sleep onset. In a second group, («conflicting») where the involvement was not logical, there were three different combinations of sleep involvement, possibly due to more than one pathophysiological mechanism.

migraine; sleep; precipitating factor; sleep deprivation; sleep excess; relieving factor; worsening factor

Crises de enxaqueca podem ser precipitadas por deprivação ou excesso de sono e o sono também se encontra associado ao alívio de crises de enxaqueca. Dada essa variabilidade de relação, estudamos os registros de 159 pacientes de ambulatório vistos consecutivamente no SITC. Em 121 havia referência a relação com o sono, em 55% de uma só maneira e em 45%, de mais de uma. Quando apenas um modo foi relatado, o alívio foi mais frequente (70%). 30% desse grupo de pacientes apresentavam crise de enxaqueca precipitada pelo sono, 24% por deprivação e 6% por excesso de sono. Quando eram múltiplos os efeitos do sono, eram eles os logicamente esperados em 65%: grupo «de acordo» (exemplo: crise precipitada por deprivação de sono e aliviada no início do sono). Em um segundo grupo («conflitante») a relação não era lógica, três tipos diversos de combinação do relacionamento tendo sido encontrados, possivelmente devido à participação de mais de um mecanismo fisiopatológico.

enxaqueca; sono; fator precipitante; deprivação de sono; excesso de sono; fator de alívio; fator de piora

Elaine Inamorato^I; Suzanmeire N. Minatti-Hannuch^II; Eliova Zukerman^III

^IMestranda. Sector for Investigation and Treatment of Headaches (SITC), Department of Neurology, Escola Paulista de Medicina

^IIMédica Assistente-Doutor. Sector for Investigation and Treatment of Headaches (SITC), Department of Neurology, Escola Paulista de Medicina

^IIIProfessor Adjunto, Chefe do SITC. Sector for Investigation and Treatment of Headaches (SITC), Department of Neurology, Escola Paulista de Medicina

SUMMARY

Migraine attacks may be precipitated by sleep deprivation or excessive sleep and sleep is also associated with relief of migraine attacks. In view of this variable relationship we studied the records of 159 consecutive outpatients of our Headache Unit. In 121 records there was reference to sleep involvement, in 55% by a single form and in 45% by more than one form. When only one form was related, relief was most common (70%). 30% of that group of patients had the migraine attack precipitated by sleep, 24% by deprivation and 6% by sleep excess. When the effects of sleep were multiple, these effects were as expected logically in 65%: «in accordance» group (e.g attack precipitated by sleep deprivation and relieved by sleep onset. In a second group, («conflicting») where the involvement was not logical, there were three different combinations of sleep involvement, possibly due to more than one pathophysiological mechanism.

Key words: migraine, sleep, precipitating factor, sleep deprivation, sleep excess, relieving factor, worsening factor.

RESUMO

Crises de enxaqueca podem ser precipitadas por deprivação ou excesso de sono e o sono também se encontra associado ao alívio de crises de enxaqueca. Dada essa variabilidade de relação, estudamos os registros de 159 pacientes de ambulatório vistos consecutivamente no SITC. Em 121 havia referência a relação com o sono, em 55% de uma só maneira e em 45%, de mais de uma. Quando apenas um modo foi relatado, o alívio foi mais frequente (70%). 30% desse grupo de pacientes apresentavam crise de enxaqueca precipitada pelo sono, 24% por deprivação e 6% por excesso de sono. Quando eram múltiplos os efeitos do sono, eram eles os logicamente esperados em 65%: grupo «de acordo» (exemplo: crise precipitada por deprivação de sono e aliviada no início do sono). Em um segundo grupo («conflitante») a relação não era lógica, três tipos diversos de combinação do relacionamento tendo sido encontrados, possivelmente devido à participação de mais de um mecanismo fisiopatológico.

Palavras-chave: enxaqueca, sono, fator precipitante, deprivação de sono, excesso de sono, fator de alívio, fator de piora.

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

Aceite: 8-junho-1993.

Dra. Suzanmeire Negro Minatti-Hannuch Av. Profa. Ida Kolb 225, Bloco 3, Apto. 182 -02508-000 São Paulo SP - Brasil.

1. Berger RJ, Oswald I. Effects of sleep deprivation on behavior, subsequent sleep and dreaming. J Ment Sci 1962, 108:457-465.
2. Blau JN. Resolution of migraine attacks: sleep and the recovery phase. J Neurol Neurosurg Psychiatry 1982, 45:223-226.
3. Blau JN, Thavapplan M. Preventing migraine: a study of precipitating factors. Headache 1988, 28:481-483.
4. Blau JN. Sleep deprivation headache. Cephalalgia 1990, 10:157-160.
5. Borbely AA, Bauman F, Brandus D, Strauch I, Lehmann D. Sleep-deprivation: effect on sleep stages and EEG power density in man. Electroenceph Clin Neurophysiol 1981, 51: 483-493.
6. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia 1988, (Suppl 17): 19-28.
7. Dexter JD, Weitzman ED. The relationship of nocturnal headaches to sleep stage patterns. Neurology 1970, 20:513-518.
8. Dexter JD. The relationship between stage III+IV+REM sleep and arousals with migraine. Headache 1979, 19:364-369.
9. Dexter JD, Riley TL. Studies in nocturnal migraine. Headache 1975, 15:51-62.
10. Falaschi P, Buongiorno T, Agnoli A. Chrononeuroendocrine perspectives of ACTH and related peptides. Cephalalgia 1983, 3(Suppl 1) :111-116.
11. Feinberg I, Fein G, Floyd TC. EEG patterns during and following extended sleep in young adults. Electroenceph Clin Neurophysiol 1980, 50:467-476.
12. Ferrari E, Canepari C, Bossolo PA, Vailati A, Martignoni E, Micieli G, Nappi G. Changes of biological rhythms in primary headache syndromes. Cephalalgia 1983, 3(Suppl 1):58-68.
13. Gans M. Treating migraine by «sleep-rationing». J Nerv Ment Dis 1951, 113:405-429.
14. Kayed K, Sjaastad O. Nocturnal and early morning headaches. Ann Clin Res 1985, 17: 243-246.
15. Minatti-Hannuch SN, Inamorato E; Zukerman E. Sleep as a relieving factor in migraine treatment: a study in a emergency headache unit. Cephalalgia 1991, 11 (Suppl 11): 145.
16. Minatti-Hannuch SN, Zukerman E, Inamorato E. Fatores desencadeantes das crises de enxaqueca na infância. J Pediatria 1990, 66:127-129.
17. Parrino L, Pietrini V, Spaggiari MC, Terzano MG. Acute confusional migraine attacks resolved by sleep: lack of significant abnormalities in post ictal polysomnograms. Cephalalgia 1986, 6:96-100.
18. Sahota PK, Dexter JD. Sleep and headache syndromes: a clinical review. Headache 1990, 30:80-84.
19. Ukponmwan OE, Rupreht J, Dzoljic MR. REM sleep deprivation decreases the antinociceptive property of enkephalinase-inhibition, morphine and cold-water-swin. Gen Pharmac 1984, 15:255-258.
20. Wilknson M, Willians K, Leyton M. Observations on the treatment of the acute attack of migraine. Res Clin Stud Headache 1978, 6:141-146.

The role of sleep in migraine attacks

Papel do sono em crises de enxaqueca

Publication Dates

Publication in this collection
19 Jan 2011
Date of issue
Nov 1993

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Berger RJ, Oswald I. Effects of sleep deprivation on behavior, subsequent sleep and dreaming. J Ment Sci 1962, 108:457-465.

[2] 2. Blau JN. Resolution of migraine attacks: sleep and the recovery phase. J Neurol Neurosurg Psychiatry 1982, 45:223-226.

[3] 3. Blau JN, Thavapplan M. Preventing migraine: a study of precipitating factors. Headache 1988, 28:481-483.

[4] 4. Blau JN. Sleep deprivation headache. Cephalalgia 1990, 10:157-160.

[5] 5. Borbely AA, Bauman F, Brandus D, Strauch I, Lehmann D. Sleep-deprivation: effect on sleep stages and EEG power density in man. Electroenceph Clin Neurophysiol 1981, 51: 483-493.

[6] 6. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia 1988, (Suppl 17): 19-28.

[7] 7. Dexter JD, Weitzman ED. The relationship of nocturnal headaches to sleep stage patterns. Neurology 1970, 20:513-518.

[8] 8. Dexter JD. The relationship between stage III+IV+REM sleep and arousals with migraine. Headache 1979, 19:364-369.

[9] 9. Dexter JD, Riley TL. Studies in nocturnal migraine. Headache 1975, 15:51-62.

[10] 10. Falaschi P, Buongiorno T, Agnoli A. Chrononeuroendocrine perspectives of ACTH and related peptides. Cephalalgia 1983, 3(Suppl 1) :111-116.

[11] 11. Feinberg I, Fein G, Floyd TC. EEG patterns during and following extended sleep in young adults. Electroenceph Clin Neurophysiol 1980, 50:467-476.

[12] 12. Ferrari E, Canepari C, Bossolo PA, Vailati A, Martignoni E, Micieli G, Nappi G. Changes of biological rhythms in primary headache syndromes. Cephalalgia 1983, 3(Suppl 1):58-68.

[13] 13. Gans M. Treating migraine by «sleep-rationing». J Nerv Ment Dis 1951, 113:405-429.

[14] 14. Kayed K, Sjaastad O. Nocturnal and early morning headaches. Ann Clin Res 1985, 17: 243-246.

[15] 15. Minatti-Hannuch SN, Inamorato E; Zukerman E. Sleep as a relieving factor in migraine treatment: a study in a emergency headache unit. Cephalalgia 1991, 11 (Suppl 11): 145.

[16] 16. Minatti-Hannuch SN, Zukerman E, Inamorato E. Fatores desencadeantes das crises de enxaqueca na infância. J Pediatria 1990, 66:127-129.

[17] 17. Parrino L, Pietrini V, Spaggiari MC, Terzano MG. Acute confusional migraine attacks resolved by sleep: lack of significant abnormalities in post ictal polysomnograms. Cephalalgia 1986, 6:96-100.

[18] 18. Sahota PK, Dexter JD. Sleep and headache syndromes: a clinical review. Headache 1990, 30:80-84.

[19] 19. Ukponmwan OE, Rupreht J, Dzoljic MR. REM sleep deprivation decreases the antinociceptive property of enkephalinase-inhibition, morphine and cold-water-swin. Gen Pharmac 1984, 15:255-258.

[20] 20. Wilknson M, Willians K, Leyton M. Observations on the treatment of the acute attack of migraine. Res Clin Stud Headache 1978, 6:141-146.