Sleep disturbance as a trigger for headache: clinical and pathophysiological aspects

Objective: to assess the role of sleep disturbance as a trigger for headache in patients with chronic migraine (CM) and chronic tension-type headache, as well as to determine its relationship with psychoemotional factors and headache burden. Object and methods of the study. The study included 79 participants (mean age 39.1±8.7 years), among whom women predominated (69.6%). Patients with CM, chronic tension-type headache and control group individuals without chronic headache were examined. Headache impact (HIT-6), disability (MIDAS), pain intensity (VAS), anxiety and depression levels (HADS), and affective components of pain perception according to the McGill questionnaire were assessed. Sleep disturbances were recorded as a subjectively defined trigger. Descriptive statistics, correlation and multivariate regression analysis were used. Results. Sleep disturbance as a headache trigger was noted by 54.4% of patients, most often in chronic tension-type headache. Sleep-trigger had no independent effect on headache burden according to HIT-6, while significant predictors were the level of anxiety and the presence of CM. A decrease in the motivational-affective component of pain was found in patients with sleep-trigger. Conclusion. Sleep disturbance in primary headaches plays an indirect role, modulating affective and psychoemotional mechanisms, and does not act as an independent determinant of headache burden.