Polysomnography Study: Migraine Linked to Disturbed Sleep in Children

CHICAGO – Sleep apnea was observed in more than half of children with migraine in a study presented at the annual meeting of the American Academy of Neurology.

Polysomnography revealed sleep apnea in 56% of children with migraine, compared with 30% of those with nonmigraine headache in a study of 90 children aged 5–19 years with headache and sleep complaints.

The association between sleep apnea and migraine was significant, with an odds ratio of 2.1, Dr. Martina Vendrame, chief resident, Temple University Hospital, Philadelphia, and colleagues reported.

Two-thirds of the children with migraine also had frequent arousal during sleep.

Children with chronic migraine, defined as 15 days or more of migraine per month, took longer to fall asleep, had a shorter total sleep time, woke more frequently during the night, and had shorter REM and slow-wave sleep.

“Clinicians should ask all children with headaches and their parents about sleep problems,” including snoring, awakenings during sleep, and day-time sleepiness, Dr. Vendrame told reporters during a press briefing at the meeting. If concerns are raised, patients should be referred to ENT specialists for evaluation and treatment of sleep apnea.

Two-thirds of children in the study identified with sleep apnea were evaluated by ENT specialists, and half underwent tonsillectomy. Of these, 80% had some benefit, including reduced migraine frequency, she said.

Dr. Vendrame acknowledged that the presence of headache could contribute to sleep disturbances, as children suffering from headache will often take daytime naps. In addition, it is widely accepted that headache and sleep disorders share common pathophysiologic mechanisms. Previous studies have evaluated the relationship between headache and sleep disturbances, but this is the first to use polysomnography in children, she said.

The study comprised 60 children with migraine, 11 with chronic daily headaches, 6 with tension headaches, and 13 with nonspecific headaches.

Sleep apnea was also noted among 54% of patients with nonspecific headache, and was observed more frequently in those with a higher body mass index.

Children with chronic daily headache had shorter total sleep time, longer sleep latency, shorter REM sleep, and a higher arousal index.

Among the six children with tension headaches, 50% suffered from teeth grinding, versus 2.4% of children with nontension headaches (OR 1.95).

When asked if the study was biased by having a population of children who already had reported headaches and sleep disturbances, Dr. Vendrame said she hopes to repeat the study in a general population of children, in children without headache, and over an extended period of time to minimize the “first night” effect experienced when children are away from home.

The study was conducted at St. Christopher Hospital for Children, Drexel University, Philadelphia; and the authors had no conflicts of interest to disclose.

CHICAGO – Sleep apnea was observed in more than half of children with migraine in a study presented at the annual meeting of the American Academy of Neurology.

Polysomnography revealed sleep apnea in 56% of children with migraine, compared with 30% of those with nonmigraine headache in a study of 90 children aged 5–19 years with headache and sleep complaints.

The association between sleep apnea and migraine was significant, with an odds ratio of 2.1, Dr. Martina Vendrame, chief resident, Temple University Hospital, Philadelphia, and colleagues reported.

Two-thirds of the children with migraine also had frequent arousal during sleep.

Children with chronic migraine, defined as 15 days or more of migraine per month, took longer to fall asleep, had a shorter total sleep time, woke more frequently during the night, and had shorter REM and slow-wave sleep.

“Clinicians should ask all children with headaches and their parents about sleep problems,” including snoring, awakenings during sleep, and day-time sleepiness, Dr. Vendrame told reporters during a press briefing at the meeting. If concerns are raised, patients should be referred to ENT specialists for evaluation and treatment of sleep apnea.

Two-thirds of children in the study identified with sleep apnea were evaluated by ENT specialists, and half underwent tonsillectomy. Of these, 80% had some benefit, including reduced migraine frequency, she said.

Dr. Vendrame acknowledged that the presence of headache could contribute to sleep disturbances, as children suffering from headache will often take daytime naps. In addition, it is widely accepted that headache and sleep disorders share common pathophysiologic mechanisms. Previous studies have evaluated the relationship between headache and sleep disturbances, but this is the first to use polysomnography in children, she said.

The study comprised 60 children with migraine, 11 with chronic daily headaches, 6 with tension headaches, and 13 with nonspecific headaches.

Sleep apnea was also noted among 54% of patients with nonspecific headache, and was observed more frequently in those with a higher body mass index.

Children with chronic daily headache had shorter total sleep time, longer sleep latency, shorter REM sleep, and a higher arousal index.

Among the six children with tension headaches, 50% suffered from teeth grinding, versus 2.4% of children with nontension headaches (OR 1.95).

When asked if the study was biased by having a population of children who already had reported headaches and sleep disturbances, Dr. Vendrame said she hopes to repeat the study in a general population of children, in children without headache, and over an extended period of time to minimize the “first night” effect experienced when children are away from home.

The study was conducted at St. Christopher Hospital for Children, Drexel University, Philadelphia; and the authors had no conflicts of interest to disclose.

CHICAGO – Sleep apnea was observed in more than half of children with migraine in a study presented at the annual meeting of the American Academy of Neurology.

Polysomnography revealed sleep apnea in 56% of children with migraine, compared with 30% of those with nonmigraine headache in a study of 90 children aged 5–19 years with headache and sleep complaints.

The association between sleep apnea and migraine was significant, with an odds ratio of 2.1, Dr. Martina Vendrame, chief resident, Temple University Hospital, Philadelphia, and colleagues reported.

Two-thirds of the children with migraine also had frequent arousal during sleep.

Children with chronic migraine, defined as 15 days or more of migraine per month, took longer to fall asleep, had a shorter total sleep time, woke more frequently during the night, and had shorter REM and slow-wave sleep.

“Clinicians should ask all children with headaches and their parents about sleep problems,” including snoring, awakenings during sleep, and day-time sleepiness, Dr. Vendrame told reporters during a press briefing at the meeting. If concerns are raised, patients should be referred to ENT specialists for evaluation and treatment of sleep apnea.

Two-thirds of children in the study identified with sleep apnea were evaluated by ENT specialists, and half underwent tonsillectomy. Of these, 80% had some benefit, including reduced migraine frequency, she said.

Dr. Vendrame acknowledged that the presence of headache could contribute to sleep disturbances, as children suffering from headache will often take daytime naps. In addition, it is widely accepted that headache and sleep disorders share common pathophysiologic mechanisms. Previous studies have evaluated the relationship between headache and sleep disturbances, but this is the first to use polysomnography in children, she said.

The study comprised 60 children with migraine, 11 with chronic daily headaches, 6 with tension headaches, and 13 with nonspecific headaches.

Sleep apnea was also noted among 54% of patients with nonspecific headache, and was observed more frequently in those with a higher body mass index.

Children with chronic daily headache had shorter total sleep time, longer sleep latency, shorter REM sleep, and a higher arousal index.

Among the six children with tension headaches, 50% suffered from teeth grinding, versus 2.4% of children with nontension headaches (OR 1.95).

When asked if the study was biased by having a population of children who already had reported headaches and sleep disturbances, Dr. Vendrame said she hopes to repeat the study in a general population of children, in children without headache, and over an extended period of time to minimize the “first night” effect experienced when children are away from home.

The study was conducted at St. Christopher Hospital for Children, Drexel University, Philadelphia; and the authors had no conflicts of interest to disclose.