Chronic Migraine Associated With Comorbidities, Sleep Disorders

Chronic migraine is associated with pain, psychiatric, and endocrine/neurological comorbidities, as well as sleep disorders, according to 2 study abstracts presented at the Annual Academy of Neurology Meeting, held April 21-27 in Los Angeles, California.

Both studies analyzed data from the prospective web-based baseline survey of the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study. Data were extracted to identify people with episodic migraine and chronic migraine. Survey participants answered the Comorbidities/Endophenotypes module assessing 64 symptoms and conditions. Participants were asked if they ever had a specific symptom and, if they did, if the symptom or condition had been confirmed or diagnosed by a doctor.

Of the 12,810 participants, 11,699 had episodic migraine, and 1,111 had chronic migraine. The 2 cohorts were similar in age, with a mean age of 41.3 in the episodic migraine cohort and a mean age of 41.9 in the chronic migraine cohort. Those in the chronic migraine cohort were more likely to be women (81.5% vs 74.2%), white (88.7% vs 84%), and have a higher body mass index (28.7 kg/m² vs 27.7 kg/m²).

The first study focused on pain, psychiatric, and endocrine/neurological comorbidities reported. The researchers observed that there were 5 conditions with relative frequencies of 10% or more that were more prevalent in those with chronic migraine: chronic back pain (37.5% vs 22.5%), chronic pain (22.2% vs 7.4%), neck pain (55.3% vs 38.1%), anxiety (42.2% vs 25.7%), and depression (45.6% vs 28.1%).

“Significantly more respondents with chronic migraine versus episodic migraine reported having specific symptoms or conditions,” concluded the authors of the study. “Mechanisms explaining this association might have direct causality (chronic migraine causes the comorbidity), reverse causality (the condition increases chronic migraine risk), and shared genetic or environmental risk factors.”

Noting previous reports of sleep pattern disorders and sleep apnea being associated with increased headache severity in chronic migraine, the second study set its focus on the relationship between migraine and sleep disorders. Of the 12,810 participants, 37% were at “high risk” for sleep apnea, with 35.6% of those with episodic migraine being at high risk and 51.8% of those with chronic migraine being at high risk.

The chronic migraine cohort was also more likely to experience snoring (33.9% vs 32.1%), shortness of breath (29.8% vs 20.6%), daytime somnolence (23.4% vs 21.2%), and sleep inadequacy (24.2% vs 22.1%).