Researchers Investigate Relationship Between Sleep Disorders, Migraine in Children

The use of polysomnography (PSG) can aid researchers in further understanding the association between sleep disorders and migraine in children, according to a study published in the Journal of Medicine and Life.

“The relationship between sleep disorders and migraine has been a subject for research, mostly in adults, following initial clinical observations such as sleep deprivation as a trigger for migraine attacks or cessation of migraine attacks after sleep,” according to researchers.

However, sleep plays a vital role in children’s physical, cognitive, and behavioral development, while migraine is a highly complex, multifactorial disorder with no apparent pathophysiology and a highly polymorphic clinical picture in children.

Currently, “a systematic approach to correctly assessing sleep disorders and to trace a link between the intricacies of the pathophysiological mechanisms of migraine and disordered sleep especially in children, is lacking.”

To better understand the relationship between sleep and migraine in children, study participants completed inpatient full-night polysomnographic recordings. Investigators used these recordings to analyze sleep architecture and electroencephalographic patterns.

In this prospective study, 18 patients between the ages of 5 and 17 with a diagnosis of migraine with aura or migraine without aura underwent an overnight PSG recording. The study took place over 28 months. Due to a lack of healthy volunteers, 16 age-matched controls diagnosed with emotional disorders were included in the study.

Researchers collected data on total sleep time (TST), sleep latency, rapid eye movement (REM) latency, sleep efficiency, REM, N1, N2, N3 percentages (% TST), and arousals. Sleep disorder diagnoses were based on sleep efficiency < 89% and REM (% TST) < 17.

In migraineurs, frequency of migraine attacks was similar between patients with migraine with aura and without aura (P = .426).

From the analyzed recordings, researchers found:

• Lower TST (in minutes) in the migraine group, compared with the control group, P = .371
• Decreased sleep latency (minutes) in migraineurs, compared with the control group, P = .029
• REM latency (minutes) was prolonged in patients with migraine, compared with the control group, P = .565
• REM (%TST) was decreased in patients with migraine, compared with the control group, P = .049
• Arousals were more frequent in patients with migraine, compared with the control group, P = .011
• N1 (%TST) was increased in patients with migraine, compared with the control group, P = .018

N2, N3, and sleep efficiency were similar in both cohorts. Investigators also noted “there was a statistically significant association (P = .041) between the presence of a sleep disorder and migraine. The odds ratio of having a sleep disorder was 5.6 times higher in the migraine group, compared with the control group (odds ratio = 5.60 [0.892], 95% CI, 0.974-32.198, P =.054).”

One limitation of the study is the relatively small number of participants. However, researchers note result analyses were tailored to the small cohorts.

“Broader studies, involving large numbers of children with migraine and healthy volunteers, in different age groups, need to be carried out, in order to better define sleep abnormalities associated with migraine,” authors conclude.

Reference

Nita SA, Teleanu RI, and Bajenaru OA. The role of polysomnography in identifying sleep disorders in children with migraine. J Med Life. 2020;13(1):64-67. doi: 10.25122/jml-2020-0025.