Vendrame Martina, Kaleyias Joseph, Valencia Ignacio, Legido Agustin, Kothare Sanjeev V
Section of Neurology, Department of Pediatrics, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
Pediatr Neurol. 2008 Jul;39(1):6-11. doi: 10.1016/j.pediatrneurol.2008.03.007.
Although previous studies suggested a relationship between headache and sleep disturbances, polysomnographic findings in children with headache are rarely described. We investigated polysomnographic findings in children with headaches, and correlated them with headache type and severity, body mass index, and medical treatment. Analysis of polysomnographic findings of 90 children with migraine (60), chronic migraine (11), tension headache (6), and nonspecific headache (13) indicated that sleep-disordered breathing was more frequent among children with migraine (56.6%) and nonspecific headache (54%) vs chronic migraine (27%). Tension headache was not associated with sleep-disordered breathing. In the nonspecific headache group, children with sleep-disordered breathing had higher body mass indexes (P = 0.008). Severe migraine and chronic migraine were associated with shorter sleep time, longer sleep latency, and shorter rapid eye movement and slow-wave sleep. Fifty percent of children with tension headache manifested bruxism vs 2.4% of children with nontension headache (odds ratio, 1.95; 95% confidence interval, 1.2-4.34). Our results support an association between migraine and sleep-disordered breathing, and between tension headache and bruxism, in children. Moreover, disrupted sleep architecture with reduced rapid eye movement and slow-wave sleep in severe and chronic migraine headaches may support an intrinsic relationship between sleep and headache disorders.
尽管先前的研究表明头痛与睡眠障碍之间存在关联，但关于头痛儿童的多导睡眠图检查结果却鲜有描述。我们对头痛儿童的多导睡眠图检查结果进行了调查，并将其与头痛类型、严重程度、体重指数及药物治疗进行了关联分析。对90名患有偏头痛（60例）、慢性偏头痛（11例）、紧张性头痛（6例）和非特异性头痛（13例）的儿童的多导睡眠图检查结果分析表明，偏头痛儿童（56.6%）和非特异性头痛儿童（54%）中睡眠呼吸障碍的发生率高于慢性偏头痛儿童（27%）。紧张性头痛与睡眠呼吸障碍无关。在非特异性头痛组中，存在睡眠呼吸障碍的儿童体重指数更高（P = 0.008）。重度偏头痛和慢性偏头痛与睡眠时间缩短、睡眠潜伏期延长、快速眼动睡眠期和慢波睡眠期缩短有关。50%的紧张性头痛儿童存在磨牙症，而非紧张性头痛儿童中这一比例为2.4%（比值比，1.95；95%置信区间，1.2 - 4.34）。我们的研究结果支持儿童偏头痛与睡眠呼吸障碍之间以及紧张性头痛与磨牙症之间存在关联。此外，重度和慢性偏头痛中快速眼动睡眠期和慢波睡眠期减少导致的睡眠结构紊乱可能支持睡眠与头痛障碍之间存在内在联系。
