Department of Psychiatry, University of Hong Kong, Pokfulam Road, Hong Kong SAR, China.
J Headache Pain. 2010 Jun;11(3):187-95. doi: 10.1007/s10194-010-0199-y. Epub 2010 Feb 26.
Limited studies have investigated the prevalence of insomnia symptoms among individuals with different headache diagnoses and the association between insomnia and headache in subjects with comorbid anxiety and depression. A total of 310 community-dwelling Hong Kong Chinese women aged 40-60 years completed a self-administered questionnaire on headache, sleep difficulties, mood disturbances, and functional impairment. About 31% of the sample complained of recurrent headache unrelated to influenza and the common cold in the past 12 months. The percentages of women diagnosed to have migraine, tension-type headache (TTH), and headache unspecified were 8.4, 15.5 and 7.1%, respectively. The most frequent insomnia complaint was "problem waking up too early" (29.4%), followed by "difficulty staying asleep" (28.0%) and "difficulty falling asleep" (24.4%). Women with headaches were significantly more likely to report insomnia symptoms than those without headaches. There were no significant differences among women with migraine, TTH, and headache unspecified in the prevalence of insomnia symptoms. Logistic regression analysis showed that women with insomnia disorder as defined by an insomnia severity index total score >or=8 had 2.2-fold increased risk of reporting recurrent headache, 3.2-fold increased risk of migraine, and 2.3-fold increased risk of TTH, after adjusting for anxiety and depression. Individual insomnia symptoms were not independent predictors. The association between insomnia and headache was stronger in subjects with more frequent headaches. Our findings suggest that insomnia and the associated distress, but not insomnia symptoms alone, is an independent risk factor for recurrent headache in middle-aged women with mixed anxiety, depression and sleep disturbances.
有限的研究调查了不同头痛诊断个体中失眠症状的患病率，以及在合并焦虑和抑郁的患者中失眠与头痛之间的关联。共有 310 名年龄在 40-60 岁的香港华裔社区女性完成了一份关于头痛、睡眠困难、情绪障碍和功能障碍的自我管理问卷。大约 31%的样本在过去 12 个月内抱怨反复出现与流感和普通感冒无关的头痛。患有偏头痛、紧张型头痛（TTH）和未特指头痛的女性比例分别为 8.4%、15.5%和 7.1%。最常见的失眠抱怨是“过早醒来有困难”（29.4%），其次是“入睡困难”（28.0%）和“难以入睡”（24.4%）。有头痛的女性比没有头痛的女性更有可能报告失眠症状。偏头痛、TTH 和未特指头痛的女性中，失眠症状的患病率没有显著差异。逻辑回归分析显示，根据失眠严重指数总分>或=8 定义的失眠障碍女性报告复发性头痛的风险增加 2.2 倍，偏头痛的风险增加 3.2 倍，TTH 的风险增加 2.3 倍，调整焦虑和抑郁后。个体失眠症状不是独立的预测因素。失眠与头痛之间的关联在头痛更频繁的患者中更强。我们的研究结果表明，失眠及相关痛苦，而不仅仅是失眠症状，是中年女性合并焦虑、抑郁和睡眠障碍时复发性头痛的一个独立危险因素。
