Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, MTFS, 7489 Trondheim, Norway.
J Headache Pain. 2010 Jun;11(3):197-206. doi: 10.1007/s10194-010-0201-8. Epub 2010 Mar 12.
The aim of the study was to evaluate the association between sleep disturbance and headache type and frequency, in a random sample of participants in the third Nord-Trøndelag Health Survey. The headache diagnoses were set by neurologists using the ICHD-2 criteria performing a semi structured face-to-face interview. Sleep problems were measured by the two validated instruments Karolinska Sleep Questionnaire (KSQ) and Epworth Sleepiness Scale (ESS). Among 297 participants, 77 subjects were headache-free, whereas 135 were diagnosed with tension-type headache (TTH), 51 with migraine, and 34 with other headache diagnoses. In the multivariate analyses, using logistic regression, excessive daytime sleepiness, defined as ESS >or= 10, was three times more likely among migraineurs compared with headache-free individuals (OR = 3.3, 95% CI 1.0-10.2). Severe sleep disturbances, defined as KSQ score in the upper quartile, was five times more likely among migraineurs (OR = 5.4, 95% CI 2.0-15.5), and three times more likely for subjects with TTH (OR = 3.3, 1.4-7.3) compared with headache-free individuals. Subjects with chronic headache were 17 times more likely to have severe sleep disturbances (OR = 17.4, 95% CI 5.1-59.8), and the association was somewhat stronger for chronic migraine (OR = 38.9, 95% CI 3.1-485.3) than for chronic TTH (OR = 18.3, 95% CI 3.6-93.0). In conclusion, there was a significant association between severe sleep disturbances and primary headache disorders, most pronounced for those with chronic headache. Even though one cannot address causality in the present study design, the results indicate an increased awareness of sleep problems among patients with headache.
本研究旨在评估睡眠障碍与头痛类型和频率之间的关系，研究对象为第三届诺尔兰健康调查的随机样本参与者。头痛诊断由神经病学家使用 ICHD-2 标准通过半结构化面对面访谈确定。睡眠问题通过两种经过验证的工具——卡罗林斯卡睡眠问卷（KSQ）和 Epworth 嗜睡量表（ESS）进行测量。在 297 名参与者中，77 名无头痛，135 名患有紧张型头痛（TTH），51 名患有偏头痛，34 名患有其他头痛诊断。在多变量分析中，使用逻辑回归，与无头痛个体相比，白天过度嗜睡（ESS>或=10）的偏头痛患者发生的可能性高三倍（OR=3.3，95%CI 1.0-10.2）。严重睡眠障碍（KSQ 评分位于上四分位数）的偏头痛患者发生的可能性是无头痛个体的五倍（OR=5.4，95%CI 2.0-15.5），TTH 患者发生的可能性是无头痛个体的三倍（OR=3.3，1.4-7.3）。慢性头痛患者发生严重睡眠障碍的可能性是无头痛个体的 17 倍（OR=17.4，95%CI 5.1-59.8），慢性偏头痛患者的关联更明显（OR=38.9，95%CI 3.1-485.3），而慢性 TTH 患者的关联稍弱（OR=18.3，95%CI 3.6-93.0）。总之，严重睡眠障碍与原发性头痛障碍之间存在显著关联，对于慢性头痛患者更为明显。尽管在目前的研究设计中无法确定因果关系，但结果表明，头痛患者的睡眠问题意识增强。
