Engstrøm M, Hagen K, Bjørk M, Stovner L J, Stjern M, Sand T
Department of Neuroscience; Norwegian University of Science and Technology, Norway.
Cephalalgia. 2014 May;34(6):455-63. doi: 10.1177/0333102413515339. Epub 2013 Dec 23.
We aimed to compare subjective and objective sleep quality in tension-type headache (TTH) patients and to evaluate the relationship between sleep quality and pain thresholds (PT) in controls and TTH patients.
A blinded cross-sectional study where polysomnography (PSG) and PT (to pressure, heat and cold) measurements were done in 20 patients with TTH (eight episodic (ETTH) and twelve chronic (CTTH) TTH) and 29 healthy controls. Sleep diaries and questionnaires were applied.
TTH patients had more anxiety ( P = 0.001), insomnia ( P < 0.0005), daytime tiredness ( P < 0.0005) and reduced subjective sleep quality ( P < 0.0005) compared to healthy controls. Sleep diaries revealed more long awakenings in TTH ( P = 0.01) but no total sleep-time differences. TTH patients had more slow-wave sleep ( P = 0.002) and less fast arousals ( P = 0.004) in their PSGs. CTTH subjects had lower pressure PT ( P = 0.048) and more daytime sleepiness than the controls ( P = 0.039). Among TTH lower cold PT (CPT) correlated inversely with light sleep (N1) ( R = -0.49, P = 0.003) while slow arousals correlated inversely with headache-frequency ( R = -0.64, P = 0.003).
We hypothesize that TTH patients need more sleep than healthy controls and might be relatively sleep deprived. Inadequate sleep may also contribute to increased pain sensitivity and headache frequency in TTH.
我们旨在比较紧张型头痛（TTH）患者的主观和客观睡眠质量，并评估对照组和TTH患者中睡眠质量与痛阈（PT）之间的关系。
一项双盲横断面研究，对20例TTH患者（8例发作性（ETTH）和12例慢性（CTTH）TTH）和29例健康对照者进行多导睡眠图（PSG）和PT（对压力、热和冷）测量。应用睡眠日记和问卷。
与健康对照相比，TTH患者有更多焦虑（P = 0.001）、失眠（P < 0.0005）、日间疲劳（P < 0.0005）和主观睡眠质量下降（P < 0.0005）。睡眠日记显示TTH患者有更多长时间觉醒（P = 0.01），但总睡眠时间无差异。TTH患者的PSG中有更多慢波睡眠（P = 0.002）和更少快速觉醒（P = 0.004）。CTTH受试者的压力PT较低（P = 0.048），且比对照组有更多日间嗜睡（P = 0.039）。在TTH患者中，较低的冷痛阈（CPT）与浅睡眠（N1）呈负相关（R = -0.49，P = 0.003），而缓慢觉醒与头痛频率呈负相关（R = -0.64，P = 0.003）。
我们假设TTH患者比健康对照需要更多睡眠，可能存在相对睡眠不足。睡眠不足也可能导致TTH患者疼痛敏感性增加和头痛频率增加。
