Uhlig B L, Engstrøm M, Ødegård S S, Hagen K K, Sand T
Department of Neuroscience, Norwegian University of Science and Technology, Norway.
Department of Neuroscience, Norwegian University of Science and Technology, Norway Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Norway.
Cephalalgia. 2014 Sep;34(10):745-51. doi: 10.1177/0333102414540058. Epub 2014 Jun 27.
Several epidemiological studies on the association between primary headaches and insomnia have been published in recent years. Both disorders are frequent, and our purpose was to review results from population-based studies exploring this association.
We performed a literature search in PubMed for "insomnia" (or sleep disturbance) and "headache" (or migraine) linked with "epidemiology." Two hundred and eight records were identified. Three longitudinal and 10 cross-sectional studies met our inclusion criteria: population-based design with at least 200 participants including a numerical estimate of the association between headache and insomnia.
In nearly all studies, primary headaches, including migraine and tension-type headache, were significantly related to insomnia symptoms with OR estimates ranging from 1.4 to 1.7. The odds were even greater, from 2.0 to 2.6, for frequent, comorbid or severe headache. Recent large longitudinal studies from Norway found a bidirectional, possibly causal, association between headache and insomnia. However, not all studies used standardized diagnostic criteria for either headache or insomnia. Further research should use well defined and validated diagnostic criteria both for insomnia and headache types in order to improve the comparability between studies, investigate causality and clarify the relevance of the findings for clinical practice.
近年来，已发表了几项关于原发性头痛与失眠之间关联的流行病学研究。这两种疾病都很常见，我们的目的是回顾基于人群的研究结果，以探究这种关联。
我们在PubMed中检索了与“流行病学”相关的“失眠”（或睡眠障碍）和“头痛”（或偏头痛）。共识别出208条记录。三项纵向研究和十项横断面研究符合我们的纳入标准：基于人群的设计，参与者至少200名，包括对头痛与失眠之间关联的数值估计。
几乎在所有研究中，原发性头痛，包括偏头痛和紧张型头痛，都与失眠症状显著相关，比值比估计值在1.4至1.7之间。对于频繁发作、合并存在或严重的头痛，比值比甚至更高，在2.0至2.6之间。挪威最近的大型纵向研究发现头痛与失眠之间存在双向、可能是因果关系的关联。然而，并非所有研究都对头痛或失眠采用了标准化诊断标准。进一步的研究应使用针对失眠和头痛类型明确界定且经过验证的诊断标准，以提高研究之间的可比性、研究因果关系并阐明研究结果与临床实践的相关性。
