Morgan Isabel, Eguia Francisco, Gelaye Bizu, Peterlin B Lee, Tadesse Mahlet G, Lemma Seblewengel, Berhane Yemane, Williams Michelle A
Department of Epidemiology, Harvard T.H. Chan School of Public Health Multidisciplinary International Research Training Program, 677 Huntington Ave, K505F, Boston, 02115, MA, USA.
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
J Headache Pain. 2015 Mar 4;16:18. doi: 10.1186/s10194-015-0504-x.
Although in the past decade occidental countries have increasingly recognized the personal and societal burden of migraine, it remains poorly understood in Africa. No study has evaluated the impact of sleep disturbances and the quality of life (QOL) in sub-Saharan Africans with migraine.
This was a cross-sectional study evaluating adults, ≥ 18 years of age, attending outpatient clinics in Ethiopia. Standardized questionnaires were utilized to collect demographic, headache, sleep, lifestyle, and QOL characteristics in all participants. Migraine classification was based on International Classification of Headache Disorders (ICHD)-II criteria. The Pittsburgh Sleep Quality Index (PSQI) and the World Health Organization Quality of Life (WHOQOL-BREF) questionnaires were utilized to assess sleep quality and QOL characteristics, respectively. Multivariable logistic regression models were fit to estimate adjusted odds ratio (OR) and 95% confidence intervals (95% CI).
Of 1,060 participants, 145 (14%) met ICHD-II criteria for migraine. Approximately three-fifth of the study participants (60.5%) were found to have poor sleep quality. After adjustments, migraineurs had over a two-fold increased odds (OR = 2.24, 95% CI 1.49-3.38) of overall poor sleep quality (PSQI global score >5) as compared with non-migraineurs. Compared with non-migraineurs, migraineurs were also more likely to experience short sleep duration (≤7 hours) (OR = 2.07, 95% CI 1.43-3.00), long sleep latency (≥30 min) (OR = 1.97, 95% CI 1.36-2.85), daytime dysfunction due to sleepiness (OR = 1.51, 95% CI 1.12-2.02), and poor sleep efficiency (<85%) (OR = 1.93, 95% CI 1.31-2.88). Similar to occidental countries, Ethiopian migraineurs reported a reduced QOL as compared to non-migraineurs. Specifically Ethiopian migraineurs were more likely to experience poor physical (OR = 1.56, 95% CI 1.08-2.25) and psychological health (OR = 1.75, 95% CI 1.20-2.56), as well as poor social relationships (OR = 1.56, 95% CI 1.08-2.25), and living environments (OR = 1.41, 95% CI 0.97-2.05) as compared to those without migraine.
Similar to occidental countries, migraine is highly prevalent among Ethiopians and is associated with poor sleep quality and a lower QOL. These findings support the need for physicians and policy makers to take action to improve the quality of headache care and access to treatment in Ethiopia.
尽管在过去十年中西方国家越来越认识到偏头痛给个人和社会带来的负担，但在非洲，人们对其仍知之甚少。尚无研究评估撒哈拉以南非洲偏头痛患者睡眠障碍和生活质量（QOL）的影响。
这是一项横断面研究，评估年龄≥18岁、在埃塞俄比亚门诊就诊的成年人。使用标准化问卷收集所有参与者的人口统计学、头痛、睡眠、生活方式和生活质量特征。偏头痛分类基于国际头痛疾病分类（ICHD）-II标准。分别使用匹兹堡睡眠质量指数（PSQI）和世界卫生组织生活质量（WHOQOL-BREF）问卷评估睡眠质量和生活质量特征。采用多变量逻辑回归模型估计调整后的优势比（OR）和95%置信区间（95%CI）。
在1060名参与者中，145名（14%）符合ICHD-II偏头痛标准。约五分之三（60.5%）的研究参与者睡眠质量较差。调整后，与非偏头痛患者相比，偏头痛患者总体睡眠质量差（PSQI全球评分>5）的几率增加了两倍多（OR = 2.24，95%CI 1.49 - 3.38）。与非偏头痛患者相比，偏头痛患者也更有可能经历短睡眠时间（≤7小时）（OR = 2.07，95%CI 1.43 - 3.00）、长睡眠潜伏期（≥30分钟）（OR = 1.97，95%CI 1.36 - 2.85）、因困倦导致的日间功能障碍（OR = 1.51，95%CI 1.12 - 2.02）和低睡眠效率（<85%）（OR = 1.93，95%CI 1.31 - 2.88）。与西方国家类似，埃塞俄比亚偏头痛患者报告的生活质量低于非偏头痛患者。具体而言，与无偏头痛者相比，埃塞俄比亚偏头痛患者更有可能经历较差的身体健康（OR = 1.56，95%CI 1.08 - 2.25）、心理健康（OR = 1.75，95%CI 1.20 - 2.56）、社会关系（OR = 1.56，95%CI 1.08 - 2.25）和生活环境（OR = 1.41，95%CI 0.97 - 2.05）。
与西方国家类似，偏头痛在埃塞俄比亚人中非常普遍，并且与睡眠质量差和生活质量较低有关。这些发现支持医生和政策制定者采取行动改善埃塞俄比亚头痛护理质量和治疗可及性的必要性。
