Duman Taşkın, Dede Özlem H, Uluduz Derya, Seydaoğlu Gülşah, Okuyucu Esra, Melek İsmet
Department of Neurology, School of Medicine, Mustafa Kemal University, Hatay, Turkey.
Department of Neurology, School of Medicine, Istanbul University, Cerrahpasa, Istanbul, Turkey.
Ann Indian Acad Neurol. 2015 Jul-Sep;18(3):298-302. doi: 10.4103/0972-2327.160084.
To assess sleep quality in patients with primary headaches before and after prophylactic treatment using a validated sleep-screening instrument.
A total of 147 patients, including 63 tension type headache (TTH) and 84 migraine patients were included. Patients were examined in terms of frequency and severity of headaches and sleep quality before and 12 weeks after prophylactic treatment with either propranolol or amitriptyline.
Baseline Visual Analogue Score (VAS) in migraine patients was 7.99 ± 1.39 compared with 6.86 ± 1.50 in TTH group (P < 0.001). VAS score after the first month of treatment was 6.08 ± 1.88 in migraine patients and 5.40 ± 1.61 in TTH (P = 0.023). VAS scores decreased after the third month of treatment to 4.32 ± 2.29 in migraine patients and 4.11 ± 1.66 in TTH patients (P = 0.344). The decrease was significant for patients treated with amitriptyline but not for those with propranolol. Baseline Pittsburgh Sleep Quality (PSQI) scores were 5.93 ± 2.43 in migraine patients and 6.71 ± 2.39 in TTH patients. Poor quality of sleep (PSQI ≥ 6) prior to prophylactic treatment was observed in 61.4% of migraine patients and in 77.7% of TTH patients. Comparison of PSQI scores before and 3 months following treatment showed significantly improved quality of sleep in all treatment groups; the greatest significance was detected in migraine patients with initial PSQI scores of ≥6 and treated with amitriptyline (P < 0.001).
Increased understanding of routine objective sleep measures in migraine patients is needed to clarify the nature of sleep disturbances associated with primary headaches. This may in turn lead to improvements in headache treatments.
使用经过验证的睡眠筛查工具评估预防性治疗前后原发性头痛患者的睡眠质量。
共纳入147例患者，其中包括63例紧张型头痛（TTH）患者和84例偏头痛患者。在使用普萘洛尔或阿米替林进行预防性治疗前及治疗12周后，对患者的头痛频率、严重程度及睡眠质量进行检查。
偏头痛患者的基线视觉模拟评分（VAS）为7.99±1.39，而TTH组为6.86±1.50（P<0.001）。治疗第一个月后，偏头痛患者的VAS评分为6.08±1.88，TTH患者为5.40±1.61（P=0.023）。治疗第三个月后，偏头痛患者的VAS评分降至4.32±2.29，TTH患者降至4.11±1.66（P=0.344）。阿米替林治疗的患者VAS评分下降显著，而普萘洛尔治疗的患者则不然。偏头痛患者的基线匹兹堡睡眠质量指数（PSQI）评分为5.93±2.43，TTH患者为6.71±2.39。预防性治疗前，61.4%的偏头痛患者和77.7%的TTH患者存在睡眠质量差（PSQI≥6）的情况。治疗前与治疗3个月后的PSQI评分比较显示，所有治疗组的睡眠质量均有显著改善；初始PSQI评分≥6且接受阿米替林治疗的偏头痛患者改善最为显著（P<0.001）。
需要进一步了解偏头痛患者常规客观睡眠指标，以明确与原发性头痛相关的睡眠障碍的本质。这可能进而改善头痛治疗效果。
