Department of Neurology, Hallym University Hangang Sacred Heart Hospital , Seoul , Republic of Korea.
Department of Neurology, Korea University Anam Hospital , Seoul , Republic of Korea.
Chronobiol Int. 2019 Nov;36(11):1528-1536. doi: 10.1080/07420528.2019.1658202. Epub 2019 Aug 28.
Migraine attacks have a time preference of headache attack (TPHA). Chronotype is the propensity for an individual to sleep at a particular time during a 24-h period. However, limited evidence exists regarding the association between TPHA and chronotype in individuals with migraine or tension-type headache (TTH). The aim of the present study is to investigate TPHA and chronotype in individuals with migraine and TTH, which are two of the most common primary headaches. One hundred sixty-nine first-visit migraine and TTH participants were consecutively enrolled. Information on sleep onset time and wake up time on workdays and free days, and TPHA were investigated with a face-to-face interview using a questionnaire booklet. Chronotype was assessed, using the midpoint of sleep on free days, corrected for sleep extension on free days (MSFsc), by subtracting one-half of the average weekly sleep duration. Headache frequency per month, headache intensity, impact of headache, sleep quality, daytime sleepiness, insomnia severity, and mood status were also assessed. Time preference of headache attack was reported for 45.5% and 44.8% of participants with migraine and TTH, respectively. Migraineurs with TPHA had an earlier MSFsc than did migraineurs without TPHA (1:18 a.m. ± 282 min vs. 4:18 a.m. ± 186 min; = .022). Among migraineurs with TPHA, a later MSFsc was associated with a later preferential time of attack (β = 1.3, 95% confidence interval [CI] = 0.6-2.1, = .004). A later MSFsc was significantly correlated with a higher headache frequency per month among migraineurs with TPHA (β = 1.9, 95% CI = 0.3-3.4, = .023), but was not significantly correlated among migraineurs without TPHA (β = 1.4, 95% CI -1.7-4.4, = .332). Among TTH participants with TPHA, MSFsc was not significantly associated with a preferential time of attack (β = -0.2, 95% CI = -1.0 to 0.6, = .611). Headache frequency was not associated with MSFsc among TTH participants with TPHA (β = 0.2, 95% CI = -1.2 to 1.6, = .792) or among TTH participants without TPHA (β = 0.4, 95% CI = -0.5 to 1.3, = .354). In conclusion, approximately one-half of participants with migraine and TTH reported having TPHA. Migraineurs with TPHA had an earlier chronotype than did migraineurs without TPHA. A later chronotype was associated with increased headache frequency and a later time of attack among migraineurs with TPHA. Among participants with TTH, TPHA and headache frequency were not significantly associated with chronotype.
偏头痛发作有头痛发作的时间偏好（TPHA）。 睡眠时相是指个体在 24 小时周期内特定时间入睡的倾向。 然而，偏头痛或紧张型头痛（TTH）患者中 TPHA 和睡眠时相之间的关联的证据有限。 本研究旨在研究偏头痛和 TTH 患者的 TPHA 和睡眠时相，偏头痛和 TTH 是最常见的原发性头痛之一。 连续纳入了 169 名初诊偏头痛和 TTH 患者。 通过使用问卷手册进行面对面访谈，调查工作日和休息日的入睡时间和醒来时间以及 TPHA。 通过校正休息日的睡眠延长，用休息日的中点（MSFsc）评估睡眠时相，减去平均每周睡眠时间的一半。 还评估了偏头痛每月发作频率、头痛强度、头痛影响、睡眠质量、日间嗜睡、失眠严重程度和情绪状态。 分别有 45.5%和 44.8%的偏头痛和 TTH 患者报告了头痛发作的时间偏好。 有 TPHA 的偏头痛患者的 MSFsc 比没有 TPHA 的偏头痛患者更早（1:18 上午±282 分钟比 4:18 上午±186 分钟； =.022）。 在有 TPHA 的偏头痛患者中，MSFsc 越晚与攻击的偏好时间越晚相关（β=1.3，95%置信区间[CI]为 0.6-2.1， =.004）。 在有 TPHA 的偏头痛患者中，MSFsc 与偏头痛每月发作频率显著相关（β=1.9，95%CI=0.3-3.4， =.023），但在没有 TPHA 的偏头痛患者中不相关（β=1.4，95%CI=-1.7-4.4， =.332）。 在有 TPHA 的 TTH 患者中，MSFsc 与攻击的偏好时间无显著相关性（β=-0.2，95%CI=-1.0 至 0.6， =.611）。 在有 TPHA 的 TTH 患者中，MSFsc 与头痛发作频率无关（β=0.2，95%CI=-1.2 至 1.6， =.792）或在无 TPHA 的 TTH 患者中无关（β=0.4，95%CI=-0.5 至 1.3， =.354）。 总之，大约一半的偏头痛和 TTH 患者报告有 TPHA。 有 TPHA 的偏头痛患者的睡眠时相比没有 TPHA 的偏头痛患者更早。 在有 TPHA 的偏头痛患者中，MSFsc 越晚与头痛发作频率增加和攻击时间延迟有关。 在 TTH 患者中，TPHA 和头痛发作频率与睡眠时相无显著相关性。
