Child Neurology and Psychiatry Medicine, Systems Medicine Department, Tor Vergata University of Rome, Via Montpellier 1, 00133 Rome, Italy.
Child Neurology Unit, Neuroscience Department, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165 Rome, Italy.
Nutrients. 2021 May 13;13(5):1631. doi: 10.3390/nu13051631.
Headache is the most common pain complaint in the pediatric population, with tension type headache (TTH) having a prevalence of 10-15% in children. Up to 70% of pediatric patients with chronic headache also experience sleep disruption, with a likely bidirectional relationship between headache and poor sleep. Treatment options include specific pharmacological approaches as well as non-pharmacological alternatives; nutraceuticals have the advantage of a relative lack of side effects. Exogenous melatonin has been shown to be useful and safe in improving sleep-wake cycles and quality of sleep in children, helping to regulate the circadian rhythm, with a secondary positive impact on headache. Supplementation with other nutraceutical ingredients, such as tryptophan, magnesium, and B vitamins, can have significant additional effects in children with primary headache, with or without sleep disorders. Tryptophan may reduce night awakenings and improve the efficiency of sleep. Primary headache has been related to low amounts of magnesium in serum, and integration with magnesium appears to be effective in reducing headache attacks without adverse effects. There are different observational reports and uncontrolled studies suggesting a possible synergistic effect for these nutraceuticals, but there is now a need for high-quality randomized controlled trials in order to confirm these positive preliminary findings.
头痛是儿科人群中最常见的疼痛主诉，紧张型头痛（TTH）在儿童中的患病率为 10-15%。多达 70%的慢性头痛儿科患者也经历睡眠中断，头痛和睡眠不佳之间可能存在双向关系。治疗选择包括特定的药物治疗方法和非药物替代方法；营养保健品的优点是副作用相对较少。外源性褪黑素已被证明在改善儿童的睡眠-觉醒周期和睡眠质量方面有用且安全，有助于调节昼夜节律，对头痛有继发的积极影响。补充其他营养保健品成分，如色氨酸、镁和 B 族维生素，对原发性头痛儿童，无论是否存在睡眠障碍，都有显著的额外作用。色氨酸可减少夜间觉醒次数并提高睡眠效率。原发性头痛与血清中镁含量低有关，与镁结合似乎可有效减少头痛发作而无不良反应。有不同的观察性报告和非对照研究表明这些营养保健品可能具有协同作用，但现在需要高质量的随机对照试验来证实这些初步的积极发现。
