Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany.
Clinician Scientist Program, Berlin Institute of Health at Charité (BIH), Berlin, Germany.
Eur J Neurol. 2023 Oct;30(10):3322-3331. doi: 10.1111/ene.15991. Epub 2023 Jul 28.
Migraine aura, near-death experiences (NDEs), and rapid eye movement (REM) sleep intrusions might share common mechanisms. Here, we investigated the prevalence of NDEs and REM sleep intrusions in people with migraine. We hypothesized that NDEs and REM sleep intrusions are more prevalent in migraine patients with aura than in those without.
We conducted a prospective cross-sectional cohort study at a tertiary headache center, based on a prespecified sample size (n = 808). Migraine patients completed a series of questionnaires, including questions about demographic and headache characteristics, the 16-item Greyson NDE scale, four questions about REM sleep intrusions, and the Depression, Anxiety, and Stress Scale 21 (DASS-21).
Of 808 migraine patients (mean age 44.4 ± 13.3 years, 87.0% women), 353 (43.7%) had a current or previous history of migraine aura. Prevalence of NDE was 2.7% and not different in patients with and without aura (2.8% vs. 2.6%; p > 0.999). REM sleep intrusions were reported by 5.4% of participants and in a similar proportion of patients with and without aura (6.3% vs. 4.9%; p = 0.43). However, participants with REM sleep intrusions had had an NDE more often than participants without REM sleep intrusions (n = 5/44, 11.4% vs. n = 17/754, 2.2%; p = 0.005). Higher DASS-21 scores were associated with REM sleep intrusions (p < 0.001).
In this tertiary center cohort study, the prevalence of NDE and REM sleep intrusions was not influenced by migraine aura status. However, we identified an association between NDE and REM sleep intrusions, which corroborates the notion that they might share pathophysiological mechanisms.
偏头痛先兆、濒死体验（NDE）和快速眼动（REM）睡眠侵入可能具有共同的机制。在这里，我们研究了偏头痛患者中 NDE 和 REM 睡眠侵入的发生率。我们假设，与无先兆偏头痛患者相比，有先兆偏头痛患者中 NDE 和 REM 睡眠侵入更为常见。
我们在一家三级头痛中心进行了一项前瞻性横断面队列研究，基于预先确定的样本量（n=808）。偏头痛患者完成了一系列问卷，包括人口统计学和头痛特征、16 项 Greyson NDE 量表、4 项 REM 睡眠侵入问题以及抑郁、焦虑和压力量表 21（DASS-21）。
在 808 名偏头痛患者（平均年龄 44.4±13.3 岁，87.0%为女性）中，353 名（43.7%）有当前或既往偏头痛先兆史。NDE 的患病率为 2.7%，在有先兆和无先兆偏头痛患者中无差异（2.8%比 2.6%；p>0.999）。5.4%的参与者报告有 REM 睡眠侵入，有先兆和无先兆偏头痛患者的比例相似（6.3%比 4.9%；p=0.43）。然而，有 REM 睡眠侵入的参与者发生 NDE 的频率高于无 REM 睡眠侵入的参与者（n=5/44，11.4%比 n=17/754，2.2%；p=0.005）。DASS-21 评分较高与 REM 睡眠侵入相关（p<0.001）。
在这项三级中心队列研究中，NDE 和 REM 睡眠侵入的患病率不受偏头痛先兆状态的影响。然而，我们发现 NDE 和 REM 睡眠侵入之间存在关联，这证实了它们可能具有共同的病理生理机制的观点。
