Suzuki Keisuke, Suzuki Shiho, Haruyama Yasuo, Funakoshi Kei, Fujita Hiroaki, Sakuramoto Hirotaka, Hamaguchi Mai, Kobashi Gen, Hirata Koichi
Department of Neurology, Dokkyo Medical University, Mibu, Japan.
Integrated Research Faculty for Advanced Medical Sciences, Dokkyo Medical University, Mibu, Japan.
Front Neurol. 2024 Feb 26;15:1373574. doi: 10.3389/fneur.2024.1373574. eCollection 2024.
Sleep disturbances are common in migraine patients and affect quality of life. Central sensitization (CS) is likely to play a role in the increased severity and chronicity of migraine. We hypothesized that the number of comorbid sleep problems would affect headache-related disability through the effects of central sensitization (CS).
We performed a cross-sectional study including 215 consecutive patients with migraine. Insomnia was defined as a Pittsburgh Sleep Quality Index (PSQI) global score greater than 5. Probable REM sleep behavior disorder (pRBD) was defined as an RBD screening score of 5 or greater. Excessive daytime sleepiness (EDS) was defined as an Epworth Sleepiness Scale score of 10 or higher. Suspected sleep apnea (SA) was defined as patients with snoring or sleep apnea witnessed 3 or more nights a week. CS was assessed by the Central Sensitization Inventory (CSI).
Restless legs syndrome, insomnia, EDS, SA and pRBD were observed in 25.6%, 71.6%, 34.4%, 10.2%, and 21.4%, respectively, of the patients. At least one sleep problem was present in 87.0% of the patients. According to the results of the multinomial logistic regression analysis with no sleep problems as a reference, after we corrected for adjustment factors, the Migraine Disability Assessment (MIDAS) score significantly increased when three or more comorbid sleep problems were present. According to our mediation analysis, an increased number of sleep problems had a direct effect on the MIDAS score after we adjusted for other variables, and the CSI score was indirectly involved in this association.
The present study showed an association between migraine-related disability and the burden of multiple sleep problems, which was partially mediated by CS.
睡眠障碍在偏头痛患者中很常见，且会影响生活质量。中枢敏化（CS）可能在偏头痛严重程度增加和慢性化过程中起作用。我们假设合并睡眠问题的数量会通过中枢敏化（CS）的作用影响与头痛相关的残疾。
我们进行了一项横断面研究，纳入了215例连续的偏头痛患者。失眠定义为匹兹堡睡眠质量指数（PSQI）总分大于5分。疑似快速眼动睡眠行为障碍（pRBD）定义为RBD筛查得分5分或更高。日间过度嗜睡（EDS）定义为爱泼华嗜睡量表得分10分或更高。疑似睡眠呼吸暂停（SA）定义为每周有3个或更多夜晚出现打鼾或睡眠呼吸暂停的患者。通过中枢敏化量表（CSI）评估中枢敏化。
分别有25.6%、71.6%、34.4%、10.2%和21.4%的患者出现不宁腿综合征、失眠、EDS、SA和pRBD。87.0%的患者存在至少一种睡眠问题。以无睡眠问题为参照进行多项逻辑回归分析，校正调整因素后，当存在三种或更多合并睡眠问题时，偏头痛残疾评估（MIDAS）得分显著升高。根据我们的中介分析，在调整其他变量后，睡眠问题数量增加对MIDAS得分有直接影响，且CSI得分间接参与了这种关联。
本研究表明偏头痛相关残疾与多种睡眠问题负担之间存在关联，且这种关联部分由CS介导。
