Reader response: Nightly sleep duration, fragmentation, and quality and daily risk of migraine
Alex B.Berezow, Vice President of Scientific Communications, American Council on Science and Health
Submitted January 17, 2020
As a migraine sufferer on CPAP therapy, I found the study by Dr. Bertisch et al.,1 which shows no temporal link between poor sleep quality and the occurrence of migraine to be flawed. My occurrence of morning migraine—or, at the very least, sleep apnea-induced headaches that are responsive to triptans—has decreased dramatically since I began CPAP therapy.2
My personal experience, however, is merely anecdotal. So, I would suggest the following changes to their methodology to create more robust data: 1. Use polysmnography, rather than sleep diaries and wrist actigraphy, to monitor the quality of subjects' sleep. Many people—myself included—are completely unaware that they suffer from sleep apnea. Therefore, a sleep diary asking about sleep quality is inadequate to investigate a link between sleep quality and migraine. Likewise, wrist actigraphy provides no insight on blood oxygen level or the apnea-hypopnea index (AHI). 2. It would have been far better to randomize subjects to receive CPAP therapy to determine if the occurrence of migraine was reduced, either within or beyond 24 hours. It is possible that migraines are triggered not by a single night of poor sleep but by chronic sleep deprivation.
Disclosure
The authors report no relevant disclosures. Contact journal@neurology.org for full disclosures.
References
Bertisch SM, Li W, Buettner C, et al. Nightly sleep duration, fragmentation, and quality and daily risk of migraine. Neurology 2019 Epub Dec 16.
As a migraine sufferer on CPAP therapy, I found the study by Dr. Bertisch et al.,1 which shows no temporal link between poor sleep quality and the occurrence of migraine to be flawed. My occurrence of morning migraine—or, at the very least, sleep apnea-induced headaches that are responsive to triptans—has decreased dramatically since I began CPAP therapy.2
My personal experience, however, is merely anecdotal. So, I would suggest the following changes to their methodology to create more robust data: 1. Use polysmnography, rather than sleep diaries and wrist actigraphy, to monitor the quality of subjects' sleep. Many people—myself included—are completely unaware that they suffer from sleep apnea. Therefore, a sleep diary asking about sleep quality is inadequate to investigate a link between sleep quality and migraine. Likewise, wrist actigraphy provides no insight on blood oxygen level or the apnea-hypopnea index (AHI). 2. It would have been far better to randomize subjects to receive CPAP therapy to determine if the occurrence of migraine was reduced, either within or beyond 24 hours. It is possible that migraines are triggered not by a single night of poor sleep but by chronic sleep deprivation.
Disclosure
The authors report no relevant disclosures. Contact journal@neurology.org for full disclosures.
References