Migraine is often untreated and underdiagnosed, and even when it is treated, it can be difficult to treat early enough as well as find strategies to prevent attacks. A new study looks at many ways to predict more accurately, when a migraine will happen. Even through the use of mobile apps to track sleep, energy, emotions, and stress-; it enhances the ability to prevent attacks. The study was recently published on the 24th of January, 2024, under the online issue of Neurology, the medical journal of the American Academy of Neurology.
The study found that poor perceived sleep quality as well as a lower-than-usual quality of sleep on the prior night were both related to an increased risk of having a migraine the next morning. A lower-than-usual energy level the previous day was also connected with a headache the next morning. Those issues did not lead to a high risk of migraine in the afternoon or evening. The only predictors of an afternoon or evening headache were high-stress levels or having higher-than-average energy the day before.
Kathleen R. Merikangas, PhD, study author of the National Institute of Mental Health says, that these different patterns of predictors of morning and later-day headaches highlight the role of the circadian rhythms in headache. The results may give us insight into the processes underlying migraine and help us to improve treatment and prevention.
The study involved 477 individuals ages 7 through 84, including 291 female participants. Through a mobile app, for two weeks members were asked to rate their mood, stress, energy, and headaches four times a day. Once a day they also rated their sleep quality and wore sleep and physical activity monitors. Around half of the participants had a history of migraine and 59% had at least one morning headache attack during the study.
Individuals with poorer perceived sleep quality on average had a 22% increased chance of a headache attack the next morning. A decrease in the self-reported usual quality of sleep was also connected with an 18% increased chance of a headache attack the next morning. Similarly, a decrease in the usual level of energy on the prior day was linked with a 16% greater chance of headache the next morning. In contrast, greater average levels of stress and substantially higher energy than usual the day before were associated with a 17% increased chance of headache on the following afternoon or evening. After considering sleep, energy, and stress, neither anxious nor depressed mood were linked with headache attacks.
Unexpectedly, we found no connection between a person’s anxiety and depression symptoms-; either having more symptoms or having higher-than-average levels of symptoms-; and their likelihood of having a migraine attack the next day, says Merikangas. Perhaps most interesting, headaches were connected with self-rated sleep quality rather than actual measures of sleep patterns. This shows the importance of perceived physical and emotional states in the basic causes of migraine.
Our study demonstrates the importance of monitoring sleep changes as a predictor of headache attacks, says study author Tarannum M. Lateef, MD, of the Children’s National Health System in Washington, D.C. The use of apps that track sleep and other health, behavioral, and emotional states in real time can provide very valuable information that can help us to manage migraine.
A limitation of the study is that members were tracked over a short period.
The study was supported by the National Institute of Mental Health of the National Institutes of Health under grant numbers 1ZIAMH002804 and 1ZIAMH002954. The content of the study is only the responsibility of the authors and does not certainly represent the official views of the National Institutes of Health.
