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. 2019 Jan;59(1):32-45.
doi: 10.1111/head.13435. Epub 2018 Nov 1.

Sleep Disorders Among People With Migraine: Results From the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study

Dawn C Buse  1 , Jeanetta C Rains  2 , Jelena M Pavlovic  1   3 , Kristina M Fanning  4 , Michael L Reed  4 , Aubrey Manack Adams  5 , Richard B Lipton  1   3
Affiliations

Sleep Disorders Among People With Migraine: Results From the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study

Dawn C Buse et al. Headache. 2019 Jan.

Abstract

Objectives: We examined the cross-sectional association of sleep apnea and indices of sleep quality with both episodic migraine (EM) and chronic migraine (CM).

Background: Sleep apnea and abnormal patterns of sleep, such as insomnia, were associated with migraine onset, severity, and progression in previous research.

Methods: The Chronic Migraine Epidemiology & Outcomes Study, a longitudinal study, used a series of web-based surveys to assess migraine symptoms, burden, and patterns of health care utilization. Quota sampling was used from September 2012 to November 2013 to generate a representative sample of the US population. Persons who screened positive for sleep apnea on the Berlin Questionnaire are said to be at "high risk" for sleep apnea. Respondents indicated if they believed that they had sleep apnea, if a physician had diagnosed it, and if and how they were treated. Other aspects of sleep quality were assessed using the Medical Outcomes Study (MOS) Sleep Measures.

Results: Of 12,810 eligible respondents with migraine and data on sleep, 11,699 with EM (91.3%) and 1111 with CM (8.7%) provided valid data for this analyses. According to the Berlin Questionnaire, 4739/12,810 (37.0%) were at "high risk" for sleep apnea, particularly persons with CM vs EM (575/1111 [51.8%] vs 4164/11,699 [35.6%]), men vs women (1431/3220 [44.4%] vs 3308/9590 [34.5%]), people with higher body mass index, and older people (all P < .001). Among respondents to the MOS Sleep Measures, persons with CM were more likely to report poor sleep quality than those with EM, including sleep disturbance (mean [SD] values: 53.2 [26.9] vs 37.9 [24.3]), snoring (38.0 [33.9] vs 31.0 [32.1]), shortness of breath (34.9 [29.8] vs 15.3 [20.6]), somnolence (44.1 [23.4] vs 32.2 [21.2]), and less likely to report sleep adequacy (34.0 [24.2] vs 39.2 [22.1]).

Conclusions: Compared with respondents with EM, a larger proportion of those with CM were at "high risk" for sleep apnea and reported poor sleep quality. This reflects an association between CM vs EM and sleep apnea and poor sleep quality; the potential relationships are discussed.

Keywords: CaMEO; migraine; sleep apnea; sleep disorders; sleep quality; snoring.

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Conflict of interest statement

Conflict of Interest: Dawn C. Buse has received grant support and honoraria from Allergan, Amgen, Avanir, Dr. Reddy’s Laboratories, Eli Lilly, MAP Pharmaceuticals, Novartis, Teva, and Zogenix. She is on the editorial board of Current Pain and Headache Reports, Journal of Headache and Pain, Pain Medicine News, and PainPathways. Jeanetta C. Rains holds stock in ResMed, Inc. Jelena M. Pavlovic has received honoraria from Alder Biopharmaceuticals, Allergan, Dr. Reddy’s Laboratories, and the American Headache Society. Kristina M. Fanning is an employee of Vedanta Research, which has received support funded by Allergan, Amgen, Dr. Reddy’s Laboratories, Eli Lilly, GlaxoSmithKline, Merck & Co., and Novartis via grants to the National Headache Foundation. Michael L. Reed is Managing Director of Vedanta Research, which has received research funding from Allergan, Amgen, Dr. Reddy’s Laboratories, Eli Lilly, GlaxoSmithKline, Merck & Co., and Novartis via grants to the National Headache Foundation. Vedanta Research has received funding directly from Allergan for work on the CaMEO Study. Aubrey Manack Adams is a full-time employee of Allergan plc and owns stock in the company. Richard B. Lipton serves on the editorial boards of Neurology and Cephalalgia and as senior advisor to Headache. He has received research support from the NIH. He also receives support from the Migraine Research Foundation and the National Headache Foundation. He has reviewed for the NIA and NINDS and serves as consultant or advisory board member or has received honoraria from Alder, Allergan, Amgen, Autonomic Technologies, Avanir, Boston Scientific, Dr. Reddy’s Laboratories, Electrocore, Eli Lilly, eNeura Therapeutics, GlaxoSmithKline, Merck, Novartis, Teva, and Vedanta. He receives royalties from Wolff’s Headache (8th edition, Oxford University Press) and Informa. He holds stock options in eNeura Therapeutics and Biohaven.

Figures

Fig. 1.—
Fig. 1.—
CaMEO respondent disposition. CaMEO = Chronic Migraine Epidemiology and Outcomes; CM = chronic migraine; EM = episodic migraine. *22,365 respondents abandoned the survey, were over quota, or had invalid (unusable) data and were removed during data cleaning. †Met inclusion criteria: agreed to participate, screened positive for modified International Classification of Headache Disorders, 3rd edition, migraine criteria, were ≥18 years old, and had ≥1 headache in the previous 12 months.
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