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. 2023 Mar-Apr;21(2):117-128.
doi: 10.1080/15402002.2022.2050723. Epub 2022 Mar 23.

A Micro-Longitudinal Study of Naps, Sleep Disturbance, and Headache Severity in Women with Chronic Migraine

Jason C Ong  1   2 , Spencer C Dawson  3 , Hannah L Taylor  4 , Margaret Park  5 , Helen J Burgess  6 , Megan R Crawford  7 , Jeanetta C Rains  8 , Todd A Smitherman  9 , Colin A Espie  10 , Alex L Jones  11 , James K Wyatt  12
Affiliations

A Micro-Longitudinal Study of Naps, Sleep Disturbance, and Headache Severity in Women with Chronic Migraine

Jason C Ong et al. Behav Sleep Med. 2023 Mar-Apr.

Abstract

Objective: To examine the relationship between headaches, naps, and nocturnal sleep in women with chronic migraine (CM) using micro-longitudinal data from diaries and actigraphy.

Methods: 20 women with CM and 20 age and sex-matched healthy controls (HC) completed self-report questionnaires, electronic diaries, and wrist actigraphy over a 4-week period. Between-group comparisons were conducted with naps (frequency and duration) as the primary variable of interest. Within-group analyses were conducted on the CM group using hierarchical linear mixed models to examine the temporal relationships between headache severity, sleep behaviors, and sleep parameters. The primary variables of interest were naps (number and duration) and nocturnal sleep efficiency (diary and actigraphy).

Results: The CM group reported significantly more days with naps (25.85%) compared to the HC group (9.03%) during the study period (p = .0025). Within-group analyses in CM revealed that greater headache severity was associated with longer nap duration (p = .0037) and longer nap duration was associated with lower sleep efficiency measured using diaries (p = .0014) and actigraphy (p < .0001).

Conclusions: Napping is more frequent in CM than HC and nap duration in CM is associated with headache severity and nocturnal sleep disturbance. These findings provide initial support for the hypothesis that daytime napping is a behavioral coping strategy used in CM that could contribute to insomnia.

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Conflict of interest statement

Conflict of Interest Disclosures: Jason Ong is employed by Nox Health, Inc and has served as a consultant to Headspace, Inc, Vox Media, LLC, and Weight Watchers International, Inc. These activities are not related to this study. Spencer Dawson serves on the advisory board of Better Sleep. This activity is not related to this study. Todd A. Smitherman serves on an advisory board for Teva. This activity is unrelated to this study. Helen Burgess is a consultant for Natrol, LLC. This activity is not related to this study. Colin Espie is a Co-founder of and a shareholder in Big Health Inc, which developed and maintained the sleep diaries used in this study. All other authors report no conflict.

Figures

Figure 1.
Figure 1.
Hypothesized model and significant observed relationships This figure depicts a proposed temporal pathway based on the findings from this study. In this model, migraine headache severity is associated with nap duration as a sleep behavior, which leads to decreased sleep efficiency (SE) at night, as measured by both self-reported diaries and actigraphy. B = beta weights; * p<.0125
See this image and copyright information in PMC

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