Jason C Ong1,2, Spencer C Dawson3, Hannah L Taylor4, Margaret Park5, Helen J Burgess6, Megan R Crawford7, Jeanetta C Rains8, Todd A Smitherman9, Colin A Espie10, Alex L Jones11, James K Wyatt12. 1. Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 2. Nox Health, Inc, Suwanee, GA, USA. 3. Department of Psychological and Brain Sciences, Indiana University Bloomington, IN USA. 4. The Maine Sleep Center at Chest Medicine Associates, South Portland, ME, USA. 5. Chicago Sleep Health, Advocate/Illinois Masonic Hospital, Chicago, IL, USA. 6. Sleep and Circadian Research Laboratory, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA. 7. School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK. 8. Center for Sleep Evaluation, Elliot Hospital, Manchester, NH, USA. 9. Department of Psychology, University of Mississippi, Oxford, MS, USA. 10. Nuffield Department of Clinical Neurosciences, University of Oxford, Sleep & Circadian Neuroscience Institute, UK. 11. School of Psychology, Swansea University, Swansea, UK. 12. Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.
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.
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.
Authors: Donald B Penzien; Frank Andrasik; Brian M Freidenberg; Timothy T Houle; Alvin E Lake; Gay L Lipchik; Kenneth A Holroyd; Richard B Lipton; Douglas C McCrory; Justin M Nash; Robert A Nicholson; Scott W Powers; Jeanetta C Rains; David A Wittrock Journal: Headache Date: 2005-05 Impact factor: 5.887