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| This news site is not sanctioned by, nor part of, the Diamond Headache Foundation, The American Academy of Neurology OR The American Headache Society. |
| News covering selected sessions related to migraine from 2008 medical conferences. |
| Annual Meeting of the American Academy of Neurology |
Chicago, IL April 15-18, 2008 |
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Migraines Linked to Sleep Disturbances in
Children |
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BY PATRICE WENDLING
Chicago Bureau |
CHICAGO
— Sleep apnea was observed in more than half of children
with migraine in a study presented at the annual meeting of the
American Academy of Neurology.Evaluation by polysomnography
revealed sleep apnea in 56% of children with migraine compared
with 30% of those with non migraine headache in a study of 90
children aged 5-19 years with headache and sleep complaints.The
association between sleep apnea, also known as sleep-disordered
breathing, and migraine was significant, with an odds ratio of
2.1, Dr. Martina Vendrame, chief resident, Temple University
Hospital, Philadelphia, and colleagues reported.Two-thirds of
the children with migraine also had frequent arousal during
sleep.
Children with chronic migraine, defined as 15 days or more of
migraine per month, took longer to fall asleep, had a shorter
total sleep time, woke more frequently during the night, and had
shorter REM and slow-wave sleep. “Clinicians should ask all
children with headaches and their parents about sleep problems,”
including snoring, awakenings during sleep, and day-time
sleepiness, Dr. Vendrame told reporters during a press briefing
at the meeting. If concerns are raised, patientsshould be
referred to ENT specialists for evaluation and treatment of
sleep apnea.Two-thirdsof children in the study identified with
sleep apnea were evaluated by ENT specialists, and half
underwent tonsillectomy. Of these, 80% had some benefit,
including reduced migraine frequency, she said. Dr. Vendrame
acknowledged that the presence of headache could contribute to
sleep disturbances, as children suffering from headache will
often take daytime naps. In addition, it is widely accepted that
headache and sleep disorders share common pathophysiologic
mechanisms. Previous studies have evaluated the relationship
between headache and sleep disturbances, but this is the first
to use polysomnography in children, she said.The study comprised
60 children with migraine, 11 with chronic daily headaches, 6
with tension headaches, and 13 with nonspecific headaches. Sleep
apnea was also noted among 54% of patients with nonspecific
headache, and was observed more frequently in those with a
higher body mass index. Children with chronic daily headache had
shorter total sleep time, longer sleep latency, shorter REM
sleep, and a higher arousal index. Among the six children with
tension headaches, 50% suffered from teeth grinding, versus 2.4%
of children with non tension headaches (OR 1.95). Children who
are found to grind their teeth should be referred for dental
care, Dr. Vendrame suggested. When asked by reporters if the
study was biased by having a population of children who already
had reported headaches and sleep disturbances, Dr. Vendrame said
she hopes to repeat the study in a general population of
children, in children without headache, and over an extended
period of time to minimize the “first night” effect experienced
when children are away from home.
The study was conducted at St. Christopher Hospital for
Children, Drexel University, Philadelphia; and the authors had
no conflicts of interest to disclose. |
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