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Different Factors Could Predict Morning and Later-Day Migraines
Poor perceived sleep and decreased energy the day before were each associated with increased risk of having a migraine in the morning, while increased stress and energy the previous day were linked with migraine in the afternoon or evening. Researchers published the study results in Neurology.
“These different patterns of predictors of morning and later-day headaches highlight the role of the circadian rhythms in headache,” said study corresponding author Kathleen R. Merikangas, PhD, of the National Institute of Mental Health, part of the National Institutes of Health, Bethesda, Maryland. “The findings may give us insight into the processes underlying migraine and help us improve treatment and prevention.”
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The study included 477 people, aged 7 through 84 years, who used a mobile app to rate their mood, energy, stress, and headaches 4 times a day, and sleep quality once a day, over 2 weeks. Participants also wore sleep and physical activity monitors. Researchers were interested in predictors of incident morning and afternoon or evening headaches.
Among participants, 61% were female, nearly half had a history of migraine, and 59% experienced at least one morning headache attack during the study.
People with lower perceived sleep quality on average had a 22% higher risk of a headache attack the next morning, according to the study. A decrease in self-reported usual sleep quality the night before was associated with an 18% increased risk of a headache attack the next morning. Similarly, a lower-than-usual energy level was linked with a 16% increased risk of headache the next morning.
On the other hand, increased stress levels and having higher-than-usual energy levels were associated with a 17% increase in headache risk the following afternoon or evening, the study found.
Mood and anxiety disorders were not significantly associated with incident headache after controlling for other factors.
“Surprisingly, we found no link 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,” Dr Merikangas said. “Perhaps most interesting, headaches were associated with self-rated sleep quality rather than actual measures of sleep patterns. This highlights the importance of perceived physical and emotional states in the underlying causes of migraine.”
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