Abstract
ABSTRACTWe aimed to evaluate gender differences in the relationships between headache features, sleep quality, anxiety, depressive symptoms, and burden of headache in 193 patients (73 percent women) with chronic tension type headache (CTTH). Sleep quality was assessed with the Pittsburgh Sleep Quality Index. Headache features were collected with a four-week diary. The Hospital Anxiety and Depression Scale was used to assess anxiety/depressive symptoms. Headache Disability Inventory was used to evaluate the burden of headache. In men with CTTH, sleep quality was positive correlated with headache frequency (r = 0.310; p = .018), emotional (r = 0.518; p < .001) and physical (r = 0.468; p < .001) burden of headache, and depressive symptoms (r = 0.564; p < .001). In women, positive correlations were observed between sleep quality and headache intensity (r = 0.282; p < .001), headache frequency (r = 0.195; p = .021), emotional burden (r = 0.249; p = .004), and depressive symptoms (r = 0.382; p < .001). The results of stepwise regression analyses revealed that depressive symptoms and emotional burden of headache explained 37.2 percent of the variance in sleep quality in men (p < .001), whereas depressive symptoms and headache intensity explained 17.4 percent of the variance in sleep quality in women (p < .001) with CTTH. Gender differences associated with poor sleep should be considered for proper management of individuals with CTTH.
Highlights
CTension type headache (TTH) is a frequently occurring headache disorder, Acshowing a global prevalence of 42% (Ferrante et al 2013), and has important socioeconomic impact (Dowson 2015)
The current study found that depressive symptoms and emotional burden of headache in men and depressive symptoms and the intensity of headache in women ipt were significantly associated with sleep quality in individuals with chronic tension type headache (CTTH)
Current r findings would suggest that depressive symptoms are a frequent factor associated with c poor sleep quality in both men and women with CTTH, but some gender differences s were observed for other associated factors
Summary
CTension type headache (TTH) is a frequently occurring headache disorder, Acshowing a global prevalence of 42% (Ferrante et al 2013), and has important socioeconomic impact (Dowson 2015). Primary headache disorders, including TTH, have notable gender differences in their prevalence (Jarsen, and Stovner 2008). TTH has a female: male prevalence ratio about 3:1 (Manzoni and Stovner 2010). Ip headache diagnoses (migraine and TTH) and female gender have been significantly cr associated with depression in 74.7% of cases A better p understanding of gender differences in the relationships between headache clinical e features, sleep quality, mood disorders (i.e., anxiety and depressive symptoms) and c headache burden in individuals with TTH can assist clinicians in determining better Actherapeutic programs adapted to gender. The purpose of the current study was to evaluate gender differences in the relationship between headache clinical features, sleep quality, anxiety, depressive symptoms and burden of headache in men and women with TTH. Because mood disorders and sleep disturbances are generally more associated with headache frequency, we included individuals with chronic tension type headache (CTTH)
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