Abstract
Children with migraine headaches appear to have a range of sleep disturbances. The aim of the present study was to assess the NREM sleep instability in a population of school-aged individuals affected by migraine without aura (MoA). Thirty-three children with MoA (20 males, 13 females, mean age 10.45 ± 2.06 years) underwent to overnight Polysomnographic (PSG) recordings and Cyclic Alternating Pattern (CAP) analyses accordingly with international criteria. MoA group showed a reduction in sleep duration parameters (TIB, SPT, TST; p ≤ 0.001 for all) and in arousal index during REM sleep and an increase in awakenings per hour (AWK/h) vs. Controls (C) (p = 0.008). In particular, MoA children showed a reduced CAP rate% (p ≤ 0.001), CAP rate% in S1 (p ≤ 0.001) and CAP rate% in SWS (p = 0.004) vs. C. Moreover, A phases distribution were characterized by a reduction in slow wave components (total number CAP A1%, CAP A1 index) (p ≤ 0.001) and an increase of fast components representation (total number of CAP A2% and CAP A3%) (p < 0.001) in MoA vs. C. Moreover, MoA children showed an increased A1 and A2 mean duration (p ≤ 0.001). Our findings show a reduction of arousability in MoA group and lower NREM lower sleep instability associated with MoA in children.
Highlights
Sleep and headache are widely related from a clinical point of view
The aim of the present study was to assess the NREM sleep instability in a population of school- aged individuals affected by migraine without aura (MoA) vs. C
The Arousal Index during rapid eye movement sleep (REM) sleep was lower in MoA vs. C children (p < 0.001; Table 2)
Summary
Sleep and headache are widely related from a clinical point of view. The biological relationship between sleep and pain processing is not fully understood yet. A unique hypothesis about the mutual inter-relationship between sleep and primary headaches cannot be presented. NREM Sleep Instability in Pediatric Migraine between sleep disorders and primary headaches is clinically relevant since both conditions tend to establish mutual interrelationships that influence each other [2,3,4]. In this context, the clinical observation raises questions regarding the pathogenesis of these disorders, involving pivotal cerebral structures (i.e., thalamus, hypothalamus, and some brainstem nuclei) and specific neurochemical pathways both in pain perception and sleep regulation
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