The effect of insomnia correction on the duration and severity of headaches

Abstract

Introduction. Chronic tension headache and insomnia are a common mutually aggravating pathology. Drugs used to treat these nosologies most often worsen the course of the concomitant disease.Objective. To evaluate the effect of insomnia correction on the intensity and frequency of headachesMaterials and methods. The study involved 27 patients (25 women, 2 men) with chronic tension-type headache and sleep disorders. The median age was 43 ± 14.8 years. In accordance with the purpose of the study, the clinical group was divided into 2 subgroups. The first group was treated with venlafaxine and doxylamine, the patients of the second group received only venlafaxine treatment. The assessment was carried out before the start of treatment and 8 weeks after, using visual analogue scales for headache, sleep, health status, assessing the severity of insomnia using the Morin scale and the Pittsburgh Sleep Quality Inventory (PSQI), assessing the emotional state using the Sheehan anxiety and Beck depression scales and polysomnography.Results. In subgroup 1, which received correction of insomnia, there was a significant decrease in the number of days with headache (from 20 to 10, p = 0.002), pain intensity according to VAS (from 7 to 6, p = 0.01) and VAS sleep (from 6 to 4 points, p = 0.003). In the group without correction of insomnia, the number of days with headaches significantly decreased (from 15 to 12, p = 0.01), changes in the severity of headache according to VAS (from 7.5 to 6, p = 0.13) and sleep quality (from 6 to 7.5, p = 0.38) did not have a statistically significant difference. According to the results of polysomnography, patients who received correction of insomnia had an increase in the duration of slow-wave sleep by 12 minutes (p = 0.02), while in patients from the second subgroup by 4 minutes (p = 0.68).Conclusions. The use of a combination of venlafaxine and doxylamine in the first stages of treatment of patients with chronic tension-type headache and insomnia has an advantage over standard therapy. Combination therapy can reduce the intensity and frequency of headaches and improve sleep quality.