Migraine is a condition that is often underdiagnosed and untreated. Even when treated, it can be challenging to find strategies to prevent attacks. Recently, a new study has looked at ways to predict when a migraine is likely to occur. The study suggests that using mobile apps to track sleep, energy, emotions and stress can enhance the ability to prevent attacks.
According to the study, poor perceived sleep quality and a lower than usual quality of sleep on the prior night were both associated with an increased risk of having a migraine the next morning. Also, a lower than usual energy level the prior day was linked to a headache the next morning. However, those factors did not lead to an increased risk of migraine in the afternoon or evening. The only predictors of an afternoon or evening headache were increased stress levels or having higher-than-average energy the day before.
“These different patterns of predictors of morning and later-day headaches highlight the role of the circadian rhythms in headache,” said study author Kathleen R. Merikangas, PhD, of the National Institute of Mental Health, part of the National Institutes of Health in Bethesda, Maryland. “The findings may give us insight into the processes underlying migraine and help us improve treatment and prevention.”
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A study was conducted with 477 participants aged between 7 and 84, of which 291 were female. The study was carried out through a mobile app that asked the participants to rate their mood, energy, stress, and headaches four times a day for two weeks. They also rated their sleep quality once a day and wore sleep and physical activity monitors. The study found that almost half of the participants had a history of migraine, and 59% had at least one morning headache attack during the study.
The study revealed that people who reported poorer sleep quality had a 22% higher chance of experiencing a headache attack the next morning. Similarly, a decrease in the self-reported usual quality of sleep was also associated with an 18% increased chance of a headache attack the next morning. Furthermore, a decrease in the usual level of energy on the prior day was associated with a 16% greater chance of a headache the next morning. However, greater average levels of stress and substantially higher energy than usual the day before were associated with a 17% increased chance of a headache on the following afternoon or evening. After adjusting for sleep quality, energy, and stress, neither anxious nor depressed mood were found to be associated with headache attacks.
“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,” 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.”
“Our study demonstrates the importance of monitoring sleep changes as a predictor of headache attacks,” said study author Tarannum M. Lateef, MD, of the Children’s National Health System in Washington, D.C. “The use of apps that track sleep and other health, behavioral and emotional states in real time can provide valuable information that can help us to manage migraine.”
A limitation of the study is that participants were tracked over a short period of time.
The study was supported by the National Institute of Mental Health of the National Institutes of Health under grant numbers 1ZIAMH002804 and 1ZIAMH002954. The content of the study is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
