Sleep quality, arousal and pain thresholds in migraineurs. A blinded controlled polysomnographic study 英文参考文献.docVIP

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Sleep quality, arousal and pain thresholds in migraineurs. A blinded controlled polysomnographic study 英文参考文献.doc

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Sleep quality, arousal and pain thresholds in migraineurs. A blinded controlled polysomnographic study 英文参考文献

Engstr?metal.TheJournalofHeadacheandPain2013,14:12 /content/14/1/12 RESEARCH ARTICLE OpenAccess Sleepquality,arousalandpainthresholdsin migraineurs:ablindedcontrolled polysomnographicstudy MortenEngstr?m1,2*,KnutHagen1,3,MarteHeleneBj?rk4,5,LarsJacobStovner1,3,G?rilBruvikGravdahl2,3, MaritStjern1,2andTrondSand1,2 Abstract Background:Ouraimwastocomparesubjectiveandobjectivesleepqualityandarousalinmigraineandto evaluatetherelationshipbetweensleepqualityandpainthresholds(PT)incontrols,interictal,preictalandpostictal migraine. Methods:PolysomnographyandPT(topressure,heatandcold)measurementsweredonein34healthycontrols and50migraineurs.Subjectivesleepqualitywasassessedbysleepdiaries,Epworthsleepinessscale,Karolinska sleepquestionnaireandPittsburghsleepqualityindex.Migraineurswhohadtheirsleepregistrationmorethan48h fromanattackwereclassifiedasinterictalwhilethosewhowerelessthan48hfromanattackwereclassifiedas eitherpreictalorpostictal. Results:Migraineursreportedmoreinsomniaandothersleep-relatedsymptomsthancontrols,buttheobjective sleepdifferencesweresmallerandwefoundnodifferencesindaytimesleepiness.Interictalmigraineurshadmore awakenings(p=0.048),astrongtendencyformoreslow-wavesleep(p=0.050),lowerthermalpainthresholds(TPT) (heatpainthresholdsp=0.043andcoldpainthresholdsp=0.031)thancontrols.Migraineursinthepreictalphase hadshorterlatencytosleeponsetthancontrols(p=0.003).Slow-wavesleepcorrelatednegativelywithpressurePT andslowburstscorrelatednegativelywithTPT. Conclusion:LowerPTininterictalmigraineursseemsrelatedtoincreasedsleeppressure.Wehypothesizethat migraineursontheaveragesufferfromarelativesleepdeprivationandneedmoresleepthanhealthycontrols. Lackofadequaterestmightbeanattack-precipitating-andhyperalgesia-inducingfactor. Keywords:Migrainephase,Sleep,Arousal,Painthresholds Background However,therearefewpolysomnographic(PSG)stud- Migraine and sleep are related, though the pathophysio- ies on migraine patients. For patients with sleep-related logicalsignificanceisunclea