sleep quality, arousal and pain thresholds in migraineurs. a blinded controlled polysomnographic study在偏头痛患者睡眠质量,唤醒和疼痛阈值。.pdfVIP

Engstrøm et al. The Journal of Headache and Pain 2013, 14:12 /content/14/1/12 RESEARCH ARTICLE Open Access Sleep quality, arousal and pain thresholds in migraineurs: a blinded controlled polysomnographic study Morten Engstrøm1,2*, Knut Hagen1,3, Marte Helene Bjørk4,5, Lars Jacob Stovner1,3, Gøril Bruvik Gravdahl2,3, Marit Stjern1,2 and Trond Sand1,2 Abstract Background: Our aim was to compare subjective and objective sleep quality and arousal in migraine and to evaluate the relationship between sleep quality and pain thresholds (PT) in controls, interictal, preictal and postictal migraine. Methods: Polysomnography and PT (to pressure, heat and cold) measurements were done in 34 healthy controls and 50 migraineurs. Subjective sleep quality was assessed by sleep diaries, Epworth sleepiness scale, Karolinska sleep questionnaire and Pittsburgh sleep quality index. Migraineurs who had their sleep registration more than 48 h from an attack were classified as interictal while those who were less than 48 h from an attack were classified as either preictal or postictal. Results: Migraineurs reported more insomnia and other sleep-related symptoms than controls, but the objective sleep differences were smaller and we found no differences in daytime sleepiness. Interictal migraineurs had more awakenings (p=0.048), a strong tendency for more slow-wave sleep (p=0.050), lower thermal pain thresholds (TPT) (heat pain thresholds p=0.043 and cold pain thresholds p=0.031) than controls. Migraineurs in the preictal phase had shorter latency to sleep onset than controls (p=0.003). Slow-wave sleep correlated negatively with pressure PT and slow bursts correlated negatively with TPT. Conclusion: Lower PT in interictal migraineurs seems related to increased sleep pressure. We hypothesize that migraineurs on the average suffer fro