For Women With Chronic Migraine, Worse Anxiety and Sleep

Anxiety, poor sleep, and pain catastrophizing are more common in women with migraine than in healthy women, according to a study published in The Journal of Headache and Pain.

“Even in individuals without psychiatric comorbidities, specific behavioral and psychological factors are associated with migraine, especially in its chronic form,” wrote a research team from the University of L’Aquila in Italy. “Proper identification of those factors is important to improve management of migraine through nonpharmacological strategies.”

The cross-sectional study investigated the relationship between psychological factors and migraine in women without a history of psychiatric comorbidities. Researchers evaluated sleep, anxiety, depression, intolerance of uncertainty, decision making style, and pain catastrophizing using self-report questionnaires and scales in 65 women with episodic migraine, 65 women with chronic migraine, and 65 healthy women without migraine or other primary headaches.

>>Podcast: Implementing Neuromodulation Devices Into Migraine Treatment Plan With Dr Stewart Tepper

In the area of sleep, overall sleep quality, sleep disturbance severity, sleep medication use, daytime dysfunction, and insomnia symptom severity were worse in women with chronic migraine than in healthy controls. Women with episodic migraine fared better in sleep quality, sleep disturbances, and sleep medication use than women with chronic migraine, according to the study, but had more daytime dysfunction and insomnia symptoms than healthy controls.

Regarding anxiety and mood, women with chronic migraine had greater trait anxiety and general anxiety sensitivity compared with healthy controls. They were specifically more fearful of somatic and cognitive anxiety symptoms, researchers reported, but showed no difference in depression severity.

The study also found that pain catastrophizing, feelings of helplessness, and ruminative thinking were greater in women with chronic migraine compared with episodic migraine or without migraine. However, decision-making styles, intolerance of uncertainty, and strategies for coping with uncertainty were similar among the three groups of women.

“While each of these three conditions are associated to both episodic migraine and chronic migraine, the association with chronic migraine is undoubtedly more evident. In fact, scores of episodic migraine participants were in between those recognized in the healthy condition and in chronic migraine, thus suggesting a gradient distribution across the explored groups,” researchers wrote.

Reference

Pistoia F, Salfi F, Saporito G, et al S. Behavioral and psychological factors in individuals with migraine without psychiatric comorbidities. J Headache Pain. 2022;23(1):110. doi: 10.1186/s10194-022-01485-x.