背景:偏头痛患者在偏头痛发作之间和发作期间的睡眠质量通常较差。此外,广泛的研究已经确定畏光是偏头痛患者最常见和最麻烦的症状,仅次于头痛。寻求黑暗的安慰是在发作期间管理疼痛并防止发作之间复发的常见策略。鉴于每日光照对昼夜节律活动节奏和睡眠质量的影响,本研究旨在探讨偏头痛患者群畏光症状与睡眠质量的关系。
方法:使用从美国偏头痛研究注册中心(ARMR)提取的现有数据进行横断面观察性研究。完成基线问卷(光敏性评估问卷(PAQ),广义焦虑症-7(GAD-7),患者健康问卷-2(PHQ-2)),并纳入了ARMR睡眠问卷的选定问题。创建模型来描述畏光和嗜光与各种睡眠方面的关系,包括睡眠质量(SQ),睡眠障碍(SDis),睡眠发作潜伏期(SOL),睡眠相关障碍(SRI),和失眠。每个模型都是根据年龄控制的,性别,头痛频率,焦虑,和抑郁症。
结果:共852例符合纳入标准的患者纳入分析(平均年龄(SD)=49.8(13.9),86.6%(n=738)女性)。与没有畏光的患者相比,有畏光的患者的睡眠质量明显较差(p<0.001)。畏光评分与SQ相关(p<0.001),SDis(p<0.001),SOL(p=0.011),SRI(p=0.020),控制年龄后失眠(p=0.005),性别,头痛频率,抑郁症,和焦虑,这表明较高的畏光水平与较差的睡眠相关结局相关。相反,血友病评分与SQ更好的睡眠相关结局相关(p<0.007),SOL(p=0.010),失眠(p=0.014)。
结论:结果表明畏光是偏头痛患者睡眠质量差和睡眠障碍的重要预测因子。这些结果强调了对畏光和睡眠之间复杂的相互作用进行全面和系统研究的必要性,以增强我们的理解并为偏头痛患者制定量身定制的解决方案。
BACKGROUND: Patients with migraine often have poor sleep quality between and during migraine attacks. Furthermore, extensive research has identified
photophobia as the most common and most bothersome symptom in individuals with migraine, second only to headache. Seeking the comfort of darkness is a common strategy for managing pain during an attack and preventing its recurrence between episodes. Given the well-established effects of daily light exposure on circadian activity rhythms and sleep quality, this study aimed to investigate the relationship between photophobia symptoms and sleep quality in a cohort of patients with migraine.
METHODS: A cross-sectional observational study was conducted using existing data extracted from the American Registry for Migraine Research (ARMR). Participants with a migraine diagnosis who had completed the baseline questionnaires (Photosensitivity Assessment Questionnaire (PAQ), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-2 (PHQ-2)), and selected questions of the ARMR Sleep questionnaire were included. Models were created to describe the relationship of
photophobia and photophilia with various sleep facets, including sleep quality (SQ), sleep disturbance (SDis), sleep onset latency (SOL), sleep-related impairments (SRI), and insomnia. Each model was controlled for age, sex, headache frequency, anxiety, and depression.
RESULTS: A total of 852 patients meeting the inclusion criteria were included in the analysis (mean age (SD) = 49.8 (13.9), 86.6% (n = 738) female). Those with
photophobia exhibited significantly poorer sleep quality compared to patients without
photophobia (p < 0.001).
Photophobia scores were associated with SQ (p < 0.001), SDis (p < 0.001), SOL (p = 0.011), SRI (p = 0.020), and insomnia (p = 0.005) after controlling for age, sex, headache frequency, depression, and anxiety, signifying that higher levels of photophobia were associated with worse sleep-related outcomes. Conversely, photophilia scores were associated with better sleep-related outcomes for SQ (p < 0.007), SOL (p = 0.010), and insomnia (p = 0.014).
CONCLUSIONS: Results suggest that
photophobia is a significant predictor of poor sleep quality and sleep disturbances in migraine. These results underscore the necessity for comprehensive and systematic investigations into the intricate interplay between photophobia and sleep to enhance our understanding and develop tailored solutions for individuals with migraine.