Sleep quality remains low for cluster headache patients between attacks
Researchers at Karolinska Institutet have found that individuals with cluster headache have symptoms of insomnia and poor sleep quality in an active headache period, and sleep is not restored during headache-free periods. The results were recently published in Headache: the Journal of Head and Face Pain.
Cluster headache is an extremely painful headache condition which often occurs in bouts with periods of daily headache attacks which can proceed to symptom-free remission periods.
The headache attacks often occur at night, and this study investigated to what extent sleep is affected.
“We found a high degree of insomnia symptoms and poor sleep quality in cluster headache patients during an active headache bout, and the symptoms are not completely alleviated during remission period,” says Andrea Carmine Belin, associate professor and research group leader at the Department of Neuroscience, and corresponding author of the article.
Additionally, the duration of the remission period influenced sleep quality. Study participants who had been in a remission period for less than five years reported worse sleep than those with longer remission periods.
How did you conduct the study?
“We sent out a survey to over 700 patients with cluster headache. The survey contained questions on symptoms of insomnia, sleep quality, and beliefs/attitudes towards sleep,” says Felicia Jennysdotter Olofsgård, Postdoctoral researcher at the same department and first author of the article.
“We compared how individuals perceived their sleep when they were in an active headache bout as compared to individuals who were in headache-free remission periods. We additionally investigated if the length of the remission period could influence sleep.”
Clinical interventions
The next step is investigating possible clinical interventions for the reported sleep difficulties. This could possibly involve cognitive behavioural therapy to combat the association between nighttime and headache attacks. Additionally, the researchers want to measure the concentrations of different hormones in cluster headache participants during different sleep phases to study if changes in hormone levels triggers the attacks at night.
The study was mainly funded by Mellby Gård and the Swedish Brain Foundation. Involved researchers have been Caroline Ran and Stefan Spulber at the Centre for Cluster Headache, Department of Neuroscience, Anna Dahlgren and Marie Söderström at the Department of Clinical Neuroscience, Christina Sjöstrand and Maria Lantz at Danderyd Hospital and Elisabet Waldenlind, Anna Sundholm and Anna Steinberg at Karolinska University Hospital.