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Tiseo C, Vacca A, Felbush A, Filimonova T, Gai A, Glazyrina T, Hubalek IA, Marchenko Y, Overeem LH, Piroso S, Tkachev A, Martelletti P, Sacco S. Migraine and sleep disorders: a systematic review. J Headache Pain 2020; 21:126. [PMID: 33109076 PMCID: PMC7590682 DOI: 10.1186/s10194-020-01192-5] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 10/14/2020] [Indexed: 12/14/2022] Open
Abstract
Migraine and sleep disorders are common and often burdensome chronic conditions with a high prevalence in the general population, and with considerable socio-economic impact and costs.The existence of a relationship between migraine and sleep disorders has been recognized from centuries by clinicians and epidemiological studies. Nevertheless, the exact nature of this association, the underlying mechanisms and interactions are complex and not completely understood. Recent biochemical and functional imaging studies identified central nervous system structures and neurotransmitters involved in the pathophysiology of migraine and also important for the regulation of normal sleep architecture, suggesting a possible causative role, in the pathogenesis of both disorders, of a dysregulation in these common nervous system pathways.This systematic review summarizes the existing data on migraine and sleep disorders with the aim to evaluate the existence of a causal relationship and to assess the presence of influencing factors. The identification of specific sleep disorders associated with migraine should induce clinicians to systematically assess their presence in migraine patients and to adopt combined treatment strategies.
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Affiliation(s)
- Cindy Tiseo
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy
- Regional Referral Headache Centre, S.S. Filippo e Nicola Hospital, Avezzano, L'Aquila, Italy
| | - Alessandro Vacca
- Headache Center, Department of Neuroscience "Rita Levi Montalcini", University of Torino, Torino, Italy
| | - Anton Felbush
- Pain Treatment Center, OOO "Vertebra", Samara City, Russia
| | - Tamara Filimonova
- Federal State Budget Educational Institution of Higher Education "Academician Ye. A. Vagner Perm State Medical University" of the Ministry of Healthcare of the Russian Federation, Perm, Russia
| | - Annalisa Gai
- Headache Center, Department of Neuroscience "Rita Levi Montalcini", University of Torino, Torino, Italy
| | | | - Irina Anna Hubalek
- Department of Neurology, Headache Center, Charité University Medicine Berlin, Berlin, Germany
| | - Yelena Marchenko
- V. A. Almazov National Medical Research Centre, Saint-Petersburg, Russia
| | - Lucas Hendrik Overeem
- Charité - Universitätsmedizin Berlin Charité Centrum Neurologie, Neurochirurgie und Psychiatrie CC, Berlin, Germany
| | - Serena Piroso
- Department of Human Neurosciences, Sapienza University of Rome, Roma, Italy
| | - Alexander Tkachev
- Department of Neurology, Neurosurgery, medical genetics, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Roma, Italy
- Regional Referral Headache Centre, Sant'Andrea Hospital, Rome, Italy
| | - Simona Sacco
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy.
- Regional Referral Headache Centre, S.S. Filippo e Nicola Hospital, Avezzano, L'Aquila, Italy.
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Wang J, Gao Y, Liu L, Xu W, Zhang P, Liu Y, Qian X, Yu S. The association between migraine and restless legs syndrome: an updated systematic review and meta-analysis. Sleep Med 2019; 57:21-29. [PMID: 30897452 DOI: 10.1016/j.sleep.2019.01.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 11/26/2018] [Accepted: 01/03/2019] [Indexed: 01/03/2023]
Abstract
OBJECTIVE This study aims to gain further insight into the association between migraine and restless legs syndrome (RLS). METHODS A literature search of PubMed, Embase, and Web of Science was performed for studies investigating the association between any migraine and RLS; a meta-analysis of eligible studies was conducted to determine a pooled effect estimate for the association. RESULTS Fifteen studies were included in this meta-analysis. The studies differed in methodology, but all investigated the association between migraine and RLS. Pooled RLS prevalence was 17.0% [95% confidence interval (CI) 15.0%-20.0%] among migraineurs, and 7.0% (95% CI 5.0%-8.0%) among no migraine individuals. Pooled analyses showed that migraine was associated with RLS, but effect estimates were substantially higher in case-control studies [pooled odds ratio (OR) = 3.77, 95% CI 2.73-5.21; I2 = 50.1%] than in cross-sectional studies (pooled OR = 1.25, 95% CI 1.11-1.41; I2 = 34.2%). Subgroup analyses were not conducted to find potential factors that affect this association because of too few available studies. CONCLUSIONS This updated meta-analysis confirms the association between migraine and RLS. Future studies should specifically investigate the potential effects of gender, age, aura status, and type (episodic or chronic) of migraine on the association between the two disorders.
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Affiliation(s)
- Jing Wang
- School of Medicine, Nankai University, Tianjin, 300071, China; Department of Neurology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Yinghui Gao
- Peking University People's Hospital, Beijing, 100044, China; Peking University Hepatology Institute, Beijing, 100044, China; Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing, 100044, China
| | - Lin Liu
- Department of Respiratory Disease, Nanlou Division, Chinese PLA General Hospital, Beijing, 100853, China
| | - Weihao Xu
- Department of Geriatric Cardiology, Nanlou Division, Chinese PLA General Hospital, Beijing, 100853, China
| | - Peicheng Zhang
- Department of Retired Cadre, No. 51 Division, Beijing Military Command, Beijing, China
| | - Yu Liu
- Department of Retired Cadre, No. 51 Division, Beijing Military Command, Beijing, China
| | - Xiaoshun Qian
- Department of Respiratory Disease, Nanlou Division, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Shengyuan Yu
- School of Medicine, Nankai University, Tianjin, 300071, China; Department of Neurology, Chinese PLA General Hospital, Beijing, 100853, China.
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Amiri S, Behnezhad S, Azad E. Migraine headache and depression in adults: a systematic Review and Meta-analysis. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT ÖSTERREICHISCHER NERVENÄRZTE UND PSYCHIATER 2019; 33:131-140. [PMID: 30666527 DOI: 10.1007/s40211-018-0299-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 12/17/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Migraines have adverse psychological consequences, one of which is the tendency towards depression. This study aimed to investigate the effects of migraine on adults' depression in the form of a systematic review and meta-analysis METHODS: Several scientific databases were searched using relevant keywords until the end of January 2018. After reviewing the titles and abstracts and the full texts, the researchers eventually included 16 eligible articles. Major and sub-group analyses were carried out using random effects. Publication bias was also measured. RESULTS Pooled Odd Ratio (PR) = 1.95; and 95% confidence interval (CI) = CI = 1.61-2.35 were obtained in studying the effects of migraine on depression. This effect was equal to OR = 1.81 (95% CI = 1.20-2.72) in cohort studies, and OR = 2.00; 95% CI = 1.64-2.43 in cross sectional studies. The heterogeneity was high, and no publication bias was found. CONCLUSIONS Migraine can play an important role in increasing the incidence of depression in affected patients. Therefore, identifying and ultimately treating the disease can be beneficial in reducing the negative psychological effects of this disease.
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Affiliation(s)
| | | | - Esfandiar Azad
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Yang X, Liu B, Yang B, Li S, Wang F, Li K, Hu F, Ren H, Xu Z. Prevalence of restless legs syndrome in individuals with migraine: a systematic review and meta-analysis of observational studies. Neurol Sci 2018; 39:1927-1934. [PMID: 30116981 DOI: 10.1007/s10072-018-3527-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 08/05/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Recent studies have shown an association between migraine and restless legs syndrome (RLS), but RLS prevalence among individuals with migraine differs substantially across studies. The present work aimed to comprehensively assess available evidence to estimate RLS prevalence among individuals with migraine and non-migraine controls. METHOD Web of Science, PubMed, Embase, Chinese National Knowledge Infrastructure, Wanfang, and SinoMed databases were searched for observational and case-control studies of RLS prevalence among individuals with migraine. Eligible studies were meta-analyzed using Stata 12.0 software. RESULTS Pooled RLS prevalence in migraine was 19%, and the prevalence was lower in Asia (16%) than outside Asia (21%). Pooled RLS prevalence was 18.8% among individuals with migraine with aura, and 18.5% among individuals with migraine without aura; the RLS prevalence in migraine with aura (MA) was higher than that of migraine without aura (MO) (OR 1.17, 95%CI 1.01-1.34; p = 0.037). Pooled RLS prevalence in a case-control study was significantly higher among individuals with migraine (17.9%) than among non-migraine controls (7.1%) (OR 2.65, 95%CI 2.26-3.10; p < 0.001). CONCLUSION Our meta-analysis provides the first reliable pooled estimate of RLS prevalence among individuals with migraine, and it provides strong evidence that RLS risk is higher among individuals with migraine than among controls.
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Affiliation(s)
- Xinglong Yang
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, People's Republic of China
| | - Bin Liu
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, People's Republic of China
| | - Baiyuan Yang
- Department of Neurology, The Seventh People's Hospital of Chengdu, Chengdu, 650041, Sichuan, People's Republic of China
| | - Shimei Li
- Department of Anesthesia, Kunming Xishan District People's Hospital, Kunming, 650100, Yunnan, People's Republic of China
| | - Fang Wang
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, People's Republic of China
| | - Kelu Li
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, People's Republic of China
| | - Fayun Hu
- Department of Neurology, West China Hospital, SCU, Chengdu, 650041, Sichuan, People's Republic of China
| | - Hui Ren
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, People's Republic of China.
| | - Zhong Xu
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, People's Republic of China.
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Lin GY, Lin YK, Lee JT, Lee MS, Lin CC, Tsai CK, Ting CH, Yang FC. Prevalence of restless legs syndrome in migraine patients with and without aura: a cross-sectional, case-controlled study. J Headache Pain 2016; 17:97. [PMID: 27770406 PMCID: PMC5074935 DOI: 10.1186/s10194-016-0691-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 10/15/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Although the comorbidity of migraine and restless legs syndrome (RLS) has been well-documented, the association between RLS and migraine frequency has yet to be elucidated. The present study aims to evaluate the prevalence of RLS among individuals who experience low-frequency, high-frequency, or chronic migraine presenting with and without aura. METHODS We conducted a cross-sectional, case-controlled study involving 505 participants receiving outpatient headache treatment. Standardized questionnaires were administered to collect information on experiences of migraine, RLS, sleep quality, anxiety, depression, and demographics. Participants were categorized into low-frequency (1-8/month), high-frequency (9-14/month), and chronic (≥15/month) headache groups. RLS was diagnosed according to the criteria outlined by the International RLS Study Group (IRLSSG). The Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS) were used to assess sleep quality and identify symptoms of anxiety and depression. Associations between migraine frequency and RLS prevalence were investigated using multivariate linear and logistic regression. RESULTS Univariate analysis revealed an effect of migraine frequency on RLS prevalence (p = 0.026), though this effect did not persist following adjustment for baseline characteristics (p = 0.256). The trend was robust in patients whose migraines presented with auras (p univariate = 0.002; p multivariate = 0.043) but not in those without auras (p univariate and p multivariate > 0.05). Higher anxiety [odds ratio (OR) = 1.18, p = 0.019] and sleep disturbance (OR = 1.17, p = 0.023) scores were associated with higher RLS prevalence. CONCLUSIONS Higher migraine frequency correlates with a higher prevalence of RLS, particularly among patients with auras.
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Affiliation(s)
- Guan-Yu Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Kai Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Jiunn-Tay Lee
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Meei-Shyuan Lee
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Chun-Chieh Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Kuang Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsin Ting
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department of Internal Medicine, Taichung Armed Forces General Hospital, Taichung, Taiwan
| | - Fu-Chi Yang
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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Gür-Özmen S, Karahan-Özcan R. Iron Deficiency Anemia Is Associated with Menstrual Migraine: A Case–Control Study. PAIN MEDICINE 2015; 17:596-605. [DOI: 10.1093/pm/pnv029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Goulart LI, Delgado Rodrigues RN, Prieto Peres MF. Restless Legs Syndrome and Pain Disorders: What’s in common? Curr Pain Headache Rep 2014; 18:461. [DOI: 10.1007/s11916-014-0461-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Schürks M, Winter A, Berger K, Kurth T. Migraine and restless legs syndrome: a systematic review. Cephalalgia 2014; 34:777-94. [PMID: 25142142 DOI: 10.1177/0333102414537725] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Restless legs syndrome (RLS) is increasingly being reported as a comorbidity of migraine. METHODS We conducted a systematic review and meta-analysis of studies investigating RLS in headache/migraine and vice versa. We calculated the prevalence and 95% confidence intervals (CI) of RLS in headache/migraine, of headache/migraine in RLS and controls, and odds ratios (ORs) of the association between the conditions. We then determined pooled effect estimates for the associations. RESULTS We identified 24 studies. RLS prevalence in migraine ranged from 8.7% to 39.0% with no apparent differences based on gender and aura status. Prevalence among controls was compatible with the literature. Migraine prevalence in RLS ranged from 15.1% to 62.6%. We did not pool prevalence data because of high unexplained heterogeneity. High heterogeneity with respect to the association between any migraine and RLS could be explained by study design. Pooled analyses showed substantially higher effect estimates in case-control studies (pooled OR = 4.19, 95% CI 3.07-5.71; I (2) = 0.0%) than in cohort studies (pooled OR = 1.22, 95% CI 1.14-1.30; I (2) = 0.0%). CONCLUSION Our results support the concept of RLS as an important comorbidity of migraine. However, the degree of association appears to be strongly determined by study design. Potential effects by gender and aura status and the role of RLS in other headache disorders remain unclear.
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Affiliation(s)
- Markus Schürks
- Department of Neurology, University Hospital Essen, Germany
| | - Anke Winter
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Germany
| | - Tobias Kurth
- Division of Preventive Medicine, Department of Medicine; Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA College of Health Sciences, University of Bordeaux, France Inserm Research Center for Epidemiology and Biostatistics - Team Neuroepidemiology, Bordeaux, France
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