Sleep Disturbance in Children With Migraine

Abstract

The objectives of this study were to determine if (1) children with migraine experience greater sleep disturbances than their siblings, (2) those with more severe migraine have greater levels of sleep disruption, and (3) these sleep disturbances lead to greater behavioral problems and more missed school. Children aged 6 to 18 years with a diagnosis of migraine for > 6 months, who had at least one sibling without migraine in the same age range, were identified through our neurology clinic database or at the time of the clinic visit. Parents completed the (1) demographic, general health, and migraine information questionnaire; (2) Child Sleep Habits Questionnaire; and (3) Behavior Assessment System for Children: Second Edition (BASC-2) Parent Rating Scales for each child. Cases with migraine had higher total sleep (P < .02), sleep delay (P < .03), and daytime sleepiness scores (P < .001) than controls. Cases with more severe migraines had higher total sleep (P < .01) and sleep duration scores (P < .03) than those with milder headaches. In cases, higher total sleep scores predicted greater behavior problems on all four composite scales on the Behavior Assessment System for Children: Second Edition (Externalizing Problems, P < .05; Internalizing Problems, P < .005; Behavior Systems Index, P < .003; and Adaptability Skills, P < .006). We conclude that children with migraine are prone to greater sleep and behavioral disturbances than children without headache. Sleep disorders should be routinely queried and appropriate advice on sleep hygiene provided. (J Child Neurol 2006;21:761—766; DOI 10.2310/7010.2006.00191).

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References

Miller VA , Palermo TM , Powers SW , et al: Migraine headaches and sleep disturbances in children. Headache 2003;43:362—368.

Bruni O. , Fabrizi P. , Ottaviano S. , et al: Prevalence of sleep disorders in children and adolescents with headache: A case-control study. Cephalalgia 1997;17:492—498.

Giroud M. , Nivelon JL , Dumas R. : Somnambulism and migraine in children. A non-fortuitous associaton. Arch Fr Pediatr 1987;44: 263—265.

Barabas G. , Ferrari M. , Matthews WS : Childhood migraine and somnambulism. Neurology 1983;33:948—949.

Smedje H. , Broman JE , Hetta J. : Associations between disturbed sleep and behavioral difficulties in 635 children aged six to eight years: A study based on parents' perspectives. Eur Child Adolesc Psychiatry 2001;10:1—9.

Smedje H. , Broman JE , Hetta J. : Short-term prospective study of sleep disturbances in 5-8 year old children . Acta Paediatr 2001; 90:1456—1463.

Pearl PL , Efron L. , Stein MA : Children, sleep and behavior: A complex association. Minerva Pediatr 2002;54:79—91.

Anttila P. , Sourander A. , Metsahonkala L. , et al: Psychiatric symptoms in children with primary headache. J Am Acad Child Adolesc Psychiatry 2004;43:412—419.

Gartstein MA , Noll RB , Vannatta K. : Childhood aggression and chronic illness: Possible protective mechanisms. J Appl Dev Psychol 2000;21:315—333.

10.

Varni JW , Rapoff MA , Waldron SA , et al: Chronic pain and emotional distress in children and adolescents . Dev Behav Pediatr 1996;17:154—161.

11.

Winner PK , Wasiewski W. , Gladstein J. , Linder S. : Multicenter prospective evaluation of proposed pediatric migraine revisions to the IHS criteria. Headache 1997;37:545—548.

12.

Owens J. , Spirito A. , McGuinn M. : The Children's Sleep Habits Questionnaire (CSHQ): Psychometric properties of a survey instrument for school-aged children. Sleep 2000;23:1043— 1051.

13.

Reynolds CR , Kamphus RW : Behavior Assessment System for Children: Second Edition. Circle Pines (MN), AGS Publishing, 2004 .

14.

Jennum P. , Jensen R. : Sleep and headache. Sleep Med Rev 2002;6: 471—479.

15.

Smith R. : Impact of migraine on the family. Headache 1998;38: 423—426.

16.

O'Brien LJ , Gozal D. : Sleep in children with attention deficit/ hyperactive disorder. Minerva Pediatr 2004;56:585—601.

17.

Cortesi F. , Giannotti F. , Ottaviano S. : Sleep problems and daytime behavior in childhood idiopathic epilepsy. Epilepsia 1999;40: 1557—1565.

18.

Becker DA , Fennell EB , Carney PR : Sleep disturbance in children with epilepsy. Epilepsy Behav 2003;4:651—658.

19.

Stores G. , Wiggs L. , Campling G. : Sleep disorders and their relationship to psychological disturbance in children with epilepsy. Child Care Health Dev 1998;24:5—19.

20.

Wirrell E. , Blackman M. , Barlow K. , et al: Sleep disturbances in children with epilepsy compared to their nearest aged siblings. Dev Med Child Neurol 2005;47:754—759.

21.

Russo MB , Sing H. , Santiago S. , et al: Visual neglect: Occurrence and patterns in pilots in simulated overnight flight. Aviat Space Environ Med 2004;75:323—332.

22.

Martinez-Gonzalez D. , Obermeyer W. , Fahy JL , et al: REM sleep deprivation induces changes in coping responses that are not reversed by amphetamine. Sleep J Sleep Sleep Disord Res 2004;74: 609—617.

23.

Greenberg R. , Pillard R. , Pearlman C. : The effect of dream (stage REM) deprivation on adaptation to stress. Psychosom Med 1972 ; 34:257—262.

24.

Mertens HW , Collins WE : The effects of age, sleep deprivation, and altitude on complex performance . Hum Factors 1986;28:541— 551.

25.

Fuller KH , Waters WF , Binks PG , Anderson T. : Generalized anxiety and sleep architecture: A polysomnographic investigation . Sleep J Sleep Res Sleep Med 1997;20:370—376.

26.

Spoormaker VI , van den Bout J. : Depression and anxiety complaints; relations with sleep disturbances. Eur Psychiatry 2005 ;20:243—245.