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Corpus Callosum is written by a psychiatrist at a small community hospital somewhere in midwestern USA. Email to cc.scienceblogger at gmail dot com.


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Better Sleep May Mean Fewer Transformed Migraines

Category: Medicine
Posted on: June 30, 2006 10:44 PM, by Joseph j7uy5

There's a brief article on Medpage Today, about a small study that suggests that improving sleep can improve the course of a particular type of headache.  (A nicety to the article is that it provides 0.25 CME's.)

They write specifically about , which is a kind of headache that occurs daily, with the daily headaches developing after a person has had some episodic migraines.  

...The study included 43 women with transformed migraine treated at a single center. They were randomized to usual medical care with behavioral sleep modification or usual medical care plus sham behavioral instructions. All sleep medications were discontinued during the study.

Behavioral sleep modification included scheduling consistent bedtime that allows eight hours in bed, eliminating TV watching and other such activities in bed, the use of visualization techniques, moving dinner to at least four hours before bedtime, limiting fluid intake within two hours of bedtime, and discontinuing naps.

Sham instructions included things that would sound plausible to the patient but not impact sleep hygiene, such as to schedule a consistent dinner time, and have one protein serving at breakfast.

The behavioral sleep medication group had a greater reduction in migraine frequency from 24.2 episodes in 28 days at baseline down to about 17 in 28 days compared to an increase in frequency for the sham group from 23.2 episodes in 28 days at baseline to about 24 in 28 days (P=0.001).

Headache index scores decreased significantly in the treatment group compared to the control arm: a decrease from 46.7 to 28.3 compared to a decrease from 50.2 to 44.1 (P<0.01).

Of the 23 patients who received behavioral sleep modification instructions, 35% reverted back to having episodic rather than daily migraines while none of the sham group reverted to episodic migraines (P=0.029)...

The nice thing about this is that it is inexpensive, and it can't hurt.  I do wonder, though, whether it was actually the improved sleep, or some other factor that was important.  I am particularly suspicious of the role of television-watching.  

Maybe if everyone turned off their TV, they would have fewer migraines.

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