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Clinical correlates of insomnia in patients with persistent post-traumatic headache compared with migraine

BACKGROUND: Close associations between insomnia with other clinical factors have been identified in migraine, but there have been few studies investigating associations between insomnia and clinical factors in patients with persistent post-traumatic headache (PPTH). The study objective was to contra...

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Autores principales: Kim, Soo-Kyoung, Chong, Catherine D., Dumkrieger, Gina, Ross, Katherine, Berisha, Visar, Schwedt, Todd J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Milan 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161138/
https://www.ncbi.nlm.nih.gov/pubmed/32295535
http://dx.doi.org/10.1186/s10194-020-01103-8
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author Kim, Soo-Kyoung
Chong, Catherine D.
Dumkrieger, Gina
Ross, Katherine
Berisha, Visar
Schwedt, Todd J.
author_facet Kim, Soo-Kyoung
Chong, Catherine D.
Dumkrieger, Gina
Ross, Katherine
Berisha, Visar
Schwedt, Todd J.
author_sort Kim, Soo-Kyoung
collection PubMed
description BACKGROUND: Close associations between insomnia with other clinical factors have been identified in migraine, but there have been few studies investigating associations between insomnia and clinical factors in patients with persistent post-traumatic headache (PPTH). The study objective was to contrast the severity of insomnia symptoms in PPTH, migraine, and healthy controls, and to identify factors associated with insomnia in patients with PPTH vs. migraine. METHODS: In this cross-sectional cohort study, 57 individuals with PPTH attributed to mild traumatic brain injury, 39 with migraine, and 39 healthy controls were included. Participants completed a detailed headache characteristics questionnaire, the Migraine Disability Assessment Scale (MIDAS), Insomnia Severity Index (ISI), Hyperacusis Questionnaire (HQ), Allodynia Symptom Checklist, Photosensitivity Assessment Questionnaire, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory, Post-Traumatic Stress Disorder (PTSD) checklist, Ray Auditory Verbal Learning Test, and the Trail Making Test A and B to assess headache characteristics, disability, insomnia symptoms, sensory hypersensitivities, and neuropsychological factors. Fisher’s test and one-way ANOVA or Tukey’s Honest Significant Difference were used to assess group differences of categorical and continuous data. Stepwise linear regression analyses were conducted to identify clinical variables associated with insomnia symptoms. RESULTS: Those with PPTH had significantly higher ISI scores (16.7 ± 6.6) compared to migraine patients (11.3 ± 6.4) and healthy controls (4.1 ± 4.8) (p <  0.001). For those with PPTH, insomnia severity was most strongly correlated with the BDI (Spearman’s rho (ρ) = 0.634, p <  0.01), followed by Trait Anxiety (ρ = 0.522, p <  0.01), PTSD (ρ = 0.505, p <  0.01), HQ (ρ = 0.469, p <  0.01), State Anxiety (ρ = 0.437, p <  0.01), and MIDAS scores (ρ = 0.364, p <  0.01). According to linear regression models, BDI, headache intensity, and hyperacusis scores were significantly positively associated with insomnia severity in those with PPTH, while only delayed memory recall was negatively associated with insomnia severity in those with migraine. CONCLUSIONS: Insomnia symptoms were more severe in those with PPTH compared to migraine and healthy control cohorts. Depression, headache intensity, and hyperacusis were associated with insomnia in individuals with PPTH. Future studies should determine the bidirectional impact of treating insomnia and its associated symptoms.
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spelling pubmed-71611382020-04-22 Clinical correlates of insomnia in patients with persistent post-traumatic headache compared with migraine Kim, Soo-Kyoung Chong, Catherine D. Dumkrieger, Gina Ross, Katherine Berisha, Visar Schwedt, Todd J. J Headache Pain Research Article BACKGROUND: Close associations between insomnia with other clinical factors have been identified in migraine, but there have been few studies investigating associations between insomnia and clinical factors in patients with persistent post-traumatic headache (PPTH). The study objective was to contrast the severity of insomnia symptoms in PPTH, migraine, and healthy controls, and to identify factors associated with insomnia in patients with PPTH vs. migraine. METHODS: In this cross-sectional cohort study, 57 individuals with PPTH attributed to mild traumatic brain injury, 39 with migraine, and 39 healthy controls were included. Participants completed a detailed headache characteristics questionnaire, the Migraine Disability Assessment Scale (MIDAS), Insomnia Severity Index (ISI), Hyperacusis Questionnaire (HQ), Allodynia Symptom Checklist, Photosensitivity Assessment Questionnaire, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory, Post-Traumatic Stress Disorder (PTSD) checklist, Ray Auditory Verbal Learning Test, and the Trail Making Test A and B to assess headache characteristics, disability, insomnia symptoms, sensory hypersensitivities, and neuropsychological factors. Fisher’s test and one-way ANOVA or Tukey’s Honest Significant Difference were used to assess group differences of categorical and continuous data. Stepwise linear regression analyses were conducted to identify clinical variables associated with insomnia symptoms. RESULTS: Those with PPTH had significantly higher ISI scores (16.7 ± 6.6) compared to migraine patients (11.3 ± 6.4) and healthy controls (4.1 ± 4.8) (p <  0.001). For those with PPTH, insomnia severity was most strongly correlated with the BDI (Spearman’s rho (ρ) = 0.634, p <  0.01), followed by Trait Anxiety (ρ = 0.522, p <  0.01), PTSD (ρ = 0.505, p <  0.01), HQ (ρ = 0.469, p <  0.01), State Anxiety (ρ = 0.437, p <  0.01), and MIDAS scores (ρ = 0.364, p <  0.01). According to linear regression models, BDI, headache intensity, and hyperacusis scores were significantly positively associated with insomnia severity in those with PPTH, while only delayed memory recall was negatively associated with insomnia severity in those with migraine. CONCLUSIONS: Insomnia symptoms were more severe in those with PPTH compared to migraine and healthy control cohorts. Depression, headache intensity, and hyperacusis were associated with insomnia in individuals with PPTH. Future studies should determine the bidirectional impact of treating insomnia and its associated symptoms. Springer Milan 2020-04-15 /pmc/articles/PMC7161138/ /pubmed/32295535 http://dx.doi.org/10.1186/s10194-020-01103-8 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Kim, Soo-Kyoung
Chong, Catherine D.
Dumkrieger, Gina
Ross, Katherine
Berisha, Visar
Schwedt, Todd J.
Clinical correlates of insomnia in patients with persistent post-traumatic headache compared with migraine
title Clinical correlates of insomnia in patients with persistent post-traumatic headache compared with migraine
title_full Clinical correlates of insomnia in patients with persistent post-traumatic headache compared with migraine
title_fullStr Clinical correlates of insomnia in patients with persistent post-traumatic headache compared with migraine
title_full_unstemmed Clinical correlates of insomnia in patients with persistent post-traumatic headache compared with migraine
title_short Clinical correlates of insomnia in patients with persistent post-traumatic headache compared with migraine
title_sort clinical correlates of insomnia in patients with persistent post-traumatic headache compared with migraine
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161138/
https://www.ncbi.nlm.nih.gov/pubmed/32295535
http://dx.doi.org/10.1186/s10194-020-01103-8
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