A Micro-Longitudinal Study of Naps, Sleep Disturbance, and Headache Severity in Women with Chronic Migraine

ABSTRACT

Objective

To examine the relationship between headaches, naps, and nocturnal sleep in women with chronic migraine (CM) using micro-longitudinal data from diaries and actigraphy.

Methods

20 women with CM and 20 age and sex-matched healthy controls (HC) completed self-report questionnaires, electronic diaries, and wrist actigraphy over a 4-week period. Between-group comparisons were conducted with naps (frequency and duration) as the primary variable of interest. Within-group analyses were conducted on the CM group using hierarchical linear mixed models to examine the temporal relationships between headache severity, sleep behaviors, and sleep parameters. The primary variables of interest were naps (number and duration) and nocturnal sleep efficiency (diary and actigraphy).

Results

The CM group reported significantly more days with naps (25.85%) compared to the HC group (9.03%) during the study period (p = .0025). Within-group analyses in CM revealed that greater headache severity was associated with longer nap duration (p = .0037) and longer nap duration was associated with lower sleep efficiency measured using diaries (p = .0014) and actigraphy (p < .0001).

Conclusions

Napping is more frequent in CM than HC and nap duration in CM is associated with headache severity and nocturnal sleep disturbance. These findings provide initial support for the hypothesis that daytime napping is a behavioral coping strategy used in CM that could contribute to insomnia.

Acknowledgments

We would like to thank Sarah Snyder, Toni Iurcotta, and Athanasios Kondilis for their help in data acquisition and management.

Disclosure statement

Jason Ong is employed by Nox Health, Inc and has served as a consultant to Headspace, Inc, Vox Media, LLC, and Weight Watchers International, Inc. These activities are not related to this study. Spencer Dawson serves on the advisory board of Better Sleep. This activity is not related to this study. Todd A. Smitherman served on an advisory board for Teva. This activity is unrelated to this study. Helen Burgess is a consultant for Natrol, LLC. This activity is not related to this study. Colin Espie is a Co-founder of and a shareholder in Big Health Inc, which developed and maintained the sleep diaries used in this study. All other authors report no conflict.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website

Additional information

Funding

This study was funded by the National Institute of Neurological Disorders and Stroke of the National Institutes of Health under grant number NS081088 awarded to the first author.