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What factors affect sleep quality in people with tension-type headache?

In a recent study, researchers examined the factors linked to sleep quality in patients with chronic tension-type headache.

A tension-type headache is a common condition with a prevalence of about 42% in the general population worldwide. Symptoms include pain around the forehead (sometimes described as a “vice-like grip”) and the back of the neck. Tension-type headaches are usually limited and episodic and easily treated with over-the-counter pain medications. However, some people suffer from chronic tension-type headaches that occur in varying intensity for more than 15 days every month, causing significant disability.

A complex interaction of several factors is thought to cause tension-type headaches. Poor sleep quality is an important cause and consequence. A recent study in Spain looked at the factors that affect the quality of sleep in patients with chronic tension-type headache. The results were recently published in PLOS One.

As part of an international headache study, researchers recruited patients with a chronic tension-type headache from several university-based hospitals between January 2015 and June 2016. They asked the patients to keep a four-week headache diary at the start of the study recording the quality and frequency of their headaches. Patients also completed standardized questionnaires assessing their sleep quality, headache burden and disability, anxiety and depression, health-related quality of life and pressure pain thresholds at various parts of the body.

Complex interaction of factors affects sleep quality in chronic tension-type headache

They assessed a total of 180 patients with a chronic tension-type headache at the start of the study, and they assessed 135 of these patients again at 12 months. Statistical analysis showed that at the start of the study, sleep quality was significantly linked to headache intensity, frequency, duration, emotional and physical burden of headache, and depression. Depression and emotional burden of headache accounted for 27.5% of the variance in sleep quality at baseline.

After 12 months, sleep quality was significantly linked to a burden of headache, depression, pain pressure thresholds, vitality and mental health. Pain pressure thresholds in the fingers and over the neck accounted for 30% of the variance of sleep quality at 12 months.

Further studies needed to clarify these interactions

Since different factors were more significant at baseline and 12 months, the researchers concluded that there is a complex interaction affecting sleep quality in patients with chronic tension-type headaches. A clearer understanding of this interaction could provide opportunities to improve sleep quality in patients with chronic tension-type headache.

Written by Julie McShane, Medical Writer

Reference: Benito-Gonzales E, Palacios-Cena M, Fernandez-Munoz JJ, et al. Variables associated with sleep quality in chronic tension-type headache: A cross-sectional and longitudinal design. PLOS ONE May 17, 2018. Doi:10.1371/journal.pone.0197381.

Julie Mcshane MA MB BS
Julie Mcshane MA MB BS
Julie studied medicine at the Universities of Cambridge and London, UK. Whilst in medical practice, she developed an interest in medical writing and moved to a career in medical communications. She worked with companies in London and Hong Kong on a wide variety of medical education projects. Originally from Ireland, Julie is now based in Dublin, where she is a freelance medical writer. She enjoys contributing to the Medical News Bulletin to help provide a source of accurate and clear information about the latest developments in medical research.
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