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How Do Migraines Affect Sleep?

Researchers investigated how migraines affect the quality of sleep. The third most common illness in the world,1 migraine affects an estimated one billion people every year.2

In the United States, more than 157 million workdays are lost annually due to migraines1. Migraines affect men, women, and children.

Unfortunately, many migraine sufferers do not seek treatment.

Typical sleep quality measurements

People with migraines often experience sleep disturbances. Researchers discovered that sleep problems and migraines are linked, but very little research has been performed to learn more about this connection.

People with migraines often have difficulty measuring sleep disturbances because each person has a different experience. Doctors developed a questionnaire to evaluate sleep quality,3 known as the Pittsburgh Sleep Quality Index (PSQI).

The PSQI consists of a series of questions that assess different measures of sleep quality. The PSQI also allows input from the patients’ partners.

The questionnaire results in a reliable measure of patients’ subjective sleep quality.3 A more accurate measure of sleep disturbances is the sleep study.

Technically known as a polysomnographic (PSG) study, sleep studies involve the simultaneous recording of multiple parameters related to sleep and wakefulness.4

Alternate measures of sleep abnormalities

While sleep studies are the gold standard for measuring sleep abnormalities, the Migraine Disability Assessment (MIDAS) measures the effects of migraine pain. It is a questionnaire used by doctors to better understand how migraines affect one’s daily life.5

The MIDAS questionnaire assesses the number of days with pain over the last three months, and how much that pain prevented normal daily activities.

Researchers from King’s College London recently completed a meta-analysis that investigated differences in the PSQI and PSG scores of people with migraines versus those without.

They also looked for any links between PSQI and MIDAS scores. Their results were published in the online issue of the journal, Neurology.

The researchers included 32 studies that involved 10,243 people. The data from these studies were statistically analyzed to assess PSQI, PSG, and MIDAS scores.

Study results confirmed that migraines affect sleep

The study determined that adults with migraines had worse PSQI scores than those without. Those with chronic migraines had even higher PSQI scores.2

Further, adults and children with migraines have less REM sleep as measured by the sleep study. Children with migraines had lower total sleep time and took longer to fall asleep than other children.2

The researchers did not find any link between PSQI and MIDAS scores.

Large-scale research needed

Because sleep quality seems to be interlinked with migraines, study authors recommend sleep interventions as part of a migraine treatment program.

Additionally, people with migraines should avoid medicines that might disturb their sleep. The study results point to a link between REM sleep and migraines which requires further study.

The study authors recommend additional, large-scale research studies are performed which include PSG to improve the data.


  1. Migraine Research Foundation. Migraine Facts – Migraine Research Foundation. Published 2015. Accessed September 27, 2021. https://migraineresearchfoundation.org/about-migraine/migraine-facts/
  2. Stanyer EC, Creeney H, Nesbitt AD, Robert Holland PR, Hoffmann J. Subjective sleep quality and sleep architecture in patients with migraine: A meta-analysis. Neurology. Published online September 22, 2021:10.1212/WNL.0000000000012701. doi:10.1212/wnl.0000000000012701
  3. Shahid A, Wilkinson K, Marcu S, Shapiro CM. Pittsburgh Sleep Quality Index (PSQI). STOP, THAT and one hundred other sleep scales. Published online 2011:279-283. doi:10.1007/978-1-4419-9893-4_67
  4. Armon C, Gardner-Johnson K, Roy A, Nowack WJ. Polysomnography: Overview, parameters monitored, staging of sleep. eMedicine. Published online on December 5, 2020. Accessed September 27, 2021. https://emedicine.medscape.com/article/1188764-overview
  5. What Is the MIDAS Test? | Migraine.com. Published 2020. Accessed September 27, 2021. https://migraine.com/pro/midas

Rebecca Blankenship BSc
Rebecca Blankenship BSc
Rebecca Blankenship is a freelance technical writer. She reviews, edits, and authors internal quality documentation required for regulatory compliance. She has twenty years experience in industrial pharma/medical device quality management systems and an honors BSc in chemistry. She is a natural born rule follower and enjoys applying this strength to help others be audit ready to meet regulatory requirements. She also loves learning about the latest scientific discoveries while writing for Medical News Bulletin. Her free time is spent as a full-time mom, encouraging can-do attitudes and cooperation in her three children.


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