Association of primary headaches with sleep disorders in Siberian adolescents

Objective. To establish an association between different primary headaches (PH) and sleep disorders taking into account psychosocial problems in Siberian adolescents. Material and methods. The study included 5.606 adolescents (2.605 boys, 3.001 girls) aged 11—18 years in three large Siberian cities: Krasnoyarsk, Abakan, and Kyzyl. The diagnosis of PH was based on migraine and tension-type headache (TTH) identification questionnaire and international headache criteria. Nighttime sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI), daytime sleepiness — using the Pediatric Daytime Sleepiness Scale (PDSS), psychosocial problems — using the Strengths and Difficulties Questionnaire (SDQ). Multinomial logistic regression with inclusion of gender, age, and overall psychosocial problems was used to identify the association of headache with sleep disorders. Results. Associations were established between PH (adjusted for gender, age, and psychosocial problems) and going to bed after 11:00 p.m., sleep latency > 15 min, falling asleep after 12:00 p.m., getting up before 7:00 a.m., reduced sleep duration (<8 hours for those younger 14 years and <7 hours for those older 14 years), difficulty getting up, feeling of insufficient sleep, dyssomnia, daytime sleepiness, asthenic syndrome, feeling of pain during sleep and bad dreams. TTH is more associated with sleep disorders (going to bed after 23:00 (OR 1.4, 95% CI 1.02—2.0), sleep duration <7 hours for those younger 14 years and <6 hours for those older 14 years (OR 1.6, 95% CI 1.04—2.3)). Migraine is more associated with sleep quality (dyssomnia (OR 1.8, 95% CI 1.2—2.8), especially with sleep latency >1 hour (OR 7.2, 95% CI 2.6—20.1), daytime sleepiness (OR 3.0, 95% CI 2.1—4.2) and asthenic syndrome (OR 5.7, 95% CI 3.6—9.2)). At the same time, children with PH showed a higher level of psychosocial problems, as determined by the SDQ scale. Inclusion of psychosocial problems in multinomial logistic regression model to determine the associations between PH and sleep parameters noticeable decreased statistical significance of OR. This indicates an important role of psychosocial problems in associations between PH and sleep disorders. Conclusion. Associations of primary headache with sleep disorders and psychosocial problems should be taken into account in complex treatment and prevention of primary headache.