An association was established between excessive daytime sleepiness (EDS) and a high frequency of headaches, but not between EDS and chronic migraine or chronic tension-type headache (CTTH). The results were published in Cephalalgia.
Espen S. Kristoffersen, PhD from Akershus University Hospital in Norway, and colleagues conducted a cross-sectional survey of 30,000 people age 30 to 44 via a mail questionnaire designed to determine the presence of possible chronic headache (defined as ≥15 headache days in the previous month and/or ≥180 headache days in the previous year) in the local population. After further screening, including an interview with two headache specialists, 323 eligible individuals were selected to participate in the study.
The participants completed the Epworth Sleepiness Scale (ESS) questionnaire, which assesses excessive daytime sleepiness by asking respondents to rate their likelihood of falling asleep while engaged in eight different activities on a scale of 0 to 3. The ESS scores were dichotomized into scores ≤10 and >10, which are considered clinically significant EDS. Participants also provided information regarding their sociodemographic status, level of disability (with the Migraine Disability Assessment [MIDAS]), and emotional distress (using the Hopkins Symptom Checklist-25 [HSCL-25]). Severe disability due to migraine (ie, MIDAS score >20) was reported by 49% and 78% of study participants with CTTH and chronic migraine, respectively, and emotional distress by 56% and 52%, respectively.
The overall prevalence of EDS was 21.1% in patients with chronic migraine and CTTH. The prevalence of EDS in chronic migraine was 22.9% overall and the prevalence of EDS in CTTH was 20.8% overall.
Our findings that increased frequency, but not type of headache, increased EDS may contribute to the hypothesis that it is the burden of complex pain rather than the specific condition that is associated with EDS.