Relationship between insomnia and headache in community-based middle-aged Hong Kong Chinese women |
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Authors: | Wing-Fai Yeung Ka-Fai Chung Chun-Yue Wong |
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Institution: | (1) Department of Psychiatry, University of Hong Kong, Pokfulam Road, Hong Kong SAR, China; |
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Abstract: | Limited studies have investigated the prevalence of insomnia symptoms among individuals with different headache diagnoses
and the association between insomnia and headache in subjects with comorbid anxiety and depression. A total of 310 community-dwelling
Hong Kong Chinese women aged 40–60 years completed a self-administered questionnaire on headache, sleep difficulties, mood
disturbances, and functional impairment. About 31% of the sample complained of recurrent headache unrelated to influenza and
the common cold in the past 12 months. The percentages of women diagnosed to have migraine, tension-type headache (TTH), and
headache unspecified were 8.4, 15.5 and 7.1%, respectively. The most frequent insomnia complaint was “problem waking up too
early” (29.4%), followed by “difficulty staying asleep” (28.0%) and “difficulty falling asleep” (24.4%). Women with headaches
were significantly more likely to report insomnia symptoms than those without headaches. There were no significant differences
among women with migraine, TTH, and headache unspecified in the prevalence of insomnia symptoms. Logistic regression analysis
showed that women with insomnia disorder as defined by an insomnia severity index total score ≥8 had 2.2-fold increased risk
of reporting recurrent headache, 3.2-fold increased risk of migraine, and 2.3-fold increased risk of TTH, after adjusting
for anxiety and depression. Individual insomnia symptoms were not independent predictors. The association between insomnia
and headache was stronger in subjects with more frequent headaches. Our findings suggest that insomnia and the associated
distress, but not insomnia symptoms alone, is an independent risk factor for recurrent headache in middle-aged women with
mixed anxiety, depression and sleep disturbances. |
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Keywords: | Anxiety Depression Headache Insomnia Migraine Tension-type headache |
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