A survey study to investigate the relationship of sleep disorders, depression and anxiety in headache patients

Abstract

Objective: There is a complex relationship among pain, sleep and mood, with boundaries indistinguishable from each other. Pain can disrupt the quality of sleep, disturbance of sleeping pattern can create pain and the reflection of this period can manifest itself as depression and anxiety in people.Materials and Methods: A total of 297 patients, followed up due to headache, were enrolled in the study. Patient study groups were classified as episodic tension-type headache (TTH), migraine, chronic migraine and chronic tension-type headache. Patient assessments were performed by Epworth sleepiness scale, Hamilton Anxiety Rating scale (HAM-A) and Hamilton Depression Rating scale (HDRS).Results: In all groups, excessive daytime sleepiness accompanied the clinical picture. In episodic TTH group, HAM-A was 12.27 +/- 3.34 (p<0.001), in migraine group, 10.09 +/- 2.94 (p<0.05), in chronic migraine group HAM-A was 7.90 +/- 2.41 (p>0.05), and in group with chronic TTH, HAM-A was 5.71 +/- 2.51 (p>0.05); anxiety scores were increased in episodic TTH and migraine groups when compared to other groups and also normal population. In episodic TTH group, HDRS was 8.34 +/- 3.85 (p>0.05); in migraine group, 9.01 +/- 1.25 (p>0.05); in chronic TTH group, 10.05 +/- 3.40 (p<0.001) and in group with chronic migraine HDRS was 11.70 +/- 3.25 (p<0.001). The depression scores were increased in chronic migraine group and chronic TTH group when compared to other groups and to normal population.Conclusion: As a conclusion, we suggest that pain, depression, anxiety and disorders of sleep should be considered as a whole and patient approach should be planned according to this concept.