Objectives: This is an observational study aimed to investigate
the activity of autonomic nervous system during sleep in
patients with sleep-related migraine.
Methods: Eight consecutive migraineurs without aura were
enrolled (6 women and 2 men), aged 30 to 62 years (mean
48.1 ± 9.3 years). Inclusion criteria were: high frequency of
attacks (> 5 per month) and occurrence of more than 75% of
the attacks during sleep causing an awakening. Patients were
compared with a control group of 55 healthy subjects (23 men
and 32 women, mean age 54.2 ± 13.0 years), and with a further
control group of 8 age- and gender-matched healthy controls.
Patient and controls underwent polysomnography and
heart rate variability analysis.
Results: A signifi cant reduction of the LF/HF ratio during N2
and N3 sleep stages was observed in migraineurs compared
with controls. No differences in sleep macrostructure were observed;
CAP time and CAP rate were lower in migraineurs than
in controls. Conclusions: These fi ndings indicate a peculiar modifi cation of
the autonomic balance during sleep in sleep-related migraine.
The reduction of LF/HF ratio in NREM sleep was observed in controls,
but it was quantitatively much more evident in migraineurs.
Changes in LF/HF could be consequent to an autonomic
unbalance which could manifest selectively (or alternatively
become more evident) during sleep. These fi ndings, together
with the reduction in CAP rate, could be an expression of reduced
arousability during sleep in patients with sleep-related
migraine. The simultaneous involvement of the autonomic,
arousal, and pain systems might suggest involvement of the
- Autonomic nervous system
- cyclic alternating pattern
- heart rate variability
- sleep-related migraine