title: The prevalence and spectrum of sleep problems in women with transformed migraine.
abstract: OBJECTIVE
  It is our clinical observation that patients with transformed migraine (TM) almost invariably report nonrestorative sleep. In this study we sought first to validate that clinical observation, then to describe the prevalence and spectrum of factors that might contribute to nonrestorative sleep in a TM population.
  
  
  BACKGROUND
  Although headaches have been linked with sleep problems for over a century, there is little information about the spectrum or prevalence of specific sleep problems associated with TM in adults.
  
  
  METHODS
  We conducted a detailed sleep interview on 147 consecutive women with TM. Subjective sleep quality was assessed by asking patients to describe their state upon awakening as "refreshed" or "tired."
  
  
  RESULTS
  None of the 147 patients reported awakening "refreshed," and 83.7% stated that they awakened "tired." Sleep complaints were prevalent and varied in this population.
  
  
  CONCLUSIONS
  Although the relationship between pain and sleep is complex and ill understood, we found a very high prevalence of nonrestorative sleep and a similarly high prevalence of modifiable poor sleep habits in patients with TM. Since behavioral approaches have been found effective in improving sleep quality in patients with poor sleep hygiene, we propose that studies be undertaken to assess the impact of such treatment on TM.
authors.affiliation: Neurology, University of North Carolina, Chapel Hill, 27599-7025, USA.
authors.forename: Anne H
authors.initials: AH
authors.lastname: Calhoun
authors.forename: Sutapa
authors.initials: S
authors.lastname: Ford
authors.forename: Alan G
authors.initials: AG
authors.lastname: Finkel
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Kahn
authors.forename: J Douglas
authors.initials: JD
authors.lastname: Mann
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D020773:Headache Disorders / Q000150:complications; D006801:Humans; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications*; D009657:North Carolina / Q000453:epidemiology; D015995:Prevalence; D012893:Sleep Wake Disorders / Q000150:complications* / Q000453:epidemiology