title: Serotonin effects on sleep and emotional disorders in adolescent migraine.
abstract: OBJECTIVE
  To determine frequency of emotional disorders and sleep disturbances in adolescent migraineurs with episodic and chronic headaches. To determine the relationship of whole blood serotonin, caffeine consumption, and frequency of sleep and mood disorders.
  
  
  BACKGROUND
  The neurotransmitter serotonin has been implicated to play a role in the initiation and maintenance of sleep and in modulating mood. A putative role in migraine pathophysiology is also known.
  
  
  METHODS
  Adolescents from 13 to 17 years of age were identified from our headache clinic with episodic or chronic migraine (according to International Classification of Headache Disorders-Second Edition criteria) and healthy controls enrolled. Psychological rating scales were completed, including Adolescent Symptom Inventory (4th Edition) and Child Depression Inventory. Sleep questionnaires (Pediatric Sleep Questionnaire and Child Sleep Habit Questionnaire) were completed by the teenager's parents/guardian. Whole blood serotonin levels were drawn and analyzed and caffeine consumption obtained by history.
  
  
  RESULTS
  A total of 18 controls (8 girls) and 15 patients each with episodic migraines (9 girls) and chronic migraine (10 girls) were studied. Patients with headache had significantly more sleep problems than controls. Patients with chronic migraines had increased daytime sleepiness and dysthymia compared with teenagers with episodic migraines. Serotonin levels were not significantly different, and no association was noted between serotonin levels and sleep abnormalities or emotional rating scales. Increased caffeine intake was related to sleep and depressive complaints.
  
  
  CONCLUSIONS
  Sleep and emotional disorders were common in adolescents with migraine. Sleep disorders and dysthymia were more prevalent with increased headache frequency. No correlation was noted with whole blood serotonin levels.
authors.affiliation: Department of Neurology, Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Pakalnis
authors.forename: Mark
authors.initials: M
authors.lastname: Splaingard
authors.forename: Deborah
authors.initials: D
authors.lastname: Splaingard
authors.forename: Donna
authors.initials: D
authors.lastname: Kring
authors.forename: Andrew
authors.initials: A
authors.lastname: Colvin
mesh_terms: D000293:Adolescent; D000342:Affective Symptoms / Q000097:blood* / Q000150:complications / Q000523:psychology; D000367:Age Factors; D002110:Caffeine / Q000008:administration & dosage / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000097:blood* / Q000150:complications / Q000523:psychology; D019964:Mood Disorders / Q000097:blood / Q000150:complications / Q000523:psychology; D011446:Prospective Studies; D012701:Serotonin / Q000097:blood / Q000502:physiology*; D012890:Sleep / Q000502:physiology; D012893:Sleep Wake Disorders / Q000097:blood* / Q000150:complications / Q000523:psychology
chemical_list: D012701:Serotonin; D002110:Caffeine