title: Headache, drugs and sleep.
abstract: BACKGROUND
  Headache and sleep mechanisms share multiple levels of physiological interaction. Pharmacological treatment of headache syndromes may be associated with a broad range of sleep disturbances, either as a direct result of the pharmacology of the drug used, or by unmasking physiological alterations in sleep propensity seen as part of the headache symptom complex.
  
  
  OBJECTIVE
  This review summarises known sleep and circadian effects of various drugs commonly used in the management of headache disorders, with particular attention paid to abnormal sleep function emerging as a result of treatment.
  
  
  METHODS
  Literature searches were performed using MEDLINE, PubMed, and the Cochrane database using search terms and strings relating to generic drug names of commonly used compounds in the treatment of headache and their effect on sleep in humans with review of additional pre-clinical evidence where theoretically appropriate.
  
  
  CONCLUSIONS
  Medications used to treat headache disorders may have a considerable impact on sleep physiology. However, greater attention is needed to characterise the direction of the changes of these effects on sleep, particularly to avoid exacerbating detrimental sleep complaints, but also to potentially capitalise on homeostatically useful properties of sleep which may reduce the individual burden of headache disorders on patients.
authors: Headache Group, Department of Clinical Neuroscience, Institute of Psychiatry, King's College London, UK Surrey Sleep Research Centre, University of Surrey, UK Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, UK alexander.nesbitt@kcl.ac.uk.
authors: Alexander D
authors: AD
authors: Nesbitt
authors: Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, UK.
authors: Guy D
authors: GD
authors: Leschziner
authors: Department of Neurology, Charing Cross Hospital, Imperial College Healthcare NHS Foundation Trust, UK.
authors: Richard C
authors: RC
authors: Peatfield
mesh_terms: D000700:Analgesics / Q000009:adverse effects*; D006261:Headache / Q000188:drug therapy*; D006801:Humans; D012890:Sleep / Q000187:drug effects*
chemical_list: D000700:Analgesics
keywords: NREM; REM; Sleep; circadian; cluster headache; drugs; headache; insomnia; melatonin; migraine; polysomnography; restless legs syndrome; somnolence