title: Specific headache factors predict sleep disturbances among youth with migraine.
abstract: BACKGROUND
  There is a paucity of pediatric data addressing the complex relationship between primary headaches and sleep disturbances. Our study objective was to explore headache-related factors that predict sleep disturbance and to compare sleep complaints with other forms of headache-related disability among youth with migraines.
  
  
  METHODS
  A prospective cohort study was conducted in patients 10-18 years old with migraine or probable migraine and without daily sleep complaints. The patients completed a 90-day internet-based headache diary. On headache days, patients rated headache intensity, answered Pediatric Migraine Disability Assessment-based questions modified for daily scoring, and reported sleep disturbances that resulted as a direct effect of proximate headaches.
  
  
  RESULTS
  Fifty-two patients generated 4680 diary entries, 984 patients (21%) involved headaches. Headache intensity (P = 0.009) and timing of headache onset (P < 0.001) were predictive of sleep disturbances. Three Pediatric Migraine Disability Assessment-based items were also associated with sleep disturbances: partial school-day absence (P = 0.04), recreational activities prevented (P < 0.001), and decreased functioning during recreational activities (P < 0.001). Sleep disturbances correlated positively and significantly with daily headache disability scores (rpb = 0.35; P < 0.01).
  
  
  CONCLUSIONS
  We conclude that specific headache factors predict sleep disturbances among youth with primary headaches.
authors.affiliation: Departments of Pediatrics and Neurology, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio. Electronic address: geoffrey.heyer@nationwidechildrens.org.
authors.forename: Geoffrey L
authors.initials: GL
authors.lastname: Heyer
authors.affiliation: Departments of Pediatrics and Neurology, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio.
authors.forename: Sean C
authors.initials: SC
authors.lastname: Rose
authors.affiliation: Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio.
authors.forename: Kelsey
authors.initials: K
authors.lastname: Merison
authors.affiliation: Department of Center for Human Psychophysiology, Miami University, Oxford, Ohio.
authors.forename: Sara Q
authors.initials: SQ
authors.lastname: Perkins
authors.affiliation: Departments of Pediatrics and Neurology, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio.
authors.forename: Jo Ellen M
authors.initials: JE
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008881:Migraine Disorders / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*
keywords: MIDAS; PedMIDAS; adolescent; diary; disability; migraine; pediatric