title: Study of sleep microstructure in patients of migraine without aura.
abstract: OBJECTIVE
  Although the relationship between sleep and migraine has been widely reported, studies on sleep microstructure are few. The aim was to study and compare microstructural polysomnographic characteristics in patients of "migraine without aura" (MOA) with controls.
  
  
  METHODS
  Twenty-five patients of MOA and 25 age- and gender-matched healthy controls were subjected to overnight polysomnography. Microstructural sleep analysis, including arousal and cyclic alternating pattern (CAP) analysis was performed. Arousals and CAP parameters were compared between the two groups using the Mann-Whitney U test (p ≤ 0.05).
  
  
  RESULTS
  The overall arousal index (p = 0.528) and that during non-rapid eye movement (NREM) sleep (p = 0.503) were comparable between the two groups. However, the arousal index was lower in migraineurs during rapid eye movement (REM) sleep (p = 0.001). The overall CAP rate (p = 0.020) as well as the number of CAP cycles and sequences (p = 0.032) was lower among migraineurs. The total phase A duration (p < 0.0001) was increased, and conversely, phase B duration (p = 0.001) was decreased in migraineurs. The phase A1 duration (p = 0.036) was higher in migraineurs. Finally, phase A1 (p = 0.357) index was comparable, and conversely, A2 (p < 0.0001) and A3 (p = 0.020) indices were decreased in migraineurs.
  
  
  CONCLUSIONS
  This study showed a decreased REM arousability as well as a decreased overall CAP rate and CAP cycling in patients with migraine as compared to controls. This indicates that there is probably an alteration of the arousal mechanisms in patients with migraine that may facilitate the occurrence of headache paroxysms during sleep.
authors.affiliation: Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, 560029, India.|Department of Clinical Neurosciences, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, 560029, India.
authors.forename: C
authors.initials: C
authors.lastname: Nayak
authors.affiliation: Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, 560029, India. sanjib_sinha2004@yahoo.co.in.
authors.forename: S
authors.initials: S
authors.lastname: Sinha
authors.affiliation: Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, 560029, India.
authors.forename: M
authors.initials: M
authors.lastname: Nagappa
authors.affiliation: Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, 560029, India.
authors.forename: K
authors.initials: K
authors.lastname: Nagaraj
authors.affiliation: Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, 560029, India.
authors.forename: G B
authors.initials: GB
authors.lastname: Kulkarni
authors.affiliation: Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, 560029, India.
authors.forename: K
authors.initials: K
authors.lastname: Thennarasu
authors.affiliation: Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, 560029, India.
authors.forename: A B
authors.initials: AB
authors.lastname: Taly
mesh_terms: D000328:Adult; D000513:Alpha Rhythm / Q000502:physiology; D001143:Arousal / Q000502:physiology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005071:Evoked Potentials; D005260:Female; D006801:Humans; D008297:Male; D020326:Migraine without Aura / Q000175:diagnosis* / Q000503:physiopathology*; D017286:Polysomnography / Q000379:methods*; D012016:Reference Values; D012895:Sleep, REM / Q000502:physiology*; D013826:Theta Rhythm / Q000502:physiology
keywords: Arousal; CAP; Migraine without aura; Sleep microstructure