title: Excessive daytime sleepiness is associated with an exacerbation of migraine: A population-based study.
abstract: BACKGROUND
  Previous studies have shown that migraine and sleep disturbances are closely associated. Excessive daytime sleepiness (EDS) is a common symptom of various types of sleep disturbance. Findings from clinic-based studies suggest that a high percentage of migraineurs experience EDS. However, the prevalence and clinical impact of EDS among migraineurs at the population level have rarely been reported. The objective of this study was to investigate the prevalence and impact of EDS among migraineurs using a population-based sample in Korea.
  
  
  METHODS
  We selected a stratified random sample of Koreans aged 19 to 69 years and evaluated them using a semi-structured interview designed to identify EDS, headache type, and the clinical characteristics of migraine. If the score on the Epworth Sleepiness Scale (ESS) was more than or equal to 11, the participant was classified as having EDS.
  
  
  RESULTS
  Of the 2,695 participants that completed the interview, 143 (5.3 %) and 313 (11.6 %) were classified as having migraine and EDS, respectively. The prevalence of EDS was significantly higher in participants with migraine (19.6 %) and non-migraine headache (13.4 %) compared to non-headache controls (9.4 %). Migraineurs with EDS had higher scores on the Visual Analogue Scale (VAS) for headache intensity (6.9 ± 1.8 vs. 6.0 ± 1.9, p = 0.014) and Headache Impact Test-6 (59.8 ± 10.2 vs. 52.5 ± 8.2, p < 0.001) compared to migraineurs without EDS.
  
  
  CONCLUSIONS
  Approximately 20 % of migraineurs had EDS in this population-based sample. Excessive daytime sleepiness was associated with an exacerbation of some migraine symptoms.
authors.affiliation: Department of Neurology, Bio Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea.
authors.forename: Jiyoung
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea.
authors.forename: Soo-Jin
authors.initials: SJ
authors.lastname: Cho
authors.affiliation: Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Won-Joo
authors.initials: WJ
authors.lastname: Kim
authors.affiliation: Sleep Disorders Center, Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, South Korea.
authors.forename: Kwang Ik
authors.initials: KI
authors.lastname: Yang
authors.affiliation: Clinical Neuroscience Center, Department of Neurology, Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Chang-Ho
authors.initials: CH
authors.lastname: Yun
authors.affiliation: Department of Neurology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul, 07441, South Korea. chumk@hallym.ac.kr.
authors.forename: Min Kyung
authors.initials: MK
authors.lastname: Chu
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D010147:Pain Measurement / Q000379:methods; D011159:Population Surveillance; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D055815:Young Adult
keywords: Epidemiology; Excessive daytime sleepiness; Headache; Migraine; Sleep; Sleepiness