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Cognitive-Behavioral Therapy for Insomnia to Reduce Chronic Migraine: A Sequential Bayesian Analysis
Todd A Smitherman1, Alexander J Kuka1, Anne H Calhoun2
1Department of Psychology, Migraine and Behavioral Health Laboratory, University of Mississippi, Oxford, MS, USA.
Headache
|May 8, 2018
Summary
Cognitive-behavioral treatment for insomnia (CBTi) significantly reduced monthly headache frequency in adults with chronic migraine. This meta-analysis supports CBTi as an effective intervention for managing migraine comorbidities.
Area of Science:
- Neurology
- Behavioral Science
- Psychiatry
Background:
- Insomnia frequently co-occurs with chronic migraine.
- Previous small trials suggest cognitive-behavioral treatment of insomnia (CBTi) may decrease migraine frequency.
- This study synthesizes existing CBTi trials for adults with chronic migraine.
Purpose of the Study:
- To quantitatively synthesize CBTi trials for adults with chronic migraine using Bayesian methods.
- To assess the efficacy of CBTi in reducing headache frequency in this population.
Main Methods:
- Bayesian meta-analysis of two randomized controlled trials comparing CBTi to sham interventions.
- Gaussian linear models were used to analyze changes in headache frequency.
- Posterior distributions from one study informed the analysis of the second study.
Main Results:
- Combined analysis showed a decrease of 6.2 monthly headache days in the CBTi group compared to controls.
- There is a 97.5% probability that CBTi is at least 2.7 days more effective than control interventions.
- Individuals completing CBTi experienced greater headache reduction.
Conclusions:
- Cognitive-behavioral interventions for insomnia show promise in reducing headache frequency for chronic migraine patients.
- Targeting comorbid insomnia may improve migraine outcomes.
- Behavioral interventions are effective for migraineurs with comorbid conditions.
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