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Endogenous pain modulation after sleep restriction in migraine: a blinded crossover study
Jan Petter Neverdahl1,2,3, Martin Uglem4,5,6, Dagfinn Matre7
1Department of Neuromedicine and Movement Sciences, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Trondheim, 7491, Norway. jan.p.neverdahl@ntnu.no.
The Journal of Headache and Pain
|October 3, 2024
Summary
Sleep restriction may worsen pain modulation in migraine patients, particularly those with sleep-related migraine. This suggests a mechanism for how insufficient sleep affects migraine susceptibility.
Area of Science:
- Neuroscience
- Pain Research
- Sleep Science
Background:
- Migraine patients are susceptible to sleep disturbances.
- The impact of sleep restriction on migraine is not well understood.
- Sleep-related migraine may differ from non-sleep-related migraine in response to sleep changes.
Purpose of the Study:
- To investigate the effect of sleep restriction on endogenous pain modulation in migraine patients and healthy controls.
- To compare the effects of sleep restriction in sleep-related versus non-sleep-related migraine.
Main Methods:
- 39 migraine patients and 31 controls underwent pain assessments after normal sleep and after two nights of partial sleep restriction.
- Temporal summation and conditioned pain modulation (CPM) were measured using heat pain stimuli and cold pressor tests.
- Statistical analysis used two-level models to compare the effects of sleep restriction between groups.
Main Results:
- Conditioned pain modulation for temporal summation of heat pain showed a trend towards reduction after sleep restriction in migraine patients compared to controls (p=0.060).
- Exploratory analysis revealed a significantly greater reduction in CPM after sleep restriction in sleep-related migraine patients compared to non-sleep-related migraine patients (p=0.017).
- No other significant differences were found for temporal summation or CPM.
Conclusions:
- Migraine patients may possess a subtly altered endogenous pain modulation system.
- Sleep restriction appears to have a pronociceptive effect, potentially explaining migraine vulnerability to insufficient sleep.
- This pronociceptive effect seems more pronounced in sleep-related migraine than in non-sleep-related migraine.
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