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Sleep Disorders in Medication-Overuse Headache: Prevalence and Associated Factors
Elena R Lebedeva1,2, Iana A Kniazeva1,2, Denis V Gilev3
1Department of Neurology, Ural State Medical University, Yekaterinburg, Russia.
European Journal of Neurology
|July 16, 2026
Summary
Medication-overuse headache (MOH) patients frequently experience sleep disorders like insomnia and restless legs syndrome. Headache treatment significantly improves these sleep issues, highlighting the need for early screening in MOH patients.
Area of Science:
- Neurology
- Sleep Medicine
- Clinical Research
Background:
- Sleep disorders are known to worsen headache burden.
- The prevalence and reversibility of sleep disorders in medication-overuse headache (MOH) are not well understood.
- This study investigates sleep disorders in MOH patients.
Purpose of the Study:
- To evaluate the prevalence of sleep disorders in patients with medication-overuse headache (MOH) compared to controls.
- To identify factors associated with sleep disorders in MOH.
- To assess the impact of headache treatment on sleep disorders in MOH patients.
Main Methods:
- A prospective case-control study involving 171 MOH patients and 173 controls.
- Utilized semi-structured interviews, validated questionnaires, headache/sleep calendars, and polysomnography.
- Follow-up assessments were conducted after headache treatment.
Main Results:
- Chronic insomnia (60.2%) and restless legs syndrome (37.4%) were more prevalent in MOH patients than controls.
- Factors linked to insomnia in MOH included nocturnal headaches, nighttime analgesic use, overweight, and hypertension.
- Following treatment, chronic insomnia decreased to 33.3% and restless legs syndrome to 14.9% (p < 0.001).
Conclusions:
- This study is the first to show a high prevalence of sleep disorders in MOH patients.
- Sleep disorders in MOH are reversible following successful headache treatment.
- Recommends early screening for sleep disorders in individuals with MOH.
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