Beyond pain relief: rethinking sleep outcomes in CGRP-targeted migraine therapy

Calcitonin gene-related peptide (CGRP)-targeted therapies have changed migraine treatment, but their effects on sleep remain incompletely understood. This review summarizes the emerging evidence on sleep outcomes with CGRP-targeted therapies, including monoclonal antibodies and gepants. Available studies suggest improvement in subjective sleep measures and few reported sleep-related adverse events, but the data are limited. Current findings do not establish whether sleep improvements reflect direct CGRP pathway modulation or improved migraine control. Interpretation is further complicated by patient heterogeneity, including comorbid sleep disorders, psychiatric symptoms, chronic pain, autonomic dysfunction, and concomitant medications. Future studies should use multidimensional sleep assessment and longitudinal objective measures to clarify whether CGRP-targeted therapies influence sleep physiology, sleep perception, or both.