A time series analysis of daily hassles and mood changes in the 3 days before the migraine attack

Daily hassles, mood changes, and sleep quality in the 3 days preceding migraine attacks were prospectively studied and compared with migraine-free control days. Nineteen female migraine patients, aged 20 to 49 years, kept a 10-week diary four times per day and produced complete data on daily hassles (incidence and stressfulness), mood (alert, tense, irritable, annoyed, depressed, and tired), sleep quality, and migraine. Significant results indicated increased hassles, particularly in the 24 premigraine hours; psychological arousal (increased irritability, annoyance, and tenseness), predominantly from 60 to 24 hours before the attack; repeated fatigue in the 60 premigraine hours, with a peak immediately before the attack; and a sharp decrease in sleep quality in the night preceding the attack. The authors also found that those attacks that came on during phases of heightened activity--particularly in the afternoon--were preceded by more substantial and more significant elevations of hassles and psychological arousal than were attacks that occurred during unwinding phases, particularly at night.