ArticleHeadache2021
Baseline sleep quality, stress, and depressive symptoms, and subsequent headache occurrence in a six-week prospective cohort study of patients with episodic migraine.
Article in Headache, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 32 citations in OpenAlex.
- The relationship between psychological stress and SARS-CoV-2 nucleocapsid-antibody response following natural infection: longitudinal findings from the Aegis study.American journal of epidemiology · 2026Article
- Sleep and Headache Disorders: What a Clinician Needs to Know.Current neurology and neuroscience reports · 2026Review
- Forecasting migraine attacks by managing daily lifestyle: a systematic review as a basis to develop predictive algorithms.Pain reports · 2025Article
- Article
- High-risk area for migraine attacks - a new concept in migraine pathophysiology.Frontiers in neurology · 2025Article
- The Glymphatic System and its Relationship to Migraine.Current neurology and neuroscience reports · 2024Review
- Sleep Symptoms in Migraine.Current neurology and neuroscience reports · 2024Review
- Sleep Symptoms and Disorders in Episodic Migraine: Assessment and Management.Current pain and headache reports · 2023Review
- Episodic Migraine and Psychiatric Comorbidity: A Narrative Review of the Literature.Current pain and headache reports · 2023Review
- Should migraine without aura be further divided? A study of 1444 female patients with migraine without aura.The journal of headache and pain · 2023Article
- Interrelationships of Sleep Quality, Obesity Severity, and Clinical Headache Features among Women with Comorbid Migraine and Obesity.Journal of clinical medicine · 2023Article
- The association between multidimensional sleep health and migraine burden among patients with episodic migraine.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023Article
- Headache related to personal protective equipment in healthcare workers during COVID-19 pandemic in Mexico: baseline and 6-month follow-up.International archives of occupational and environmental health · 2022Article
- Development of a text message-based headache diary in adolescents and children.Cephalalgia : an international journal of headache · 2022Article
- Is there a causal relationship between stress and migraine? Current evidence and implications for management.The journal of headache and pain · 2021Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
OBJECTIVES/
backgroundDespite the high prevalence of sleep disturbance, stress, and depressive symptoms among patients with episodic migraine, there has been limited prospective research examining how these comorbid symptoms relate to future headache risk.
methodsWe conducted an a priori secondary analysis of a prospective cohort study of 98 adults with episodic migraine recruited through Harvard-affiliated medical centers and local college student clinics in Boston, MA. At baseline, participants completed validated questionnaires on sleep quality, stress, and depressive symptoms. Over the next 6 weeks, they recorded headaches on twice-daily diaries. We conducted time-to-event analyses to evaluate whether these baseline symptoms were associated with headache recurrence.
resultsAt baseline, 45/98 (46%) participants had poor sleep quality, 51/98 (52%) reported moderate/high stress levels, and 18/98 (18%) had high depressive symptom scores. Over 4,406 person-days, we observed 823 discrete headaches. In multivariable models, the hazard ratios for headache recurrence were: 1.22 (95% CI 1.02, 1.46) for people with baseline poor sleep, 1.12 (95% CI 0.93, 1.35) for those with baseline moderate/high stress compared to lower levels, and 1.31 (95% CI 1.05, 1.65) for the combination of poor sleep and moderate/high stress compared to the combination of good sleep and low stress. There was no association between depression scores and headache risk.
conclusionAmong patients with episodic migraine, poor sleep was associated with a higher rate of headache recurrence over the next 6 weeks, especially among those with coexisting moderate/high stress.
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