Evidence map›Paper›PMID 40970583›Full record

ArticleHeadache2026

Insomnia severity in migraine: The role of headache frequency, aura status, and comorbidities-A cross-sectional study.

Kuang-Heng Lee, Chih-Sung Liang, Po-Kuan Yeh, Chia-Kuang Tsai, Chia-Lin Tsai, Yu-Kai Lin, Guan-Yu Lin, Ming-Chen Tsai, Yi Liu, Yuan-Zhen Ruan and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Headache, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Kuang-Heng LeeDepartment of Neurology, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan.
Chih-Sung LiangDepartment of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan.ORCID 0000-0003-1138-5586
Po-Kuan YehDepartment of Neurology, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan.
Chia-Kuang TsaiDepartment of Neurology, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan.
Chia-Lin TsaiDepartment of Neurology, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan.
Yu-Kai LinDepartment of Neurology, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan.
Guan-Yu LinDepartment of Neurology, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan.
Ming-Chen TsaiDepartment of Neurology, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan.
Yi LiuDepartment of Neurology, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan.
Yuan-Zhen RuanDepartment of Neurology, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan.
Fu-Chi YangDepartment of Neurology, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan.ORCID 0000-0001-6831-3634

Funding

Cheng Hsin General Hospital Foundation CHNDMC-114-03Tri-Service General Hospital TSGH-D-113108Tri-Service General Hospital TSGH-D-114105
6 · The paper itself

Abstract

objectiveThis study was conducted to investigate the association between migraine frequency and insomnia severity.

backgroundMigraine and insomnia frequently co-occur, yet the relationship between migraine characteristics and insomnia severity remains poorly understood. Both conditions substantially impair quality of life and daily functioning, potentially because of shared pathophysiological mechanisms. In this study, we investigated the association between migraine frequency and insomnia severity and examined the impact of aura, psychological factors, and restless legs syndrome (RLS).

methodsThis cross-sectional controlled study included 2155 participants (1954 individuals with migraine and 201 controls) who visited the neurology outpatient department of a tertiary medical center between January 2019 and October 2023. Migraine diagnosis adhered to the International Classification of Headache Disorders, 3rd edition criteria, with all participants evaluated by a board-certified neurologist and headache specialist. Insomnia severity was assessed using the Insomnia Severity Index (ISI), and psychological factors were measured using the Beck Depression Inventory-II and Hospital Anxiety and Depression Scale. RLS was diagnosed as per international criteria, and individuals with migraine were stratified by headache frequency (1-7, 8-14, or ≥15 days/month) and aura status.

resultsHigh migraine frequency was associated with increased ISI scores (adjusted regression coefficient [β] = 0.75, 95% confidence interval [CI], 0.50-1.01) and increased prevalence of clinical insomnia (ISI ≥ 15) (adjusted odds ratio [aOR] = 1.34; 95% CI, 1.17-1.53) after controlling for demographic, lifestyle, and clinical factors. In the univariate analysis, patients with migraine with aura showed higher ISI scores than those without aura (p < 0.001); however, this difference was no longer significant after adjustment for migraine frequency, depression, anxiety, RLS, and other confounders (adjusted β = 0.48; 95% CI, -0.24 to 1.20; p = 0.191). Multivariable analyses revealed significant associations between ISI total score and depression (adjusted β = 0.21; 95% CI, 0.17-0.24), anxiety (adjusted β = 0.34; 95% CI, 0.27-0.41), and RLS (adjusted β = 1.02; 95% CI, 0.53-1.51). RLS prevalence was significantly higher in the migraine group than in the control group (32.4% vs. 12.9%).

conclusionsMigraine frequency showed a graded association with insomnia severity, with additional independent contributions from psychological factors and RLS, but not from aura status. These findings underscore the multifactorial nature of sleep disturbances in migraine and the need for comprehensive management strategies that address both headache-specific factors and comorbid conditions.

Indexed as

Migraine DisordersMigraine with AuraRestless Legs SyndromeSleep Initiation and Maintenance DisordersAdultComorbidityCross-Sectional StudiesFemaleHumansMaleMiddle AgedSeverity of Illness Indexanxietyauradepressioninsomniamigrainerestless legs syndrome

Identifiers

PMID40970583
PMCPMC12951709

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.