Could sleep disturbances link migraine and mood disorders?

People who have migraine are more likely to have a mood disorder than people who do not have migraine1, but the reason has not been clear. New findings presented at ISBD 2020 suggest shared aetiologic factors, such as sleep disturbance, motor activity, stress reactivity, and pain might explain the comorbidity.

Migraine is strongly associated with mood and anxiety disorders,1 said Professor Martin Preisig, University of Lausanne:

One-third of people with bipolar disorder experience migraine

  • one in three people with bipolar disorder (BD) have migraine2 — compared with one in seven of the general population3
  • the relative risk of major depressive disorder (MDD) among people with migraine is 2.2–4.04

Do migraine and mood disorders have shared aetiologic factors?

To determine whether migraine might cause a mood disorder, or a mood disorder might cause migraine, or whether migraine and mood disorders might have a common aetiology, Professor Preisig and his colleagues analysed data from:

  • a clinical family study of treated patients with BD-I or MDD and clinical controls and over 1400 adult first-degree relatives
  • a population-based family study (CoLaus|PsyCoLaus)6 with more than 800 first-degree relatives

Family studies may provide information about the causes of migraine and mood disorder comorbidity5

They found that among the relatives:

  • migraine was significantly associated with MDD and BD-I in the clinical study,
  • migraine was significantly associated with MDD but not BD-I in the population-based study

The increased risk of migraine among relatives of patients with BD-I could indicate partially shared aetiologic factors underlying BD-I and migraine, concluded Professor Preisig.

Do sleep disturbances explain the comorbidity of migraine and mood disorders?

Kathleen Merikangas of the Intramural Research Program, National Institute of Mental Health (NIMH), described an investigation she had carried out with colleagues of participants in the NIMH family study.7 The population included 512 adult patients from community and nonclinical settings and 1444 relatives.

Could sleep disturbance and sad or anxious mood be real-time predictors of incident migraine?

Statistically significant differences were seen among the children of patients for an association between the lifetime prevalence of migraine and generalised anxiety disorder, MDD, social anxiety, BPD-II, and panic disorder, but not for BPD-I.

Manifestations of migraine and mood disorder subtypes may underlie this comorbidity, Dr Merikangas explained, for instance sleep disturbances.

Dr Merikangas and her colleagues are therefore investigating the real-time relationship between mood, sleep quality, and migraine in people with mood disorders and migraine using a variety of monitoring technologies.

It is hoped that the results will reveal whether sleep disturbances and sad or anxious mood are real-time predictors of incident migraine.

Our correspondent’s highlights from the ISBD 2020 symposium are meant as a fair representation of the scientific content presented. The views and opinions expressed on this page do not necessarily reflect those of Lundbeck.

 

AU-NOTPR-0270. December 2020

References
  1. Low NCP, Merikangas KR. CNS Spectr 2003;8:433–44.
  2. Fornaro M, Stubbs B. J Affect Dis 2015;178:88–97.
  3. https://www.migrainetrust.org/about-migraine/migraine-what-is-it/facts-figures/
  4. Martin PR, et al. Behav Res Ther 2015;73:8–18.
  5. Merikangas KR, et al. Psychol Med 1994;24:69–80.
  6. Vollenweider P, et al. Revue Medicale Suisse  2019;15:2159–63 [French]
  7. https://www.nimh.nih.gov/research/research-conducted-at-nimh/join-a-study/trials/adult-studies/nimh-family-study-of-health-and-behavior.shtml
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