Sleep Disturbances In School-Aged Children With Migraine: A Cross-Sectional Comparative Study Using Subjective And Objective Measures
Keywords:
Paediatric migraine, sleep disturbances, actigraphy, CSHQ, PSQ, sleep quality, headache frequency, sleep latencyAbstract
Background: Migraine is a prevalent neurological condition in children, often co-occurring with significant sleep disturbances. Although previous studies have explored this relationship, few have integrated both subjective and objective sleep assessments, particularly in Indian paediatric populations.
Objectives: To evaluate the pattern and severity of sleep disturbances in school-aged children with migraine using validated subjective tools and actigraphy, and to analyze their association with migraine frequency and severity.
Methods: A cross-sectional, case-control study was conducted involving 120 children aged 6–12 years: 60 with migraine (diagnosed per ICHD-3 criteria) and 60 age- and sex-matched healthy controls. Subjective sleep assessments included the Children’s Sleep Habits Questionnaire (CSHQ), Paediatric Sleep Questionnaire (PSQ), and a 7-day sleep diary. A subsample (n = 30 per group) underwent actigraphy for objective sleep analysis. Headache frequency, intensity, and clinical features were documented. Statistical analyses included t-tests, Pearson correlations, and multivariate linear regression.
Results: Children with migraine had significantly higher CSHQ scores (51.2 ± 6.4 vs. 44.3 ± 4.9, p < 0.001), especially in bedtime resistance, sleep onset delay, and night wakings. PSQ scores were also elevated (4.3 ± 1.4 vs. 2.8 ± 1.2, p < 0.001), indicating increased sleep-disordered breathing. Actigraphy confirmed reduced total sleep time (7.2 ± 0.8 vs. 8.1 ± 0.6 hours, p < 0.01), lower sleep efficiency (84.1% vs. 91.2%, p < 0.001), and prolonged sleep latency. Significant correlations were found between migraine frequency and CSHQ total score (r = 0.52), as well as actigraphy-derived sleep measures. Migraine frequency and sleep onset delay were independent predictors of poor sleep (Model R² = 0.38, p < 0.001).
Conclusion: School-aged children with migraine exhibit multidimensional sleep disturbances as measured by both subjective and objective tools. Higher headache frequency is significantly associated with greater sleep impairment. These findings support routine screening for sleep issues in paediatric migraine care and highlight the potential value of targeted sleep interventions in mitigating headache burden.
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