Researchers at the Mayo Clinic have found that frequent headaches in children appear to be associated with sleep problems.
The study, led by Kenneth Mack, M.D., Ph.D., paediatric neurologist specializing in headache, found that more than two-thirds of children studied who suffer from chronic daily headache also experience sleep disturbance, especially delay in sleep onset, and that of the children with episodic headaches, one-fifth had sleep problems.
Dr Mack said that the researchers had undertaken this study to scientifically study their observation in the clinic that many children suffer from both headaches and sleep problems.
"The number of patients who have headaches and also sleep disturbance surprised us. We've continually seen that children with headaches are poor sleepers and that they're fatigued because they have poor sleep. We've known that when people don't get enough sleep they get more headaches, but we'd not appreciated the frequency of sleep disturbance with chronic daily headache," he said.
The study involved a retrospective chart review of 100 children ages 6 to 17 with chronic daily headache - headache present 15 or more days a month for three months or more, and 100 children in the same age category with episodic headache - headache that occurs with less frequency than chronic daily headache.
In addition to sleep onset delay, sleep problems found in children studied included awakening during the night or too early in the morning, or not feeling refreshed after sleep.
{{/usCountry}}In addition to sleep onset delay, sleep problems found in children studied included awakening during the night or too early in the morning, or not feeling refreshed after sleep.
{{/usCountry}}Dr Mack further said that sleep problems and headaches fed each other, and that only when sleep problems were brought under control either with medication or non-medication treatment, could the problem of headaches be brought under control.
"They feed on each other: sleep problems make the headaches worse, and the headaches make the sleep problems worse. Also, the worse the headaches, the more likely children are to have sleep problems, and vice versa. They could have a common cause, or one problem could be an early sign of the other. It's going to be hard to control the headaches till you get the sleep problems under control either with medication or non-medication treatment," he added.
According to Lenora Lehwald, M.D., Mayo Clinic neurology resident and study investigator, one step in stopping headaches was by inculcating good sleep hygiene in children.
"Educating the patient and family on things like good sleep habits may in and of itself help to improve the sleep quality and thus the headaches in the long run. A child should use his bedroom for just the types of activities that would be sedating and relaxing. TVs, video games - things that are exciting and get the child interested, motivated and activated - should not be in the bedroom. Also, it's important for children to have a routine for calming down and preparing for sleep the last hour they plan to be awake. They should choose activities that make them drowsy, like reading," she said.
The study also found that age is one factor that puts children at risk for headache. Teenagers have the highest level of risk which may be partly due to a higher stress level for teens than for younger children. It was also noted that a typical teen gets less than the 9.5 hours of sleep per night that is needed. Family history of headache, time of year and stress level also appear to impact headache risk, say the researchers.
The study further revealed that 10 to 20 percent of children have episodic headache. Chronic daily headache occurs in up to 4 percent of girls and up to 2 percent of boys.
The findings will be presented at the 24th Annual Conference on Sleep Disorders in Infancy and Childhood in Rancho Mirage, California.