Kronik migren ve insomnia hastasında bilişsel davranışçı terapi uygulamasının sonuçları

Öz

Uyku ve migren arasındaki ilişki karmaşık ve iki yönlüdür. Migren özellikle uykusuzlukla birlikte görülür ve uykusuzlukla tetiklenir. Bilişsel davranışçı terapi (BDT), kronik ağrısı olan kişilerde uykuyu iyileştirmede etkili bir tedavi olma potansiyeline sahiptir. Kronik migreni olan bireylerde eşlik eden uykusuzluğun davranışsal tedavisi, baş ağrısı sıklığında önemli bir azalma sağlamıştır. Kronik uykusuzluk ve kronik migreni olan 45 yaşındaki kadın hastamızda ağrı için BDT uygulamasının baş ağrısı ve uyku üzerinde olumlu etkileri olduğunu gözlemlediğimiz bu vakayı sunuyoruz.

Anahtar Kelimeler

• Kronik migren
• Uykusuzluk
• Bilişsel davranışçı terapi

Results of cognitive behavioral therapy in patients with chronic migraine and insomnia

Öz

The relationship between sleep and migraine is complex and bidirectional. Migraine is particularly seen with insomnia and triggered by insomnia. Cognitive behavioral therapy (CBT) has the potential to be an effective treatment for improving sleep in people with chronic pain. Behavioral treatment of comorbid insomnia in individuals with chronic migraine has resulted in a significant reduction in headache frequency. We wanted to present our case because we observed that the application of CBT for pain had positive effects on headache and sleep in our 45-year-old female patient with chronic insomnia and chronic migraine.

Anahtar Kelimeler

• Chronic migraine
• Insomnia
• Cognitive behavioral therapy

Kaynakça

1. Tiseol C, Vacca A, Felbush A, Filimonova T, Gai A, Glazyrina T. Migraine and sleep disorders: a systematic review. J Headache Pain .2020; 21:126 https://doi.org/10.1186/s10194-020-01192-5
2. Smitherman TA, Walters BA, Davis RE, et al. Randomized controlled pilot trial of behavioral insomnia treatment for chronic migraine with comorbid insomnia. Headache. 2016 ;56:276-91. https://doi.org/10.1111/head.12760
3. Yang CP, Wang SJ. Sleep in patients with chronic migraine. Curr Pain Headache Rep. 2017;21:39. https://doi.org/10.1007/s11916-017-0641-9
4. Whale K, Dennis J, Wylde V, Beswick A, Gooberman R. The effectiveness of non-pharmacological sleep interventions for people with chronic pain: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2022;23:440. https://doi.org/10.1186/s12891-022-05318-5
5. American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed. Darien, IL. Am Acad Sleep Med. 2014;3rd edition.
6. Headache Classification Committee of the International Headache Society (IHS), The International Classification of Headache Disorders, Third ed., 38, Cephalalgia,, 2018, pp. 1–211.
7. Saçmacı H , Tanik N, İnan LE. Current perspectives on the ımpact of chronic migraine on sleep quality: A literature review. Nat Sci Sleep. 2022 ;14:1783-1800. https://doi.org/10.2147/NSS.S335949
8. Kelman L. The triggers or precipitants of the acute migraine attack. Cephalalgia. 2007;27:394–402. https://doi.org/10.1111/j.1468-2982.2007.01303.x

9. Vgontzas A, Pavlović JM. Sleep disorders and migraine: Review of literature and potential pathophysiology mechanisms. Headache. 2018;58:1030–1039. https://doi.org/10.1111/head.13358
10. Gardani M, Bradford DRR, Russell K, et al. A systematic review and meta-analysis of poor sleep, insomnia symptoms and stress in undergraduate students. Sleep Med Rev. 2022;61:101565. https://doi.org/10.1016/j.smrv.2021.101565
11. Sandoe CH, Sasikumar S, Lay C, Lawler V. The impact of shift work on migraine: a case series and narrative review. Headache. 2019;59:1631–1640. https://doi.org/10.1111/head.13622
12. Law EF, Ritterband L, Zhou C, Palermo TM. Intervention for Sleep and Pain in Youth (ISPY-RCT): protocol for a two-phase randomized controlled trial of sequenced cognitive-behavioral therapy for insomnia and pain management in adolescents with migraine. Trials. 2023 ;24:25. https://doi.org/10.1186/s13063-022-07035-9
13. Calhoun AH, Ford S. Behavioral sleep modification may revert transformed migraine to episodic migraine. Headache. 2007;47(8):1178-83. https://doi.org/10.1111/j.1526-4610.2007.00780.x
14. Ong JC, Park M. Chronic headaches and insomnia: Working toward a biobehavioral model. Cephalalgia. 2012;32(14):1059-70. https://doi.org/10.1177/0333102412455709
15. Goder R, Fritzer G, Kapsokalyvas A, et al. Polysomnographic findings in nights preceding a migraine attack. Cephalalgia 2001;21(1): 31–37. https://doi.org/10.1046/j.1468-2982.2001.00141.x
16. Drake Jr ME, Pakalnis A, Andrews JM and Bogner JE. Nocturnal sleep recording with cassette EEG in chronic headaches. Headache 1990; 30(9): 600–603. https://doi.org/10.1111/j.1526-4610.1990.hed3009600.x
17. Dexter JD. The relationship between stage III+ IV+ REM sleep and arousals with migraine. Headache. 1979; 19(7): 364–369. https://doi.org/10.1111/j.1526-4610.1979.hed1907364.x