Gerilim Tipi Baş Ağrısı Olan Hastalarda Uyku Bozuklukları, Depresyon ve İlişkili Faktörlerin Değerlendirilmesi

Yıl 2021, , 120 - 124, 30.06.2021

Fettah Eren Şerefnur Öztürk

https://doi.org/10.15321/GenelTipDer.2021.297

Öz

Amaç: Gerilim tipi baş ağrısı (GTB) etiyolojisinde uyku bozukluğu önemlidir. Ağrı, uykunun birçok safhasına etki ederek uyku kalitesini bozmaktadır. Ayrıca, psikojenik etmenler de uyku kalitesini etkilemektedir. Bu nedenle GTB de uyku kalitesi, depresyon ve gündüz uykululuk durumu incelenmiştir.

Gereç ve Yöntem: Çalışmaya 50 GTB hastası ve 40 kontrol alındı. Ağrı sıklığı, süresi, şiddeti, analjezik miktarı ve tedaviye cevap sorgulandı. Ağrı şiddeti için Görsel Ağrı Skalası (VAS) kullanıldı. Hastalarda yaş, cinsiyet, medeni durum, yaşam ortamı, sigara ve alkol kullanımı, eğitim, maddi durum, kilo ve boy değerlendirildi. Pittsburgh Uyku Kalitesi İndeksi (PUKİ), Beck Depresyon Ölçeği (BDÖ) ve Epworth Uykululuk Ölçeği (EUÖ) uygulandı. PUKİ 0-5, 6-10 ve 10 üzeri olarak 3 gruba ayrıldı. Veriler SPSS Windows 16 sürümü ile değerlendirildi.

Bulgular: Çalışmada 50 (42 kadın, 8 erkek) hasta vardı. Ortalama±SD sonuçlar: yaş 37,92±14,18; boy 162,2±7,91; kilo 69,96±15,2; PUKİ 12,26±6,05; BDÖ 31,12±15,43 ve EUÖ 9,34±4,80 idi. Uyku süresi, latansı ve bozukluğu, ilaç sayısı ve PUKİ hastalarda daha yüksekti (p<0,01). Uyku kalitesi, gündüz uykululuğu, BDÖ ve EUÖ puanları benzerdi (p>0,05). Hastaların sosyodemografik özellikleri, ağrı şiddeti, analjezik kullanımı ile uyku bozukluğu arasında ilişki yoktu (p>0,05). BDÖ ile uyku bozukluğu ve gündüz uykululuk durumu arasında pozitif korelasyon vardı (p<0,05; r=0,57; 0,52).

Sonuç: GTB hastalarında uyku bozukluğu daha fazladır. Depresif durum arttıkça uyku bozukluğu ve gündüz uykululuğu artmaktadır. Bu nedenle bu hastalarda uyku bozukluğu ve depresyonun da sorgulanması önemlidir.

Anahtar Kelimeler

Baş ağrısı, uyku bozukluğu, depresyon

Evaluation of Sleep Disorders, Depression and Related Factors in Patients with Tension-type Headache

Öz

Objective: Sleep disorder is important in etiology of tension-type headache (TTH). Pain affects many stages of sleep and disrupts sleep quality. Also, psychogenic factors affect sleep quality. So, sleep quality, depression and daytime sleepiness were investigated in TTH.

Material and Methods: Fifty TTH patients and 40 controls were included to study. Pain frequency, duration, severity, amount of analgesic and response to treatment were questioned. Visual Pain Scale (VAS) was used for pain severity. Age, sex, marital status, living environment, smoking and alcohol use, education, financial status, weight and height were evaluated. Pittsburgh Sleep Quality Index (PSQI), Beck Depression Scale (BDI) and Epworth Sleepiness Scale (ESS) were made. PSQI was divided into 3 groups as 0-5, 6-10 and above 10. The results were evaluated with SPSS Windows 16 version.

Results: 50 patients (42 females, 8 males) were included to study. Mean±SD results: age 37.92±14.18; length 162.2±7.91; weight 69.96±15.2; PSQI 12.26±6.05; BDI 31.12±15.43 and ESS 9.34±4.80. Sleep duration, latency and disorder, drug count and PSQI were higher in patients (p<0.01). Sleep quality, daytime sleepiness, BDI and ESS scores were similar (p>0.05). There was no relationship between sociodemographic characteristics, pain severity, analgesic use and sleep disorder (p>0.05). There was a positive correlation between BDI and sleep disorder and daytime sleepiness (p<0.05; r=0.57; 0.52).

Conclusion: Sleep disorder is higher in patients with TTH. As depressive condition increases, sleep disorder and daytime sleepiness increase. Therefore, it is important to question sleep disorder and depression in these patients.

Anahtar Kelimeler

Headache, sleep disorder, depression

Kaynakça

• Global Burden of Disease Study C. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015;386:743-800.
• Fumal A, Schoenen J. Tension-type headache: current research and clinical management. Lancet Neurol 2008;7:70-83.
• Rasmussen BK, Jensen R, Schroll M, Olesen J. Epidemiology of headache in a general population-a prevalence study. J Clin Epidemiol 1991;44:1147-57.
• De Tommaso M, Fernández-de-las-Peñas C. Tension type headache. Curr Rheumatol Rev 2016;12:1-13.
• Cathcart S, Petkov J, Winefield AH, Lushington K, Rolan P. Central mechanisms of stress-induced headache. Cephalalgia 2010;30:285-95.
• Puca F, Genco S, Prudenzano MP, et al. Psychiatric comorbidity and psychosocial stress in patients with tension-type headache from headache centers in Italy. The Italian Collaborative Group for the Study of Psychopathological Factors in Primary Headaches. Cephalalgia 1999;19:159-64.
• Holroyd KA, Stensland M, Lipchik GL, et al. Psychosocial correlates and impact of chronic tension-type headaches. Headache 2000;40:3-16.
• Zebenholzer K, Lechner A, Broessner G, et al. Impact of depression and anxiety on burden and management of episodic and chronic headaches-a cross-sectional multicentre study in eight Austrian headache centres. J Headache Pain 2016;17:15.
• Barbanti P, Fabbrini G, Aurilia C, et al. A casecontrol study on excessive daytime sleepiness in episodic migraine. Cephalalgia 2007;27:1115-9.
• ICHD-III. International classification of headache disorder: Headache Classification Subcommittee of the International Headache Society, 3nd edition. Cephalalgia 2013;33:629-808.
• Ogon M, Krismer M, Söllner W, Kantner-Rumplmair W, Lampe A. Chronic low back pain measurement with visual analogue scales in different settings. Pain 1996;64:425-8.
• Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193-213.
• Johns MW. Sleepiness in different situations measured by the Epworth Sleepiness Scale. Sleep 1994;17:703-10.
• Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N. Psychometric properties of a Persian-language version of the Beck Depression Inventory-Second edition: BDI-II-PERSIAN. Depress Anxiety 2005;4:185-92.
• Almoznino G, Benoliel R, Sharav Y, Haviv Y. Sleep disorders and chronic craniofacial pain: characteristics and management possibilities. Sleep Med Rev 2017;33:39-50.
• Kelman L and Rains J. Headache and sleep: examination of sleep patterns and complaints in a large clinical sample of migraineurs. Headache 2005;45:904-10.
• Uhlig BL, Engstrøm M, Ødegård SS, Hagen KK, Sand T. Headache and insomnia in population-based epidemiological studies. Cephalalgia 2014;34:745-51.
• Kikuchi H, Yoshiuchi K, Yamamoto Y, Komaki G, Akabayashi A. Does sleep aggravate tension-type headache? An investigation using computerized ecological momentary assessment and actigraphy. Biopsychosoc Med 2011;5:10.
• Caspersen N, Hirsvang JR, Kroell L, et al. Is there a relation between tension-type headache, temporomandibular disorders and sleep?. Pain Res Treat 2013;2013:845684.
• Probyn K, Bowers H, Caldwell F, et al. CHESS Team. Prognostic factors for chronic headache: a systematic review. Neurology 2017;89:291-301.
• Spiegelhalder K, Regen W, Nanovska S, Baglioni C, Riemann D. Comorbid sleep disorders in neuropsychiatric disorders across the life cycle. Curr Psychiatry Rep 2013;15:364.
• Ferrari AJ, Somerville AJ, Baxter AJ, et al. Global variation in the prevalence and incidence of majör depressive disorder: a systematic review of the epidemiological literature. Psychol Med 2013;43:471-81.
• Baxter AJ, Scott KM, Vos T, Whiteford HA. Global prevalence of anxiety disorders: a systematic review and meta-regression. Psychol Med 2013;43:897-910.
• Song TJ, Cho SJ, Kim WJ, et al. Anxiety and depression in tension-type headache: a population-based study. PLoS One 2016;11:e0165316.
• Ashina S, Bendtsen L, Buse DC, et al. Neuroticism, depression and pain perception in migraine and tension‐type headache. Acta Neurol Scand 2017;136:470-6.
• Palacios-Ceña M, Fernández-Muñoz JJ, Castaldo M, et al. The association of headache frequency with pain interference and the burden of disease is mediated by depression and sleep quality, but not anxiety, in chronic tension type headache. J Headache Pain 2017;18:19.
• Houle TT, Butschek RA, Turner DP, et al. Stress and sleep duration predict headache severity in chronic headache sufferers. Pain 2012;153:2432-40.