Migraine and insufficient sleep: The effect of sleep restriction on nociceptive evoked potentials in migraine

Background The association between insufficient sleep and migraine is largely unexplained. In this blinded cross-over study we investigate whether insufficient sleep disturbs processing of nociceptive signals more in individuals with migraine compared to those without migraine. Methods Evoked potentials to nociceptive laser stimuli and high density electrical dermal stimuli were recorded in migraine and control subjects after two nights of habitual sleep and after two nights of sleep restriction (4 h sleep/night). Researchers conducting the measurements and data processing were blinded to diagnosis and sleep condition. Both recordings were interictal in 21 migraine subjects. Amplitudes, amplitude habituation and latencies were compared to measurements in 31 controls. Results Electrically induced N2P2 amplitude showed more habituation after sleep restriction compared to habitual sleep in the migraine group (p < 0.025). The migraine group also had less N2P2 amplitude habituation after habitual sleep compared to the control group (p < 0.035). We found no effect of sleep restriction on N2P2 amplitude habituation to laser stimulation, and no effect of sleep restriction on N2P2 amplitudes. Conclusion Insufficient sleep may slightly increase cortical inhibitory responses in migraine. Our findings support that migraine is associated with a vulnerability for insufficient sleep between attacks.