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Does sleep aggravate tension-type headache?: An investigation using computerized ecological momentary assessment and actigraphy

机译：睡眠会加剧紧张型头痛吗？：使用计算机生态瞬时评估和书法的调查

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Background Both insufficient sleep and oversleeping have been reported as precipitating and aggravating factors of tension-type headache (TTH). However, previous studies relied on recalled self-reports, and the relationship has not been confirmed prospectively and objectively in a daily life situation. Recently, ecological momentary assessment (EMA) using electronic diaries, i.e., computerized EMA, is used to record subjective symptoms with the advantages of avoiding recall bias and faked compliance in daily settings. In addition, actigraphy has become an established method to assess sleep outside laboratories. Therefore, the aim of this study was to investigate the within-individual effect of sleep on the following momentary headache intensity in TTH patients during their daily lives utilizing EMA and actigraphy. Methods Twenty-seven patients with TTH wore watch-type computers as electronic diaries for seven consecutive days and recorded their momentary headache intensity using a visual analog scale of 0-100 approximately every six hours, on waking up, when going to bed, and at the time of headache exacerbations. They also recorded their self-report of sleep quality, hours of sleep and number of awakenings with the computers when they woke up. Physical activity was continuously recorded by an actigraph inside the watch-type computers. Activity data were analyzed by Cole's algorithm to obtain total sleep time, sleep efficiency, sleep latency, wake time after sleep onset and number of awakenings for each night. Multilevel modeling was used to test the effect of each subjective and objective sleep-related variable on momentary headache intensity on the following day. Results Objectively measured total sleep time was significantly positively associated with momentary headache intensity on the following day, while self-reported sleep quality was significantly negatively associated with momentary headache intensity on the following day. Conclusions Using computerized EMA and actigraphy, longer sleep and worse sleep quality were shown to be related to more intense headache intensity on within-individual basis and they may be precipitating or aggravating factors of TTH.
机译：背景技术睡眠不足和过度睡眠均被报道为紧张型头痛（TTH）的诱发因素和加重因素。但是，以前的研究依赖于回忆的自我报告，在日常生活中，这种关系尚未得到前瞻性和客观的证实。近来，使用电子日记，即计算机化的EMA的生态瞬时评估（EMA）被用于记录主观症状，其优点是避免了在日常情况下的召回偏见和伪造的依从性。另外，书法术已经成为评估实验室外部睡眠的既定方法。因此，本研究的目的是利用EMA和书法检查睡眠对TTH患者日常生活中随后的瞬间头痛强度的个体内部影响。方法27例TTH患者连续7天佩戴手表式计算机作为电子日记，并在大约6小时，醒着，睡觉时和睡觉时使用视觉模拟量表（0-100）记录他们的瞬时头痛强度。头痛加剧的时间。他们还用计算机记录了自己的睡眠质量，睡眠时间和醒来次数的自我报告。手表型计算机内部的活动记录仪连续记录了体育活动。通过Cole算法对活动数据进行分析，以获得总的睡眠时间，睡眠效率，睡眠潜伏期，入睡后的唤醒时间以及每晚的清醒次数。第二天使用多层次建模来测试每个主观和客观睡眠相关变量对瞬时头痛强度的影响。结果客观测量的总睡眠时间与第二天的瞬时头痛强度显着正相关，而自我报告的睡眠质量与第二天的瞬时头痛强度显着负相关。结论使用计算机化EMA和书法，在个人内部显示更长的睡眠时间和更差的睡眠质量与更剧烈的头痛强度有关，它们可能是TTH的诱发或加重因素。

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