The Prevalence and Characteristics of Primary Headache and Dream-Enacting Behaviour in Japanese Patients with Narcolepsy or Idiopathic Hypersomnia: A Multi-Centre Cross-Sectional Study

PLoS One. 2015 Sep 29;10(9):e0139229. doi: 10.1371/journal.pone.0139229. eCollection 2015.

Abstract

Background: Because the prevalence and characteristics of primary headache have yet to be thoroughly studied in patients with hypersomnia disorders, including narcolepsy and idiopathic hypersomnia, we examined these parameters in the Japanese population.

Methods: In a multicentre cross-sectional survey, among 576 consecutive outpatients with sleep disorders, 68 narcolepsy patients and 35 idiopathic hypersomnia patients were included. Additionally, 61 healthy control subjects participated. Semi-structured headache questionnaires were administered to all participants.

Results: The patients with narcolepsy (52.9%) and idiopathic hypersomnia (77.1%) more frequently experienced headache than the healthy controls (24.6%; p<0.0001). The prevalence rates were 23.5%, 41.2% and 4.9% for migraine (p<0.0001) and 16.2%, 23.5% and 14.8% (p = 0.58) for tension-type headache among the narcolepsy patients, the idiopathic hypersomnia patients and the control subjects, respectively. Those who experienced migraine more frequently experienced excessive daytime sleepiness, defined as an Epworth Sleepiness Scale score of ≥10, than those who did not experience headache among the patients with narcolepsy (93.8% vs. 65.6%, p = 0.040) and idiopathic hypersomnia (86.7% vs. 37.5%, p = 0.026). Dream-enacting behaviour (DEB), as evaluated by the rapid eye movement sleep disorders questionnaire, was more frequently observed in the narcolepsy patients than in the idiopathic hypersomnia patients and the control subjects. An increased DEB frequency was observed in the narcolepsy patients with migraines compared to those without headache.

Conclusions: Migraines were frequently observed in patients with narcolepsy and idiopathic hypersomnia. DEB is a characteristic of narcolepsy patients. Further studies are required to assess the factors that contribute to migraines in narcolepsy and idiopathic hypersomnia patients.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Asian People / statistics & numerical data
  • Comorbidity
  • Cross-Sectional Studies
  • Disorders of Excessive Somnolence / epidemiology*
  • Disorders of Excessive Somnolence / ethnology
  • Female
  • Headache / epidemiology*
  • Headache / ethnology
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Migraine Disorders / epidemiology
  • Migraine Disorders / ethnology
  • Narcolepsy / epidemiology*
  • Narcolepsy / ethnology
  • Outpatients / statistics & numerical data
  • Polysomnography
  • Prevalence
  • REM Sleep Behavior Disorder / epidemiology*
  • REM Sleep Behavior Disorder / ethnology
  • Surveys and Questionnaires*
  • Young Adult

Grants and funding

This study was supported by a grant from the Japanese Society of Sleep Medicine (Dr. K Suzuki was the recipient of a Young Investigator Award from the Japanese Society of Sleep Medicine in 2012). Sleep & Stress Clinic and Kokubunji Sakura Clinic provided support in the form of salaries for authors K Hayashida and YU and M Murata respectively, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the‘author contributions’ section.