Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20210068
Brazilian Journal of Pain
Review Article

Migraine and sleep deprivation: integrative review

Migrânea e privação do sono: revisão integrativa

Tania Gouvêa Thomaz; Ana Ester Amorim de Paula; Daniel de Moraes Alves; Luana Lemos Alves; Pedro Guilherme Mol da Fonseca

http://dx.doi.org/10.5935/2595-0118.20210068 BrJP, vol.4, n4, p.379-387, 2021
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Abstract

BACKGROUND AND OBJECTIVES: Migraine is a type of primary headache, and its pathophysiology remains incomplete. The relationship between sleep and migraine is easily identified by migraine patients. The aim of this review was to investigate the relationship between sleep deprivation and migraine.

CONTENTS: A search was made for articles using the terms: “migraine” and “sleep deprivation” in the Pubmed, Biblioteca Virtual da Saúde (Virtual Health Library - LILACS and IBECS) and Scielo databases. The first analysis was based on title and abstract. In cases where the title and abstract were not clear, the article was accessed in its entirety. After applying the exclusion criteria, 49 articles remained. These articles were analyzed and organized into two tables: one for articles that treated sleep as a trigger and the other for articles that explored the pathophysiological relationship between sleep and migraine.

CONCLUSION: It is possible that sleep deprivation causes or worsens migraine crisis due to its ability to cause oxidative stress in the brain. This in turn activates TRPA1 receptors located on first-order trigeminal neurons. Activation of these receptors initiates the sensitization process of the trigeminal system that culminates with the antidromic release of calcitonin gene-related peptide in the dural afferents of these neurons in the trigeminal ganglion. The relationship between insomnia and migraine seems to converge with this same pathophysiological process, since sleep deprivation imposed by insomnia would be able to generate a migraine crisis through increased oxidative stress.

Keywords

Headache, Migraine disorders, Sleep deprivation

Resumo

JUSTIFICATIVA E OBJETIVOS: Migrânea é um tipo de cefaleia primária e sua fisiopatologia permanece incompleta. A relação entre o sono e a migrânea é facilmente identificada pelos pacientes migranosos. O objetivo deste estudo foi investigar a relação entre privação de sono e a migrânea.

CONTEÚDO: Foi feita uma busca por artigos utilizando os termos: “migraine” e “sleep deprivation” nas bases de dados Pubmed, Biblioteca Virtual da Saúde (LILACS e IBECS) e Scielo. A primeira análise foi feita com base no título e no resumo. Nos casos em que o título e o resumo não foram esclarecedores, o artigo foi acessado na íntegra. Após a aplicação dos critérios de exclusão, restaram 49 artigos. Estes artigos foram analisados e organizados em duas tabelas: uma destinada aos artigos que tratavam o sono como um gatilho e a outra com artigos que exploravam a relação fisiopatológica entre sono e migrânea.

CONCLUSÃO: É possível que a privação do sono provoque ou agrave as crises de migrânea devido a sua capacidade de causar estresse oxidativo no cérebro, que ativa receptores TRPA1 localizados nos neurônios trigeminais de 1a ordem. A ativação destes receptores inicia o processo de sensibilização do sistema trigeminal que culmina com a liberação antidrômica de peptídeo relacionado ao gene da calcitonina nos aferentes durais destes neurônios no gânglio trigeminal. A relação da insônia com a migrânea parece confluir para este mesmo processo fisiopatológico, já que a privação de sono imposta pela insônia seria capaz de gerar a crise migranosa através do aumento do estresse oxidativo.

Palavras-chave

Cefaleia, Privação do sono, Transtornos de migrânea

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Submitted date:
08/04/2021

Accepted date:
09/21/2021

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