Sleep disturbances and quality of life in Sub-Saharan African migraineurs
Research article
1 Department of Epidemiology, Harvard T.H. Chan School of Public Health Multidisciplinary International Research Training Program, 677 Huntington Ave, K505F, Boston 02115, MA, USA
2 Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
3 Department of Mathematics Statistics, Georgetown University, Washington, DC, USA
4 Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
The Journal of Headache and Pain 2015, 16:18Â
doi:10.1186/s10194-015-0504-x
Published: 4 March 2015
Abstract (provisional)
Background Although in the past decade occidental countries have increasingly recognized
the personal and societal burden of migraine, it remains poorly understood in Africa.
No study has evaluated the impact of sleep disturbances and the quality of life (QOL)
in sub-Saharan Africans with migraine. Methods This was a cross-sectional study evaluating
adults, ? 18Â years of age, attending outpatient clinics in Ethiopia. Standardized
questionnaires were utilized to collect demographic, headache, sleep, lifestyle, and
QOL characteristics in all participants. Migraine classification was based on International
Classification of Headache Disorders (ICHD)-II criteria. The Pittsburgh Sleep Quality
Index (PSQI) and the World Health Organization Quality of Life (WHOQOL-BREF) questionnaires
were utilized to assess QOL and sleep quality characteristics, respectively. Multivariable
logistic regression models were fit to estimate adjusted odds ratio (OR) and 95% confidence
intervals. Results Of 1,060 participants, 145 (14%) met ICHD-II criteria for migraine.
Approximately three-fifth of the study participants (60.5%) were found to have poor
sleep quality. After adjustments, migraineurs had over a two-fold increased odds (OR?=?2.24,
95%CI 1.49-3.38) of overall poor sleep quality (PSQI global score gt;5) as compared
with non-migraineurs. Compared with non-migraineurs, migraineurs were also more likely
to experience short sleep duration (?7Â hours) (OR?=?2.07, 95%CI 1.43-3.00), long sleep
latency (?30Â min) (OR?=?1.97, 95%CI 1.36-2.85), daytime dysfunction due to sleepiness
(OR?=?1.51, 95%CI 1.12-2.02), and poor sleep efficiency (lt;85%) (OR?=?1.93, 95%CI
1.31-2.88). Similar to occidental countries, Ethiopian migraineurs reported a reduced
QOL as compared to non-migraineurs. Specifically Ethiopian migraineurs were more likely
to experience poor physical (OR?=?1.56, 95% CI 1.08-2.25) and psychological health
(OR?=?1.75, 95% CI 1.20-2.56), as well as poor social relationships (OR?=?1.56, 95%
CI 1.08-2.25), and living environments (OR?=?1.41, 95%CI 0.97-2.05) as compared to
those without migraine. Conclusion Similar to occidental countries, migraine is highly
prevalent among Ethiopians and is associated with poor sleep quality and a lower QOL.
These findings support the need for physicians and policy makers to take action to
improve the quality of headache care and access to treatment in Ethiopia.