The Silent Saboteur: The Impact of Headaches on Sleep Quality, Central Sensitization, Depression, Anxiety, and Stress

Introduction: This study aimed to investigate the impacts of primary headaches on sleep quality, central sensitization (CS), and psychological factors, including depression, anxiety, and stress, to provide insights for an integrated management approach in patients with headaches. Headache is a common public health problem. Understanding the multifaceted impact of these conditions on various health aspects is essential for comprehensive headache management.
Methods: This descriptive observational study included individuals with primary headaches and asymptomatic controls. Participants were categorized into two groups based on the presence of headaches: A headache group and a headache-free group. Assessments were conducted in a sequential manner to evaluate sleep quality, CS, and emotional well-being, using the Pittsburgh Sleep Quality Index, CS inventory, and Depression, Anxiety, and Stress Scale-21, respectively. Group differences were analyzed using independent t-tests.
Results: The study included 78 individuals with primary headaches and 54 asymptomatic controls. The headache group showed significantly poorer sleep quality (p<0.001), increased CS (p<0.001), and higher levels of psychological distress, including depression (p=0.008), anxiety (p<0.001), and stress (p<0.001), compared to the headache-free group.
Discussion and Conclusion: These findings emphasize the compounded impact of headaches on both physical and psychological health parameters. The observed differences in sleep quality, CS, and psychological distress between the headache and headache-free groups highlight the need for a multidisciplinary approach to headache management. Addressing these interconnected aspects may enable improvement in therapeutic outcomes and quality of life in individuals with headaches.

Keywords: Central nervous system sensitization; Depression; Headache; Migraine disorders; Sleep