Linking photophobia, sleep disturbances, and migraine chronicity: evidence from a retrospective analysis

Abstract

Background: Interictal photophobia and sleep disturbances are common in migraine patients and may contribute to migraine chronicity. However, the interplay between these symptoms and their role in the progression from episodic migraine (EM) to chronic migraine (CM) is not fully understood. This study investigates the association of ictal and interictal photophobia and sleep disturbances with CM. Methods: We conducted a retrospective analysis of 500 patients diagnosed with migraine based on the International Classification of Headache Disorders (ICHD-3) criteria. Patients were classified into EM and CM groups. Data on photophobia, sleep disturbances, and clinical characteristics were collected. Logistic regression and network analyses were performed to identify predictors and explore symptom interconnections. Results: Among 500 participants (mean age: 41.03 +/- 11.06 years84.2% female), 311 had EM, and 189 had CM. Ictal photophobia was present in 89.8% and interictal photophobia in 93.4% of patients, with 61.0% reporting severe interictal photophobia. Sleep disturbances were common, with 44.9% reporting difficulty falling asleep. Logistic regression identified medication overuse (OR: 5.007, 95% CI: 3.01-8.31, p < 0.001) and aura (OR: 0.226, 95% CI: 0.07-0.71, p = 0.012) as significant predictors of CM. Network analysis revealed stronger associations between interictal photophobia, daytime sleepiness, and medication overuse in CM compared to EM. Conclusions: Interictal photophobia and sleep disturbances are significant factors in the chronicity of migraine. These findings suggest that managing these symptoms may reduce migraine progression. Further research is needed to explore targeted interventions for CM patients.