Studies were identified by searching papers indexed on PubMed and Scopus. Data sources, search strategy, and data extraction ![]() This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. ![]() Available evidence suggests that diencephalic and brainstem regions are the main anatomical structures involved in migraine pathogenesis and in sleep-wake cycle regulation, and orexins, melatonin, pituitary adenylate cyclase-activating polypeptide, serotonin, dopamine and adenosine are the most studied molecules for their possible role as mediators of this relationship. Recent biochemical and functional imaging studies identified central nervous system structures and neurotransmitters involved in the pathophysiology of migraine and also important for the regulation of normal sleep architecture, suggesting a possible causative role, in the pathogenesis of both disorders, of a dysregulation in these common nervous system pathways (Fig. ĭespite extensive investigations, the exact nature and direction of the association remains enigmatic migraine may be the result of sleep disruption, but also sleep disruption may trigger migraine, or migraine and sleep disruption may be symptoms of an unrelated medical condition, or they might be two intrinsically related phenomena with shared pathophysiological mechanisms. In fact, some studies support the evidence that migraineurs have worse sleep quality than non-migraineurs, that self-reported poor sleep quality is associated with increased frequency of attacks or chronification of migraine, and that preventive migraine treatments might improve the quality of sleep. Those disorders often coexist, and this has led to hypothesize an association not only driven by chance occurrence. Migraine and sleep disorders are common and often burdensome chronic conditions with a high prevalence in the general population. The identification of specific sleep disorders associated with migraine should induce clinicians to systematically assess their presence in migraine patients and to adopt combined treatment strategies. This systematic review summarizes the existing data on migraine and sleep disorders with the aim to evaluate the existence of a causal relationship and to assess the presence of influencing factors. Recent biochemical and functional imaging studies identified central nervous system structures and neurotransmitters involved in the pathophysiology of migraine and also important for the regulation of normal sleep architecture, suggesting a possible causative role, in the pathogenesis of both disorders, of a dysregulation in these common nervous system pathways. Nevertheless, the exact nature of this association, the underlying mechanisms and interactions are complex and not completely understood. ![]() The existence of a relationship between migraine and sleep disorders has been recognized from centuries by clinicians and epidemiological studies. Migraine and sleep disorders are common and often burdensome chronic conditions with a high prevalence in the general population, and with considerable socio-economic impact and costs.
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