Is being a night owl associated with higher migraine-related disability in patients with migraine?
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By
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Erkan Acar
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Zeynep Özdemir
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Pinar Yalinay Dikmen
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May 25, 2026
Clinical Scorecard: Does a preference for nighttime activity correlate with increased migraine-related disability in individuals with migraines?
At a Glance
| Category | Detail |
|---|
| Condition | Migraine |
| Key Mechanisms | Interactions between circadian rhythms, sleep-wake regulation, and pain modulation pathways. |
| Target Population | Patients with migraine aged 18-60 years. |
| Care Setting | Outpatient clinics of neurology departments. |
Key Highlights
- Migraine patients exhibited poorer sleep quality compared to healthy controls (PSQI: 7.28 vs. 4.37, p < 0.001).
- Chronic migraine patients showed the highest disability (MIDAS: 36.17 vs. 9.63, p < 0.001).
- No significant difference in chronotype distribution between migraine patients and controls (p = 0.48).
- Morning chronotypes had lower MIDAS scores compared to intermediate and evening types, though differences were non-significant (p = 0.082).
Guideline-Based Recommendations
Diagnosis
- Diagnosis of migraine established according to the International Classification of Headache Disorders, third edition (ICHD-III).
Management
Monitoring & Follow-up
- Assess sleep quality and chronotype in migraine patients.
Risks
- Sleep disturbances are primary triggers for migraine attacks.
Patient & Prescribing Data
200 patients with migraine and 110 healthy controls.
Improvement in sleep quality has been observed after treatment in migraine patients.
Clinical Best Practices
- Evaluate sleep quality using the Pittsburgh Sleep Quality Index (PSQI).
- Assess chronotype using the Morningness-Eveningness Questionnaire (MEQ).
- Measure migraine-related disability using the Migraine Disability Assessment Scale (MIDAS).
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