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Serotonin Effects on Sleep and Emotional Disorders in Adolescent Migraine

Authors

  • Ann Pakalnis MD,

    1. From the Department of Neurology, Ohio State University College of Medicine, Columbus, OH (A. Pakalnis); Sleep Medicine Center, Nationwide Children's Hospital, Columbus, OH (M. Splaingard); Department of Pediatrics, Ohio State University College of Medicine, Columbus, OH (A. Pakalnis and M. Splaingard); Section of Neurology, Nationwide Children's Hospital, Columbus, OH (A. Pakalnis, D. Splaingard, and D. Kring); Department of Psychology, Nationwide Children's Hospital, Columbus, OH, USA (A. Colvin).
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  • Mark Splaingard MD,

    1. From the Department of Neurology, Ohio State University College of Medicine, Columbus, OH (A. Pakalnis); Sleep Medicine Center, Nationwide Children's Hospital, Columbus, OH (M. Splaingard); Department of Pediatrics, Ohio State University College of Medicine, Columbus, OH (A. Pakalnis and M. Splaingard); Section of Neurology, Nationwide Children's Hospital, Columbus, OH (A. Pakalnis, D. Splaingard, and D. Kring); Department of Psychology, Nationwide Children's Hospital, Columbus, OH, USA (A. Colvin).
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  • Deborah Splaingard MS,

    1. From the Department of Neurology, Ohio State University College of Medicine, Columbus, OH (A. Pakalnis); Sleep Medicine Center, Nationwide Children's Hospital, Columbus, OH (M. Splaingard); Department of Pediatrics, Ohio State University College of Medicine, Columbus, OH (A. Pakalnis and M. Splaingard); Section of Neurology, Nationwide Children's Hospital, Columbus, OH (A. Pakalnis, D. Splaingard, and D. Kring); Department of Psychology, Nationwide Children's Hospital, Columbus, OH, USA (A. Colvin).
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  • Donna Kring PNP,

    1. From the Department of Neurology, Ohio State University College of Medicine, Columbus, OH (A. Pakalnis); Sleep Medicine Center, Nationwide Children's Hospital, Columbus, OH (M. Splaingard); Department of Pediatrics, Ohio State University College of Medicine, Columbus, OH (A. Pakalnis and M. Splaingard); Section of Neurology, Nationwide Children's Hospital, Columbus, OH (A. Pakalnis, D. Splaingard, and D. Kring); Department of Psychology, Nationwide Children's Hospital, Columbus, OH, USA (A. Colvin).
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  • Andrew Colvin PhD

    1. From the Department of Neurology, Ohio State University College of Medicine, Columbus, OH (A. Pakalnis); Sleep Medicine Center, Nationwide Children's Hospital, Columbus, OH (M. Splaingard); Department of Pediatrics, Ohio State University College of Medicine, Columbus, OH (A. Pakalnis and M. Splaingard); Section of Neurology, Nationwide Children's Hospital, Columbus, OH (A. Pakalnis, D. Splaingard, and D. Kring); Department of Psychology, Nationwide Children's Hospital, Columbus, OH, USA (A. Colvin).
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  • Funding support: This study was supported in part by a research grant from Nationwide Children's Research Institute.

  • Conflict of Interest: None

A. Pakalnis, 700 Children's Drive, Columbus, OH 43205, USA.

Abstract

Objective.— To determine frequency of emotional disorders and sleep disturbances in adolescent migraineurs with episodic and chronic headaches. To determine the relationship of whole blood serotonin, caffeine consumption, and frequency of sleep and mood disorders.

Background.— The neurotransmitter serotonin has been implicated to play a role in the initiation and maintenance of sleep and in modulating mood. A putative role in migraine pathophysiology is also known.

Methods.— Adolescents from 13 to 17 years of age were identified from our headache clinic with episodic or chronic migraine (according to International Classification of Headache Disorders-Second Edition criteria) and healthy controls enrolled. Psychological rating scales were completed, including Adolescent Symptom Inventory (4th Edition) and Child Depression Inventory. Sleep questionnaires (Pediatric Sleep Questionnaire and Child Sleep Habit Questionnaire) were completed by the teenager's parents/guardian. Whole blood serotonin levels were drawn and analyzed and caffeine consumption obtained by history.

Results.— A total of 18 controls (8 girls) and 15 patients each with episodic migraines (9 girls) and chronic migraine (10 girls) were studied.

Patients with headache had significantly more sleep problems than controls. Patients with chronic migraines had increased daytime sleepiness and dysthymia compared with teenagers with episodic migraines. Serotonin levels were not significantly different, and no association was noted between serotonin levels and sleep abnormalities or emotional rating scales. Increased caffeine intake was related to sleep and depressive complaints.

Conclusions.— Sleep and emotional disorders were common in adolescents with migraine. Sleep disorders and dysthymia were more prevalent with increased headache frequency. No correlation was noted with whole blood serotonin levels.

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