Sleep disorders in children and adolescents with tension-type headaches

Introduction. Tension-type headache (TTH) represents a widespread and recurrent disease in adults, children, and adolescents, adversely affecting the quality of life, learning achievements, and social functioning. In recent publications, a high incidence of comorbid disorders in patients with TTH is discussed, in particular sleep disorders. The aim of the study was to assess the nature and prevalence of sleep disorders in children and adolescents with frequent episodic TTH and chronic TTH. Materials and methods. One hundred fifty patients aged from 8 years to 16 years 11 months with TTH were examined. Of them, 91 (49 boys, 42 girls) had frequent episodic TTH, 59 (26 boys, 33 girls) had chronic TTH. There was used Sleep Disturbance Scale for Children including 26 questions for parents. Results. The present study confirms the high incidence of sleep disorders among TTH children and adolescents. TTH was diagnosed in 129 (86.0%) out of 150 patients. The most frequently diagnosed varying degrees of severity (clinically relevant and borderline, when assessing sleep disorders in children) were insomnia (disorders of initiating and maintaining sleep) - in 65.3% of patients (including 60.4% with frequent episodic TTH and 72.9% with chronic TTH), excessive somnolence - in 74.7% (67.1% and 86.4%), sleep breathing disorders - in 26.7% (23.1% and 32.2%), disorders of arousal/nightmares - in 46.0% (42.9% and 50.8%), sleep-wake transition disorders - in 65.3% (67.1% and 62.7%), sleep hyperhidrosis - in 31.3% (26.4% and 39.0%). Thus, all sleep disorders (except for sleep-wake transition disorders) were significantly more common among the patients with chronic TTH. At the same time, in the subgroup of patients with TTH and any sleep disorders, significantly more prominent indicators of the frequency, the intensity of TTH and its negative impact on the daily activity were revealed, compared to patients with TTH lacking sleep disorders. Conclusion. The results of the assessment of children and adolescents with TTH show that when planning preventive therapy for TTH and evaluating its results, not only main clinical characteristics of TTH should be taken into account, but also the manifestations and severity of comorbid disorders, including sleep disorders observed in most patients with TTH. The revealed prevalence of various sleep disorders in the subgroup of patients with chronic TTH confirms that sleep disorders and anxiety disorders refer to significant risk factors for the transition of TTH to a chronic form, and such patients need more active multimodal treatment.

Download Full-text

Trauma and Its Sequelae in Children and Adolescents

Creating Trauma-Informed Schools ◽

10.1093/oso/9780190873806.003.0002 ◽

2019 ◽

pp. 9-23

Author(s):

Eileen A. Dombo ◽

Christine Anlauf Sabatino

Keyword(s):

Child Development ◽

Children And Adolescents ◽

Negative Impact ◽

Significant Risk ◽

The United States ◽

Epidemiological Studies ◽

Externalizing Disorders ◽

Traumatic Experiences ◽

Childhood Experiences ◽

Adverse Experiences

The most current research on trauma and child development demonstrates that there are significant risk factors for school success. At the same time, resilience and protective factors help other children overcome these obstacles. Chapter 2 explores the effects of trauma on children and adolescents. Data from the Adverse Childhood Experiences Study, as well as other academic and epidemiological studies, are used to address the negative impact of traumatic experiences on child development. The neurobiology of trauma is explored along with other bio-psycho-social-spiritual effects of abuse, neglect, and other adverse experiences affecting children in the United States. Internalizing and externalizing disorders present in children who experience abuse are also addressed.

Download Full-text

Electromyographic Biofeedback-Assisted Relaxation Training in Juvenile Episodic Tension-Type Headache: Clinical Outcome at Three-Year Follow-Up the in of and for on with at is an as by

Cephalalgia ◽

10.1046/j.1468-2982.2001.218193.x ◽

2001 ◽

Vol 21 (8) ◽

pp. 798-803 ◽

Cited By ~ 31

Author(s):

L Grazzi ◽

F Andrasik ◽

D D'Amico ◽

M Leone ◽

F Moschiano ◽

...

Keyword(s):

Children And Adolescents ◽

Relaxation Training ◽

Tension Type Headache ◽

Migraine Treatment ◽

Behavioural Treatment ◽

Electromyographic Biofeedback ◽

Clinical Benefits ◽

Type Headache ◽

Tension Type Headaches

Although tension-type headaches are more common than migraine in children and adolescents, the limited studies that have been conducted with juveniles have focused chiefly on migraine treatment and its course. This report describes the clinical benefits for an electromyographic biofeedback-assisted relaxation treatment program for a group of children and adolescents experiencing episodic tension-type headache and examines whether the clinical presentation changed for headaches that remained. Of the 54 consecutive juveniles who began treatment, 38 completed and were available to participate in the 3-year follow-up. Headaches improved measurably immediately following treatment, with further gains being evident through 3 years. The few headaches that did occur at 3 years were nearly identical symptom-for-symptom to those that were experienced prior to treatment. This report suggests that behavioural treatment is a viable and durable intervention for juvenile episodic tension-type headache, but more definitive claims cannot be made due to the uncontrolled nature of the study. Further investigation is warranted.

Download Full-text

553 Assessment of sleep disorders in children and adolescents with obesity

SLEEP ◽

10.1093/sleep/zsab072.551 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A219-A219

Author(s):

Raquel Simone Maccarini Zarpellon ◽

Regina Maria Vilela ◽

Rosana Bento Radominski ◽

Ana Chrystina de Souza Crippa

Keyword(s):

Childhood Obesity ◽

Data Collection ◽

Children And Adolescents ◽

Sleep Disorders ◽

Respiratory Disorder ◽

Overweight Children ◽

Sleep Breathing Disorders ◽

Breathing Disorders ◽

The Mean ◽

Wake Transition

Abstract Introduction When studying the inherent aspects of sleep it is important to assess how the quality and quantity of sleep in the last two decades may be one of the reasons for the increase in childhood obesity, which has been growing rapidly worldwide. This study aims to assess the presence of sleep disorders in overweight children and adolescents. Methods An descriptive study was conducted with data collection from 43 patients between 6 and 13 years old diagnosed as overweight. They were patients of a specialized service for children and adolescents with obesity that is part of the Hospital de Clínicas of the Federal University of Paraná, located in Curitiba, Brazil. To investigate the presence of sleep disorders, the Sleep Disturbance Scale for Children (SDSC) questionnaire was administered. The factors assessed were: Disorders of Initiating and Maintaining Sleep, Sleep Breathing Disorders, Disorders of Arousallnightmures, Sleep Wake Transition Disorders, Disorders of Excessive Somnolence and Sleep Hyperhydrosis. Results The mean age of the patients that took part in the research was 10 years and 7 months (± 1.95). The mean BMI of the participants was 29.57 kg/m2 (± 4.38), the majority being diagnosed with obesity. The sum of all SDSC factors demonstrated the presence of pathological sleep in 58.1% (25) of the sample, whereas 51.2% (22) of the patients had Sleep Breathing Disorders and 58.1% (25) had the Sleep Wake Transition Disorder. Conclusion The present study demonstrated the presence of sleep disorders in overweight children and adolescents. As for Sleep Respiratory Disorder, a situation has already been advocated in the current literature for this audience. In relation to the Sleep-Wake Transition Disorder and pathological sleep, further research is needed to prove the presence of the disorder in other groups studied. Here is the suggestion that future research be done with subjective and objective data collection on sleep within a larger sample, in order to confirm the association between sleep disorders and childhood obesity. Support (if any):

Download Full-text

Use of Nutraceutical Ingredient Combinations in the Management of Tension-Type Headaches with or without Sleep Disorders

Nutrients ◽

10.3390/nu13051631 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1631

Author(s):

Paolo Curatolo ◽

Romina Moavero

Keyword(s):

Sleep Disorders ◽

Positive Impact ◽

Pediatric Population ◽

Treatment Options ◽

Primary Headache ◽

Tension Type Headache ◽

Poor Sleep ◽

Bidirectional Relationship ◽

Type Headache ◽

Tension Type Headaches

Headache is the most common pain complaint in the pediatric population, with tension type headache (TTH) having a prevalence of 10–15% in children. Up to 70% of pediatric patients with chronic headache also experience sleep disruption, with a likely bidirectional relationship between headache and poor sleep. Treatment options include specific pharmacological approaches as well as non-pharmacological alternatives; nutraceuticals have the advantage of a relative lack of side effects. Exogenous melatonin has been shown to be useful and safe in improving sleep-wake cycles and quality of sleep in children, helping to regulate the circadian rhythm, with a secondary positive impact on headache. Supplementation with other nutraceutical ingredients, such as tryptophan, magnesium, and B vitamins, can have significant additional effects in children with primary headache, with or without sleep disorders. Tryptophan may reduce night awakenings and improve the efficiency of sleep. Primary headache has been related to low amounts of magnesium in serum, and integration with magnesium appears to be effective in reducing headache attacks without adverse effects. There are different observational reports and uncontrolled studies suggesting a possible synergistic effect for these nutraceuticals, but there is now a need for high-quality randomized controlled trials in order to confirm these positive preliminary findings.

Download Full-text

Global Burden of Headache Disorders in Children and Adolescents 2007–2017

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010250 ◽

2020 ◽

Vol 18 (1) ◽

pp. 250

Author(s):

Matilde Leonardi ◽

Licia Grazzi ◽

Domenico D’Amico ◽

Paolo Martelletti ◽

Erika Guastafierro ◽

...

Keyword(s):

Children And Adolescents ◽

Tension Type Headache ◽

Global Burden ◽

Specific Information ◽

Headache Disorders ◽

Substantial Impact ◽

Public Health Policies ◽

School Activities ◽

Type Headache ◽

Years Lived With Disability

Headache disorders are prevalent and disabling conditions impacting on people of all ages, including children and adolescents with substantial impact on their school activities and leisure time. Our study aims to report specific information on headaches in children and adolescents based on the Global Burden of Disease (GBD) study, that provides estimates for incidence, prevalence, fatal and non-fatal outcomes. We relied on 2007 and 2017 GBD estimates for prevalence and Years Lived with Disability (YLDs) at the global level and in WHO regions. The results show that, migraine and tension-type headache (TTH) together account for 37.5% of all-cause prevalence and for 7% of all-cause YLDs. Over the past decade, prevalence rates showed a mild increase of TTH in all ages and of migraine alone for adolescents. The YLDs increased among females of all ages with some regional differences that might be connected to the unequal availability of effective acute and prophylactic treatments across world regions. GBD data support the need to promote public health policies and strategies including diagnosis, pharmacological and non-pharmacological treatments that are expected to help reduce the disability and burden associated to migraine and TTH among children and adolescents.

Download Full-text

Sleep Disorders in Children and Adolescents

Child and Adolescent Psychiatric Clinics of North America ◽

10.1016/s1056-4993(20)30108-5 ◽

2021 ◽

Vol 30 (1) ◽

pp. i

Author(s):

Argelinda Baroni ◽

Jessica R. Lunsford-Avery

Keyword(s):

Children And Adolescents ◽

Sleep Disorders

Download Full-text

Sleep Disorders in Adults with Down Syndrome

Journal of Clinical Medicine ◽

10.3390/jcm10143012 ◽

2021 ◽

Vol 10 (14) ◽

pp. 3012

Author(s):

Sandra Giménez ◽

Miren Altuna ◽

Esther Blessing ◽

Ricardo M. Osorio ◽

Juan Fortea

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Down Syndrome ◽

Sleep Disorders ◽

Negative Impact ◽

Current Knowledge ◽

Sleep Disruption ◽

Physical And Mental Health ◽

Future Directions

Sleep disorders, despite being very frequent in adults with Down syndrome (DS), are often overlooked due to a lack of awareness by families and physicians and the absence of specific clinical sleep guidelines. Untreated sleep disorders have a negative impact on physical and mental health, behavior, and cognitive performance. Growing evidence suggests that sleep disruption may also accelerate the progression to symptomatic Alzheimer’s disease (AD) in this population. It is therefore imperative to have a better understanding of the sleep disorders associated with DS in order to treat them, and in doing so, improve cognition and quality of life, and prevent related comorbidities. This paper reviews the current knowledge of the main sleep disorders in adults with DS, including evaluation and management. It highlights the existing gaps in knowledge and discusses future directions to achieve earlier diagnosis and better treatment of sleep disorders most frequently found in this population.

Download Full-text

Platelet Superoxide Dismutase in Migraine and Tension-Type Headache

Cephalalgia ◽

10.1046/j.1468-2982.1994.014003215.x ◽

1994 ◽

Vol 14 (3) ◽

pp. 215-218 ◽

Cited By ~ 44

Author(s):

T Shimomura ◽

H Kowa ◽

T Nakano ◽

A Kitano ◽

H Marukawa ◽

...

Keyword(s):

Superoxide Dismutase ◽

Radical Scavenging ◽

Tension Type Headache ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Sod Activity ◽

Low Concentrations ◽

Type Headache ◽

Tension Type Headaches ◽

Headache Patients

Superoxide dismutase (SOD) is a radical-scavenging enzyme. We determined Cu, Zn-SOD concentrations and activities in platelets from subjects with migraine and tension-type headaches. Thirty migraine without aura (MWoA) patients, 9 migraine with aura (MWA) patients, and 53 tension-type headache patients were selected for study. Thirty healthy volunteers composed the control group. Concentrations of platelet SOD were determined using enzyme-linked immunosorbent assay techniques. The activity of platelet SOD was determined by measuring reductivity of nitroblue tetrazolium. Low concentrations of platelet SOD were found in patients with MWA and MWoA. Platelet SOD activity decreased in MWA patients but not in patients with MWoA or tension-type headaches. These findings suggest vulnerability to oxidative stress in patients with migraine. It is suggested that low platelet SOD levels may play an important role in the etiology of migraine.

Download Full-text

Chronic Tension-Type Headache in Children and Adolescents

Cephalalgia ◽

10.1046/j.0333-1024.2001.00275.x ◽

2001 ◽

Vol 21 (8) ◽

pp. 830-836 ◽

Cited By ~ 41

Author(s):

Ishaq Abu-Arafeh

Keyword(s):

Children And Adolescents ◽

Clinical Features ◽

Chronic Daily Headache ◽

Adult Population ◽

Tension Type Headache ◽

Stressful Events ◽

Chronic Tension Type Headache ◽

Daily Headache ◽

Ihs Criteria ◽

Type Headache

In this study, the causes, predisposing factors and clinical features of chronic daily headache in children and adolescents were studied within the population of patients attending a specialist headache. The International Headache Society's (IHS) criteria for the diagnosis of chronic tension type headache (CTTH) were assessed for their applicability in the paediatric age group. Over a period of three years, demographic and clinical data were collected prospectively on all children who attended the clinic and suffered from daily attacks of headache. One hundred and fifteen children and adolescents (32% of all clinic population) had chronic daily headache, of whom 93 patients (81%) fulfilled the IHS criteria for the diagnosis of CTTH. They were between 3-15 years of age (mean: 11.1, SD: 2.3) and their female to male ratio was 1.2: 1. Around one third of the patients also suffered from migraine (mainly migraine without aura). The headache was described as mild in 60.9%, moderate 36.5% and severe 2.6%. Headache was located at the forehead in 53% or over the whole of the head in 29.6%. Pain was described as ‘just sore’ or dull by 73.9%. During attacks of headache, at least half the patients reported light intolerance, noise intolerance, anorexia or nausea. Thirty-two percent of patients had at least one underlying chronic disease that may have contributed to the pathogenesis of the CTTH. Eleven percent had serious stressful events related to family illnesses and in four patients headaches were triggered by family bereavement. Fourteen percent were investigated with neuroimaging and 22% were referred for clinical psychology assessment and management. In conclusion, CTTH is a common cause of headache in children attending a specialist headache clinic. The clinical features closely match those of adult population and the IHS criteria for the diagnosis of CTTH can be adapted for use in children. Predisposing stressful risk factors, physical or emotional, are present in a large proportion.

Download Full-text

Abstract 2605: Hypoglycemia Does Not Increase Long-term Mortality Or Morbidity In Diabetic Patients With Myocardial Infarction. A Report From The Digami 2 Trial.

Circulation ◽

10.1161/circ.116.suppl_16.ii_577 ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Linda G Mellbin ◽

Klas Malmberg ◽

Anders Waldenstrom ◽

Hans Wedel ◽

Lars Ryden

Keyword(s):

Myocardial Infarction ◽

Blood Glucose ◽

Negative Impact ◽

Significant Risk ◽

Significant Risk Factor ◽

Diabetic Patients ◽

Type 2 Dm ◽

Hazard Ratios

Aims Tight, insulin-based glucose control is recommended to diabetic patients (DM pat) with acute myocardial infarction (AMI). A potential draw-back would be if insulin induced hypoglycaemia (HG) had a negative impact of future prognosis. Methods 1253 pat (mean age 68 years; 67% males) with type 2 DM and suspect AMI were followed for a median of 2.1 years. 947 were randomised to insulin infusion during at least 24 hours while 306 were treated routinely. HG (blood glucose<3.0 mmol/L with or without symptoms) was recorded during hospitalisation. Unadjusted and adjusted (age, sex, smoking, previous MI and heart failure, renal function, duration of DM, coronary interventions, blood glucose at randomisation) Hazard Ratios (HR) and 95% Confidence Intervals (CI) for cardiovascular events (CVE = death, MI or stroke) during follow up were calculated. Results 153 pat (12.2%) experienced HG. During the first 24 hours 111 (11.7%) insulin-treated pat experienced HG (symptomatic 23.4%) compared with 3 (1.0%) pat on routine treatment (symptomatic 33.3%). As outlined in the figure HG was not an independent predictor of subsequent CVE. Conclusion Insulin induced HG was not a significant risk factor for subsequent CVE in AMI-pat with type 2 DM. Hypoglycaemic seem to identify patients at high risk for other reasons.

Download Full-text