PSYCHOLOGICAL TROUBLES ARE RELATED TO SLEEP PATTERN DISORDERS IN HEADACHE SCHOOL-AGED CHILDREN

Introduction Headache is a common disorder in children and adolescents, associated with the presence of several disorders such as emotional, behavioural difficulties and sleep disorders. Aim of the study was to verify the relationship between psychological troubles of headache patients and sleep patterns. Materials and methods Population study consists of 64 subjects (27 females), aged 8-12 years (mean 9.4 years, SD±1.03), consecutively referred to the third University Level Headache Centre for Developmental Age of the Department of Child and Adolescent Neuropsychiatry of the Second University of Naples since January 2007. All the mothers of the subjects were asked to fill in the Child Behaviour Checklist 4-18 (CBCL) and the Sleep Disturbances Scale for Children (SDSC) questionnaire to describe psychological profile and assess sleep troubles. The SDSC is a sleep questionnaire that consists of 26 items subdivided into six sleep disorders subscales: disorders in initiating and maintaining sleep (DIMS), sleep breathing disorders (SBD), disorders of arousal (DA), sleep-wake transition disorders (SWTD), disorders of excessive somnolence (DES), and sleep hyperhydrosis (SHY), widely used in paediatric age both in its original and modified version. To verify the relationship with psychological assessment, we considered only some of the scales of SDSC such as DIMS, DA, SWTD, and Total value. Results According to ICHD-II criteria, headache subtype distribution was as follows: migraine without aura (71.87%), episodic tension-type headache (7.81%), and chronic tension-type headache (7.81%). Psychological CBCL assessment (Total problems item) showed an interesting relation with sleep disorders as DIMS and parasomnias (DA and SWTD) (respectively r=.37, p=0.019; r=.39, p=0.015; r=37, p=0.019). Discussion As shown in recent medical literature, migraine children revealed a specific behavioural phenotype characterized by internalizing problems, as higher scores of behavioural and emotional symptoms, both of internalizing and externalizing type, than normal peers. Herein, temperament and sleep are important factors influencing all social aspects of life, both in adults and in children Conclusions Several studies on headache in children outlined the contemporary presence of headaches and parasomnias. Few studies have focused on the whole sleepwake cycle and on the circadian aspects of headache to clarify the close relationship between the two. Temperamental troubles should be considered not only for diagnostic and therapeutic purposes, but also from the aetiological aspect.