The prevalence and severity of insomnia in university students and their associations with migraine, tension-type headache, anxiety and depression disorders: a cross-sectional study

• Published in: Sleep medicine 2021-12, Vol.88, p.241-246
• Main Authors: Corrêa Rangel, Tathiana, Falcão Raposo, Maria Cristina, Sampaio Rocha-Filho, Pedro Augusto
• Format: Article
• Language: English
• Subjects: Anxiety; Anxiety - epidemiology; Cross-Sectional Studies; Depression; Depression - epidemiology; Female; Humans; Insomnia; Male; Migraine disorders; Migraine Disorders - epidemiology; Prevalence; Sleep Initiation and Maintenance Disorders - epidemiology; Students; Tension-type headache; Tension-Type Headache - epidemiology; Universities; Young Adult
• ISSN: 1389-9457; 1878-5506
• DOI: 10.1016/j.sleep.2021.10.029

There is possibly an association between migraine, tension-type headache, anxiety, depression and insomnia. These conditions are prevalent among university students. Our primary objective was to verify whether students with primary headaches (migraine and tension-type headache) have a higher prevalence of insomnia. Our secondary objective was to assess whether the impact of headaches was associated with greater severity of insomnia. Cross-sectional study. 440 students out of 3030 were randomly selected. A semi-structured questionnaire containing information about the characteristics of the headaches, including their frequencies in the last 3 months; the Headache Impact Test (HIT-6); the Hospital Anxiety Depression Scale; and the Insomnia Severity Index were used. 420 students (95.5%) agreed to participate; 51.4% men; median age of 21 (19, 23); 95 (22.6%) had insomnia; 265 (63.1%), migraine; 152 (36.2%), tension-type headache; 201 (47.9%) suffered from anxiety and 108 (25.7%), from depression. The severe impact of headache (HIT-6>55 points; OR = 3.9; p = 0.003) and anxiety (OR = 3.6; p = 0.003) were associated with insomnia (logistic regression). The severity of insomnia was positively and significantly correlated with the impact (HIT-6 score), with frequency of headache, and with having anxiety (multiple linear regression). The diagnoses of migraine and tension-type headache are not associated with the presence of insomnia. The severity of insomnia is associated with the impact and the frequency of the headaches. •The diagnoses of migraine and tension-type headache are not associated with the presence of insomnia.•A substantial/very severe impact of the headaches and the anxiety are associated with insomnia.•The severity of insomnia is correlated with the frequency of the headache attacks and the impact of headaches.