growing pains
By A . David Rothner , MD
Sweet Dreams
Children and adolescents with chronic headaches can experience a spectrum of sleep disorders , which warrants a multidisciplinary treatment approach .
THE RELATIONSHIP between childhood sleep disturbances and headaches has fascinated physicians for more than a century . Kids who have headaches experience a wide range of sleep problems , including getting too little sleep , snoring , struggling to fall or stay asleep , and having problems staying awake at school . These issues negatively impact physical and psychological health as well as academic performance .
Studies have shown that sleep disorders are more frequent in children and adolescents who have headaches than in the general childhood population . The modern study of this sleep-headache connection dates back to 1962 , when Swedish school physician Bo Bille found that 47 percent of children with migraines suffered from sleep disorders , as well . More recent research indicates that children with headaches also have a higher prevalence of other sleep problems , such as excessive daytime sleepiness , narcolepsy and insomnia .
The most common form of headache in preadolescents is migraine , followed by chronic daily headache ( CDH ), a condition in which headaches occur more than 15 days per month . Adolescents , on the other hand , more frequently have CDH , as opposed to migraine alone .
The sleep disorders seen in young headache sufferers vary depending on their age and headache type ( see sidebar ). Younger kids with headaches tend to get very little sleep , co-sleep with their parents and snore . If they have migraines , they also tend to resist sleep and have sleep anxiety .
Older children with migraines and headaches don ’ t get enough rest because they have difficulty falling asleep and wake frequently during the night . This sleep deprivation can directly impair daytime function , academic performance and overall mood .
JONATHAN ’ S STORY
Jonathan was evaluated for chronic headaches when he was 15 years old . His earlier medical history was normal , and his academic performance was above average until his headaches began 18 months prior to his evaluation .
Initially , the headaches were sporadic and moderately severe , but Jonathan soon began to experience them constantly . He described the pain as “ squeezing ,” and it worsened with activity . These were not typical migraines , as they were not associated with nausea , vomiting , or sensitivity to light and sound .
18 HEAD WISE | Volume 1 , Issue 2 • 2011