Work

Daytime Hypersomnolence in Migraine : Prevalence , Clinical Correlates and Independent Predictors in Malaysia

Year: 2026

Type: preprint

Abstract: Background and objectives Sleep disturbances, including daytime hypersomnolence, are increasingly recognized as clinically significant comorbidities of migraine that adversely affect quality of life. However, data on the prevalence and determinants of daytime hypersomnolence among migraine patients in Malaysia and the broader Southeast Asian region remain limited. This study aimed to determine the prevalence of daytime hypersomnolence and to identify the clinical and sociodemographic factors associated with excessive daytime sleepiness in adult patients with migraine. Methods A single-center, cross-sectional study was conducted between April 2024 and April 2026 at the Neurology Clinic, Hospital Canselor Tuanku Muhriz (HCTM), Universiti Kebangsaan Malaysia (UKM). Eligible participants were adults aged 18 years and above with an established diagnosis of migraine for at least one year, confirmed by a neurologist according to the International Classification of Headache Disorders, Third Edition (ICHD-3) criteria. Baseline sociodemographic and clinical migraine data were systematically collected. Daytime hypersomnolence was assessed using the validated Epworth Sleepiness Scale (ESS), with a score exceeding 10 defining the outcome. Migraine-related disability was assessed using the Migraine Disability Assessment (MIDAS) questionnaire. Data were analyzed using IBM SPSS Statistics Version 29, with binary logistic regression performed to identify independent predictors. Results A total of 278 participants were recruited (mean age 46.4 ± 15.75 years; 85.6% female ). Twenty-five participants (9.0%) met the ESS threshold for daytime hypersomnolence. On univariate analysis, factors significantly associated with daytime hypersomnolence included coffee consumption, higher MIDAS score, comorbid gastroesophageal reflux disease (GERD), higher migraine attack frequency, greater pain severity, multiple migraine-associated symptoms, and use of sumatriptan, topiramate, and propranolol (all p < 0.05). On multivariable logistic regression, independent predictors were migraine onset at age 25–54 years (OR 0.137, 95% CI: 0.039–0.479, p = 0.002), higher educational attainment (OR 9.956, 95% CI: 1.334–74.292, p = 0.025), severe migraine-related disability (MIDAS Grade IV; OR 26.182, 95% CI: 6.763–101.359, p < 0.001), and sumatriptan use (OR 4.538, 95% CI: 1.404–14.669, p = 0.012). Conclusion Daytime hypersomnolence affects approximately one in ten adult migraine patients attending a tertiary neurology clinic in Malaysia. Higher migraine-related disability, sumatriptan use, higher educational attainment, and earlier age of migraine onset are independent predictors. Routine screening for daytime hypersomnolence using ESS is practical, non-invasive, and clinically warranted as part of the holistic assessment and management of patients with migraine.

Source: Research Square

DOI: 10.21203/rs.3.rs-10500112/v1