The effect of standard time to daylight-saving clock transition on sleep and migraine headaches.

BACKGROUND

The impact of circadian misalignment on patients with migraine due to clock transitions is not well understood. Our study investigated the immediate effects of standard time (ST) to daylight saving time (DST) transition on sleep and headaches in patients with migraines.

METHODS

In this prospective observational study, 23 adults with episodic migraine were followed for 4 weeks (2 weeks before and 2 weeks after ST-DST transition on March 12, 2023). Headache variables were documented via diary, sleep data were collected using a Withings under-mattress tracker, and chronotype was determined through the Morningness-Eveningness Questionnaire.

RESULTS

Despite the lack of significant difference in mean sleep duration before and after the clock change (437.79 ± 42.96 min vs. 438.16 ± 35.47 min), a significant increase in migraines were noted after ST-DST transition, as reported by an incidence rate per 100 person days (7.76 pre-transition vs. 13.35 post-transition, p = 0.029). The mean deep sleep duration was significantly higher during the two weeks preceding the transition (94.26 ± 38.26 min) than after the clock change (83.97 ± 41.31 min; p = 0.015).

CONCLUSION

Adults with episodic migraine experienced more migraine days and reduced deep sleep after spring ST-DST transition. Our study reinforces the harmful effects of circadian disruption due to clock changes and highlights the vulnerability of patients with migraine. CURRENT KNOWLEDGE/STUDY RATIONALE: The clock transitions and resulting circadian misalignment were known to negatively impact health. Patients with migraine are particularly vulnerable to sleep changes. The circadian disruption following spring transition is known to exert a pronounced impact than fall transition. There is a dearth of studies on circadian disruption in migraines due to clock transitions. Given the higher prevalence of migraines, the impact of disability due to headaches, we aimed to study the effect of ST-DST clock transition with a novel under the mattress sleep tracker. STUDY IMPACT: The observed increase in migraine episodes following the ST-DST transition underscores the importance of circadian alignment in migraine management. The significant reduction in deep sleep suggests that interventions to enhance deep sleep, such as exercise, may help mitigate migraine exacerbations associated with clock changes. These findings may also have broader implications for circadian misalignment caused by jet lag and time zone shifts.