Napping to ease tension headaches could set up vicious cycle

Sleep problems may trigger tension headaches, but the naps patients take to minimize this pain may mean difficulty getting nighttime rest, according to a study in the Feb. 15 Journal of Clinical Sleep Medicine.

"Maybe there's a behavioral link for people who have headache and insomnia," said Jason Ong, PhD, lead author and assistant professor of behavioral sciences at Rush University Medical Center in Chicago.

Researchers compiled data regarding 32 female undergraduate students with an average of 8.11 tension headaches a month and compared it with data on 33 controls. Subjects in both groups used similar types and amounts of medications to deal with headaches, but those with frequent tension headaches were more likely to say that problems sleeping triggered their pain. They also commonly used napping or snoozing longer to ameliorate it. The authors are concerned that these headaches may be leading patients to have poor sleep hygiene, which could lead to insomnia.

"The take-home point is just to be aware that people who have headaches might have sleep disturbance, and napping may be a possible link between them," Ong said.

Physicians said this study generated an interesting hypothesis but was not definitive enough to counsel patients against using sleep to deal with tension-type headaches, which can be a very effective coping strategy. The study was small, and experts would like to see more data on participants, such as how long they slept to deal with their headaches. Were they taking daytime naps? Or were they extending how much they slept at night? Was there some other underlying disorder at the root of their problems?

"People who have sleep problems have headaches, and people who have headaches have sleep problems. You really need a longitudinal study to say what the impact is, and what direction the relationship goes," said Gretchen Tietjen, MD, professor and chair of neurology at the University of Toledo in Ohio.

The authors hope to develop projects that investigate if tension headaches and insomnia have similar root causes or feed off each other. They also will investigate behavioral interventions that may address both issues.