Nura Abdulaziz Almansour ¹ Seham Sulaiman Alsalamah ¹ Razan Saad Alsubaie ^1* Nada Naser Alshathri ¹ Yasmeen Abdullah Alhedyan ¹ Faisal Althekair ^1,2,3

• ¹ King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
• ² King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
• ³ Department of Medicine, Ministry of National Guard Health Affairs (Saudi Arabia), Riyadh, Saudi Arabia

Background: Migraine is a primary headache disorder that affects more than one billion individuals globally and imposes a significant disability burden on society. Although migraine patients commonly experience poor sleep quality, the relationship between migraine and sleep is not yet fully understood. This study therefore aimed to determine the association between sleep quality and migraine severity. Methods: A comparative cross-sectional study was conducted with 1399 participants across all regions of Saudi Arabia from August to October 2023 using standardized questionnaires. Participants were categorized into patients with migraine and non-migraine patients, according to the International Headache Society (IHS) criteria. This study utilized The Migraine Disability Assessment Scale (MIDAS) and Pittsburgh Sleep Quality Index (PSQI) to evaluate migraine severity and sleep quality, respectively . The prevalence of migraine was 25%, while poor sleep quality was evident in 42.4% of the patients. No significant difference in PSQI scores was observed between patients with migraine and non-migraine patients (p=0.821). Migraine patients with poor sleep quality showed significantly higher MIDAS scores than those with good sleep quality (10.37 vs 6.58; p=0.002), while patients with migraine with higher levels of disability had higher PSQI scores than those with lower levels of disability, although the difference was not statistically significance (7.61 vs. 6.81, p=0.053). A significant positive correlation was found between the PSQI and MIDAS scores (r= 0.179, p<0.001). MIDAS was also significantly positively correlated with the following PSQI components: subjective sleep quality (p=0.047), sleep latency (p<0.001), sleep disturbance (p<0.001), and daytime dysfunction (p<0.001). These findings suggest a notable correlation between poor sleep quality and increased migraine severity, emphasizing the importance of addressing sleep disturbance as a potential strategy to mitigate migraine severity and improve patient outcomes.