Circadian Variation of Migraine Attack Onset: A Review of Clinical Studies

Table 1

Details and results of the studies on circadian variation of migraine attack onset.

Study	Design	Time-span	Sample	Age (years) [adjustment for effect: ]	Female [adjustment for effect: ]	Migraine type (sample size if available)	Medication	Comorbid factors	Night work/shift work	Circadian variation of attack onset (peak)
Studies showing a monophasic 24-hour cyclic manner of migraine attacks
Solomon (1992) [9]	prospective	20 weeks	15 patients (USA)	no data	no data	MO, MA	NSAID or placebo used (beta-blockers excluded)	healthy (except migraine)	no data
Fox & Davis (1998) [6]	retrospective	last 3 years	1698 patients (USA)	from 18 to 60+	89%	MO, MA	use of oral contraceptives included	no data	included
Fox (2005) [5]	literature data analysis	-	1698 patients (USA)	from 18 (median: 34)	~4:1	MO, MA	excluded w. oral contraceptives	no data	not included
Gori, et al. (2005) [7]	retrospective	last 3 months	100 patients (Italy)	patients (23-50), mean: 38.6; control (23-60), mean: 37.1	no data	MO	no data	depression and anxiety symptoms; sleep quality	no data
Alstadhaug, et al. (2008) [3]	prospective	12 months	84 patients (arctic)	mean ~35	100%	MO (34), MO+MA (50)	use of oral contraceptives, beta-blockers included	healthy (except migraine); insomnia	included	at
Park, et al. (2018) [8]	prospective	90 days	82 patients (Korea)	mean 37.4	84.1%	MO (81), MA (1)	use of acute & preventive medication allowed	non-migraine type headache	not included
Studies showing a biphasic 24-hour cyclic manner of migraine attacks
Soriani, et al. (2006) [11]	prospective	12 months	115 patients (pediatric) (Italy)	5-18 yrs (median: ~10)	47% []	MO	excluded if taking prophylactic medication	no data	-	main peak at 4:4, secondary peak at 6:3
Alstadhaug, et al. (2007) [12]	prospective	12 months	68 patients (arctic)	mean 35.5	100%	MO, MA (insomnia-related (29%) & not related attacks)	excluded if taken beta-blockers	possible chronic insomnia; sleep quality on the night prior to or the night of the attack	not included	insomnia related: peak early in the morning (~) & just after noon/not related: peak just after noon
van Oosterhout, et al. (2018) [10]	cross-sectional	-	2389 patients, 189 controls (Dutch)	mean 45.2 []	83.4% []	MO, MA	use of sleep medication (no data on migraine medication)	depression and anxiety symptoms, lifetime depression; sleep quality	included	peaks: from midnight to (34.5%) & from to noon (31.7%)
de Tommaso & Delussi (2018) [13]	prospective	3 months	786 cases (Italy)	means: MO – 37.4; MO+MA – 34.2; CM – 42.5 []	~80%	MO (538), MO+MA (52), CM (196)	exclusion: use of central nervous system-active drugs or preventive treatment for primary headache	healthy (except migraine); depression and anxiety symptoms; sleep features; quality of life	no data	two peaks: at   & at (but most patients did not report a constant circadian rhythm of their attacks)

Table 1 shows the results and other important details of the selected studies on circadian variation of migraine attack onset. Abbreviations. CM: chronic migraine; MA: migraine with aura; MO: migraine without aura; NSAID: nonsteroidal anti-inflammatory drug; : adjustment for effect.