Min Kyung Chu

Prevalence, clinical characteristics and disability of migraine and probable migraine: A nationwide population-based survey in Korea

Background Epidemiological data on probable migraine (PM) in Asia have rarely been reported. This study aimed to assess the prevalence, clinical characteristics, and disability of PM in comparison with strict migraine (SM) in Korea. Methods The Korean Headache Survey (KHS) is a nationwide interview survey that investigates the status of headache disorders among adults aged 19–69. We used data from the KHS. Results In a representative sample of 1507 individuals, the one-year prevalence of SM was 6.0%, and that of PM was 11.5%. Most PM sufferers missed the criterion of typical headache duration (82.0%). Multivariable regression analyses revealed that PM sufferers had an increased odds ratio (OR) for mild headache intensity (ORu2009=u20092.08; 95% confidence interval (CI): 1.11–3.90) and decreased ORs for living in a small city (ORu2009=u20090.50; 95% CI: 0.26–0.94), living in a rural area (ORu2009=u20090.36; 95% CI: 0.14–0.92) and headache frequency five to nine days per month (ORu2009=u20090.29; 95% CI: 0.11–0.78) compared to SM sufferers. Some SM and PM sufferers experienced decreased activity (26.4% in SM vs. 18.0% in PM) and missed activity (12.1% in SM vs. 14.4% in PM) due to headache. Conclusions PM is a prevalent headache disorder in Korea. Some sociodemographic and clinical characteristics of PM are different from those of SM.

Chronic Daily Headache in Korea: Prevalence, Clinical Characteristics, Medical Consultation and Management

Background and Purpose Chronic daily headache (CDH) is a commonly reported reason for visiting hospital neurology departments, but its prevalence, clinical characteristics, and management have not been well documented in Korea. The objective of this study was to characterize the 1-year prevalence, clinical characteristics, medical consultations, and treatment for CDH in Korea. Methods The Korean Headache Survey (KHS) is a nationwide descriptive survey of 1507 Korean adults aged between 19 and 69 years. The KHS investigated headache characteristics, sociodemographics, and headache-related disability using a structured interview. We used the KHS data for this study. Results The 1-year prevalence of CDH was 1.8% (95% confidence interval, 1.1-2.5%), and 25.7% of the subjects with CDH met the criteria for medication overuse. Two-thirds (66.7%) of CDH subjects were classified as having chronic migraine, and approximately half of the CDH subjects (48.1%) reported that their headaches either substantially or severely affected their quality of life. Less than half (40.7%) of the subjects with CDH reported having consulted a doctor for their headaches and 40.7% had not received treatment for their headaches during the previous year. Conclusions The prevalence of CDH was 1.8% and medication overuse was associated with one-quarter of CDH cases in Korea. Many subjects with CDH do not seek medical consultation and do not receive appropriate treatment for their headaches.

Associations of impaired sleep quality, insomnia, and sleepiness with epilepsy: A questionnaire‐based case–control study

PURPOSEnThe purpose of this study was to document the frequency of sleep problems including poor sleep quality, excessive daytime sleepiness, and insomnia in subjects with epilepsy compared with healthy controls and to determine the factors associated with these sleep disturbances.nnnMETHODSnWe recruited 180 patients with epilepsy (age: 43.2 ± 15.6 years, men: 50.0%) and 2836 healthy subjects (age: 44.5 ± 15.0 years, men: 49.8%). Sleep and the anxiety/mood profiles were measured using the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Insomnia Severity Index, Goldberg Anxiety Scale, and Patient Health Questionnaire-9 depression scale. Associations of sleep problems with epilepsy and other factors were tested by multiple logistic regression analysis, adjusted for age, gender, body mass index, alcohol intake, smoking, perceived sleep insufficiency, and habitual snoring.nnnRESULTSnSleep disturbances were more common in the group with epilepsy than in the controls (53.3% vs. 25.5%; p<0.001). Poor sleep quality, excessive daytime sleepiness, and insomnia were significantly associated with epilepsy (odds ratio [95% confidence interval]: 3.52 [2.45-5.05], 2.10 [1.41-3.12], 5.91 [3.43-10.16], respectively). Depressive mood, anxiety, and perceived sleep insufficiency contributed to the presence of sleep disturbances. In the group with epilepsy, seizure remission for the past year related to a lower frequency of insomnia, whereas age, sex, type of epilepsy, and number of antiepileptic drugs were not correlated with sleep problems.nnnCONCLUSIONnEpilepsy was significantly associated with the higher frequency of sleep disturbances, which supports the importance of screening sleep problems in patients with epilepsy and providing available intervention.

Habitual Sleep Duration, Unmet Sleep Need, and Excessive Daytime Sleepiness in Korean Adults

Background and Purpose Sleep need differs between individuals, and so the same duration of sleep will lead to sleep insufficiency in some individuals but not others. The aim of this study was to determine the separate and combined associations of both sleep duration and unmet sleep need with excessive daytime sleepiness (EDS) in Korean adults. Methods The participants comprised 2,769 Korean adults aged 19 years or older. They completed questionnaires about their sleep habits over the previous month. The question regarding sleep need was How much sleep do you need to be at your best during the day? Unmet sleep need was calculated as sleep need minus habitual sleep duration. Participants with a score of >10 on the Epworth Sleepiness Scale were considered to have EDS. Results The overall prevalence of EDS was 11.9%. Approximately one-third of the participants (31.9%) reported not getting at least 7 hours of sleep. An unmet sleep need of >0 hours was present in 30.2% of the participants. An adjusted multivariate logistic regression analysis revealed a significant excess risk of EDS in the groups with unmet sleep needs of ≥2 hours [odds ratio (OR), 1.80; 95% confidence interval (CI), 1.27–2.54] and 0.01–2 hours (OR, 1.42; 95% CI, 1.02–1.98). However, habitual sleep duration was not significantly related to EDS. Conclusions EDS was found to be associated with unmet sleep need but not with habitual sleep duration when both factors were examined together. We suggest that individual unmet sleep need is more important than habitual sleep duration in terms of the relation to EDS.

Erratum: Analysis of Dosage Mutation in PARK2 among Korean Patients with Early-Onset or Familial Parkinson's Disease

[This corrects the article on p. 244 in vol. 10, PMID: 25045378.].

Comment on ‘Mobile phone headache: A double blind, sham-controlled provocation study’:

I read with great interest the article ‘Mobile phone headache: A double blind, sham-controlled provocation study’ by Oftedal et al (1). I would like to comment on the article and make suggestions to develop a better understanding of mobile phone headache. As with other double-blind provocation studies for mobile phone headache (2–4), the authors evaluated the effect of radiofrequency field on headache provocation among vulnerable individuals as part of a double-blind test. They concluded that there was no evidence for radiofrequency fields from mobile phones causing head pain or discomfort or influencing physiological variables. However, the conditions used in these provocation tests were not exactly the same as those experienced in actual mobile phone use. In addition to the effects of radiofrequency field during mobile phone use, local temperature changes and background noise must also be considered (5). Both local temperature changes and noise can provoke headache (6–9). When considering actual mobile phone use, double-blind provocation tests should include these conditions. In studying the role of radiofrequency in mobile phone headache provocation, the blind test should compare actual mobile phone conditions (radiofrequency + temperature + noise) and conditions without radiofrequency (no radiofrequency + temperature + noise). In addition, to identify the role of each of these conditions, the provocation test must consider combinational roles of these conditions in headache provocation. Nevertheless, this study gave an important insight into the significance of radiofrequency in headache provocation and the possible roles of nocebo effects in mobile phone headache. Mobile phone users now number over 3 billion people world-wide (10). Therefore, if there are health issues related to mobile phone use, the impact and consequences are of great significance. More refined provocation tests that include all actual mobile phone conditions will provide a better understanding of mobile phone headache. References

Sleep characteristics associated with drowsy driving

OBJECTIVEnThe aim of this study was to evaluate sleep characteristics associated with drowsy driving in an adult population.nnnMETHODSnThe study subjects consisted of 1675 adults aged 19 years or older who completed a population-based questionnaire survey on sleep habits. Experiences of drowsy driving were obtained from self-reported data. We investigated sleep-related variables including sleep duration, sleep efficiency, chronotype, subjective sleep perception, daytime sleepiness, sleep quality, and snoring. We performed multivariate logistic regression analysis to determine sleep characteristics independently associated with drowsy driving.nnnRESULTSnThe mean age of the subjects was 43.2 years, and 66.3% were men. The prevalence of self-reported drowsy driving was 23.6% (396 of 1675), and 33.1% of subjects experienced dozing at the wheel at least once a month. Multivariate analysis demonstrated that men, office and manual workers, excessive daytime sleepiness, depression, habitual snoring, and perceived insufficient sleep were independently associated with drowsy driving. Subgroup analyses revealed that reduced weekday sleep duration was a risk factor of drowsy driving in adults with perceived sufficient sleep. On the other hand, frequent alcohol drinking significantly increased risk of drowsy driving in the subgroup with perceived sleep insufficiency. Furthermore, ordinal regression analyses confirmed the association between sleep characteristics and drowsy driving across different drowsy driving frequencies.nnnCONCLUSIONnExcessive daytime sleepiness, depression, habitual snoring, and perceived insufficient sleep were sleep-related risk factors for drowsy driving. In addition to maintaining healthy sleep habits, individuals at high risk should be encouraged to evaluate underlying sleep disorders or psychiatric problems to prevent drowsy driving.

Factors associated with disability and impact of tension-type headache: findings of the Korean headache survey.

BackgroundAlthough mostly mild in symptom severity, tension-type headache (TTH) can cause disability. However, factors associated with disability of TTH have been rarely reported. This study sought to assess the factors associated with TTH-related disability and impact.MethodsWe analyzed data form the Korean Headache Survey, a nation-wide survey regarding headache in all Korean adults aged 19–69 years. TTH-related disability was measured by surveying actual disability and Headache Impact Test-6 (HIT-6). Actual disability was defined as having one or more days of activity restriction or missed activity due to headache in the last 3xa0months. The HIT-6 scoreu2009≥u200950 was regarded as significant headache impact associated with TTH. We assessed factors associated with TTH-related disability and impact using logistic regression analyses adjusting for sociodemographic variables and headache characteristics.ResultsAmong 1507 individuals, the 1-year prevalence rate of TTH was 30.7% (nu2009=u2009463), of which 4.8% reported actual disability and 21.3% had headache impact, respectively. In univariate analyses, sociodemographic variables were not associated with actual disability and headache impact, respectively. There were relationships between several headache characteristics and actual disability/headache impact. After adjustment of potential confounders, moderate headache intensity was correlated with actual disability (odds ratio [OR]: 4.41, 95% confidence interval [CI]: 1.46–13.27), while an inverse association was observed between no aggravation by routine activity and actual disability (OR: 0.32, 95% CI: 0.12–0.88). Multivariate analyses showed that ORs for headache impact were increased in those with higher headache frequency (OR: 2.54, 95% CI: 1.47–4.39 for 1–14 days/month; OR: 23.83, 95% CI: 5.46–104.03 foru2009≥u200915xa0days/month), longer headache time duration (OR: 1.84, 95% CI: 1.04–3.25 foru2009≥u20091 andu2009<u20094xa0hours; OR: 2.44 95% CI: 1.17–5.11 foru2009≥u20094xa0hours), and phonophobia (OR: 1.73, 95% CI: 1.02–2.95), whereas decreased in those with no aggravation by routine activity (OR: 0.32, 95% CI: 0.12–0.88).ConclusionsSeveral headache characteristics were associated with actual disability and headache impact among TTH individuals. Our findings suggest that there needs to be consideration careful of troublesome headache characteristics for TTH individuals suffering from disability and impact.

The effect of sleep duration in clinical features and impact of migraine: Result from a population-based study

Results Of 2,836 all participants, 152 were diagnosed as having migraine. The mean sleep duration similar between migraineurs (7.1±1.5 hours) and non-migraine controls (7.1±1.3 hours). Among migraineurs, 15 (9.9%) participants slept iÂ5 hours, 83 (54.6%) slept 5-7 hours, 44 (28.9%) slept 7-9 hours, and 10 (6.6%) slept >9 hours in weekdays. Migraineurs with sleep duration of ≤5 hours reported higher migraine attack frequency (9.8±11.3 attacks per month) comparing to a sleep duration of >5 hours (3.8±6.3 attacks per month, p=0.001). Migraineurs with ≤5 hours sleep duration showed a tendency of increased HIT-6 score (59.7±9.9) comparing to sleep duration of 7-9 hours (53.1±5.8, p=0.088). Unilateral pain was more prevalent among migraineurs with sleep duration of >5 hours comparing to sleep duration of ≤5 hours. Headache severity, pulsating quality, aggravation by movement, nausea, vomiting, photophobia and phonophobia was not significant according to sleep duration.

Excessive daytime sleepiness and migraine: a population-based study.

Results Of 2,836 all participants, 152 (5.1%) were diagnosed as having migraine. EDS was more prevalent among migraineurs comparing to non-migraine controls (25.7% for migraineurs vs. 16.3% for non-migraine controls, p=0.003). Migraineurs with EDS reported higher attack frequency per month (7.0±9.7 attacks for migraineurs vs. 3.5±5.8 for non-migraine controls, p<0.000), higher VAS score for pain intensity (7.1±1.8 for migraineurs vs. 6.0±1.9 for non-migraine controls, p=0.006), and higher HIT-6 score (60.6±10.3 for migraineurs vs. 52.8±8.3 for non-migraine controls, p<0.000) comparing to migraineurs without EDS. Migraineurs with EDS showed more of depression (OR=5.67, 95% CI 2.5-12.7), insomnia (OR=2.98, 95% CI 1.1-8.4) and sleep disordered breathing (OR=2.78, 95% CI 1.1-7.3) than migraineurs without EDS. Unilateral pain, pulsating quality, aggravation by routine physical activity, nausea, vomiting, photophobia and phonophopbia were not significant according to EDS.