Chronic migraines affect the whole family

A study shows how chronic migraines can affect the whole family.

Suffering chronic migraines takes a huge toll on family life, a new study suggests.

Researchers found that more than two thirds of patients with chronic migraine feel their condition affects their sexual intimacy and that it makes their spouse's life difficult. Patients also report feeling guilty and worried about the effect their headaches have on their partner and children.

"Our research team believes it's very important to bring these data to light, to show that chronic migraine is a burdensome and difficult condition, not only for the people who live with it, but also for the people they love," said lead researcher and clinical psychologist, Dawn Buse, PhD, Department of Neurology, Albert Einstein College of Medicine, and Montefiore Headache Center, Bronx, New York.

"We hope that these data will raise awareness among family members, coworkers, society, healthcare providers, insurers, and government agencies who fund research, so that the magnitude of the effects of chronic migraine is more fully understood."

Dr. Buse will present the research here at the American Headache Society (AHS) 56th Annual Scientific Meeting.

Pulsating Headaches

Chronic Migraine Epidemiology & Outcomes (CaMEO) was a prospective, Internet-based study. People with chronic migraine (experiencing 15 or more headache days a month) and their spouses and children completed questionnaires to provide data on the burden of migraine.

This first analysis included 994 patients with chronic migraine who were assessed by using the validated American Migraine Study/American Migraine Prevalence and Prevention screener, a modification of International Classification of Headache Disorders 3b. They therefore experienced headaches that were pulsating, were of moderate to severe pain intensity, and worsened with routine activity, accompanied by nausea, phonophobia, and photophobia.

The analysis showed that:

• 64.1% of respondents feel their headaches make their partners life difficult;
• 72.5% feel they would be better partners if they didn't have headache;
• 70.2% are easily angered or annoyed by their partners because of headache;
• 67.2% avoid sexual intimacy because of their headaches;
• 64.4% feel guilty about how their headaches affect their partner;
• 59.1% believe they would be better parents if they didn't have headaches;
• 20% missed planned family vacation within the previous year; and
• 53.6% had less enjoyment while on vacation because of headaches.

Compared with men, women, who made up 81.7% of the study sample, cancelled plans 23% less often in the previous month because of headache (relative risk [RR], 0.77; 95% confidence interval [CI], 0.61- 0.98; P = .03) and missed 49% fewer holiday/religious events (RR, 0.51; 95% CI, 0.32 - 0.80; P = .003) and 52% fewer weddings/important events (RR, 0.48; 95% CI, 0.30 - 0.79; P = .004).

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CPAP adherence improved by family support

Family support may improve a person's adherence to CPAP treatment for sleep apnea.

A new study suggests that people with obstructive sleep apnea (OSA) who are single or have unsupportive family relationships may be less likely to adhere to continuous positive airway pressure (CPAP) therapy.

Results show that individuals who were married or living with a partner had better CPAP adherence after the first three months of treatment than individuals who were single. Higher ratings of family relationship quality also were associated with better adherence. Results were adjusted for potential confounding factors including age, gender and body mass index.

"This is the first study to explore the role of family factors in CPAP adherence," said lead author Faith Luyster, PhD, research assistant professor in the School of Nursing at the University of Pittsburgh. "Having healthy relationships with family members can create an environment that supports the patient's use of CPAP."

The research abstract was published recently in an online supplement of the journal Sleep and will be presented Monday, June 2, in Minneapolis, Minnesota, at SLEEP 2014, the 28th annual meeting of the Associated Professional Sleep Societies LLC.

The study group comprised 253 patients with OSA who were participating in a CPAP adherence intervention trial. Relationship status at baseline was identified, and family relationship quality was assessed using the 12-item General Functioning subscale of the Family Assessment Device. Treatment adherence was measured objectively, and was defined as average hours of CPAP use per night during a three month follow-up period.

According to Luyster, the results provide a potential target for interventions to improve CPAP adherence.

"Family-based CPAP adherence interventions may help patients who would benefit from family support during the initial treatment period," she said.

The American Academy of Sleep Medicine reports that obstructive sleep apnea is a common sleep illness affecting up to seven percent of men and five percent of women. It involves repetitive episodes of complete or partial upper airway obstruction occurring during sleep despite an ongoing effort to breathe. The most effective treatment option for OSA is CPAP therapy, which helps to keep the airway open by providing a stream of air through a mask that is worn during sleep.

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