Cluster Headache and Fibromyalgia Increase Depression and Sleep Problems, Study Shows

"Frequent comorbidity of cluster headache with fibromyalgia and migraine significantly increases the disease burden, particularly in females, leading to heightened depression, sleep disturbances, and a decreased quality of life," the researchers reported.

Cluster headache is a primary headache disorder known for its severe pain, often described as one of the most excruciating types of headache. When coexisting with fibromyalgia, a condition characterized by widespread musculoskeletal pain, and migraine, another severe headache disorder, the impact on patients' well-being is heightened.

The comorbidities of cluster headache have been rarely studied, except for migraine, which is widely recognized to coexist with cluster headache. In contrast, the combination of migraine and fibromyalgia has been extensively researched and well-documented. Considering this, Elena P. Calandre, Institute of Neurosciences, University of Granada, Granada, Spain, and colleagues aimed to explore the comorbidity of fibromyalgia and/or migraine in patients with cluster headache and assess how these conditions amplify the physical and psychological burden experienced by the patients.

For this purpose, the research team uploaded an internet survey to the webpage of a cluster headache patient association. The survey gathered sociodemographic and clinical data, while patients completed questionnaires assessing depression, sleep quality, health-related quality of life, and healthcare resource utilization (HCRU) over the past six months. The Kruskal-Wallis test was used to analyze differences in total depression, sleep quality, and health-related quality of life scores among the groups. The chi-square test was applied to examine differences in HCRU.

Key Findings:

• A total of 91 patients with cluster headache participated in the survey. Of these, 42.9% had only cluster headache, 16.5% had both cluster headache and migraine, 11% had cluster headache and fibromyalgia, and 29.7% had cluster headache with both fibromyalgia and migraine.
• Moderate depression scores and positive suicidal ideation were found across all subgroups.
• Sleep quality and health-related quality of life were consistently poor in all subgroups, with the subgroup experiencing cluster headache with comorbid fibromyalgia and migraine showing significantly lower scores.
• Heavy healthcare resource utilization was observed in all subgroups, with no significant differences between them.

The findings showed that comorbidity of cluster headache with fibromyalgia and/or migraine appears to be relatively common and significantly heightens the psychosocial burden on patients, leading to a marked decrease in their overall quality of life. It emphasizes the importance of careful screening and monitoring for suicidal ideation in patients with these conditions to ensure timely and effective clinical interventions.

The researchers believe that their study highlights the need for further research to explore the frequency and clinical implications of this comorbidity, particularly regarding its potential impact on suicide risk. They suggest that a population-based study would provide a more representative analysis, allowing for better categorization of diagnoses and the inclusion of more rigorous outcomes, such as suicide attempts or mortality.

Reference:

Elena P. Calandre, Jorge L. Ordoñez-Carrasco, Mahmoud Slim, Fernando Rico-Villademoros, Juan M. Garcia-Leiva. Comorbidity of migraine and fibromyalgia in patients with cluster headache: psychological burden and healthcare resource utilization. A cross-sectional study.Journal of Oral & Facial Pain and Headache,2024,38(1):32-39 DOI:10.22514/jofph.2024.004