MIGRAINE AND SLEEP: BIDIRECTIONAL RELATIONSHIPS, CLINICAL IMPACT, AND MANAGEMENT IMPLICATIONS — A STRUCTURED LITERATURE REVIEW

Abstract

Migraine is a disabling neurological disorder frequently accompanied by sleep complaints, including insomnia symptoms and poor subjective sleep quality. Growing evidence supports a bidirectional relationship: disturbed sleep may precipitate migraine attacks and contribute to greater disease burden, while migraine-related symptoms may disrupt sleep continuity and impair next-day functioning. This structured literature review synthesizes contemporary evidence on the migraine–sleep association, including the prevalence of sleep disturbances in migraine, mechanistic links between sleep dysregulation and migraine, clinically relevant comorbid sleep disorders, and management implications. A structured search of PubMed/MEDLINE, Scopus, and Web of Science identified English-language peer-reviewed publications (2015–2025), including observational studies, systematic reviews, meta-analyses, and clinical guidance documents. Across study designs, poor sleep quality is consistently more common in people with migraine and is associated with higher migraine burden. Emerging longitudinal and genetic epidemiology findings are compatible with reciprocal influences between insomnia liability and migraine risk. Clinically, the reviewed evidence supports routine screening for sleep problems in migraine care, targeted evaluation and treatment of comorbid sleep disorders, and consideration of evidence-based insomnia interventions as part of integrated management.