Clinical Course of Migraine during Strict Quarantine due to SARS-CoV-2: Effect of Psychiatric Comorbidities in a Clinical Cohort.

OBJECTIVE: During the SARS-CoV-2 pandemic, there has been a significant increase in the prevalence of anxiety and depression. This study sought to establish the probability of migraine progression by comparing data from week 0 with week 12 of quarantine. METHODS: A retrospective cohort study. Three hundred ten patients were included, 238 with episodic migraine and 33 with chronic migraine; they all completed a self-administered questionnaire with demographic, clinical, and psychiatric symptom information. A multivariate statistical analysis was conducted to identify factors associated with the progression of migraine. RESULTS: This study demonstrated a 22.5% progression probability from episodic migraine to chronic migraine with an RR 2.7 and CI (1.92-3.95, p < 0.001). The increase in depression scores (p < 0.005), anxiety (p < 0.001), and alteration in sleep quality (p < 0.003) were associated with the worsening of migraine. CONCLUSION: During the SARS-CoV-2 pandemic, depression, anxiety, and the deterioration of sleep quality influenced the probability of progression from episodic migraine to chronic migraine.

Gender and Polysomnographic Profiles Findings in Obstructive Sleep Apnea Syndrome Patients Living in High Altitude.

PURPOSE: Obstructive sleep apnea (OSA) is a common sleep disorder which prevalence is 22% in men and 17% in women. It is well described that females presented different clinical and polysomnographic characteristics compared with men. Those studies were performed in plain areas. We described the analysis by gender and clinical profiles of a sample of patients with diagnostic of OSA and living at high altitude. PATIENTS AND METHODS: It is an observational study that describes differences between clinical and polysomnographic characteristics by gender in patients with OSA. Additionally, an unsupervised cluster algorithm was used to find groups of patients with similar clinical and polysomnographic characteristics. RESULTS: We included 709 patients, 51.6% were females and 48.3% were males with mean age of 64 and 62 years old, respectively, in which 90.97% presented OSA. Men presented a higher apnea and hypopnea index than women (p=0.002), besides presented more sleep polysomnographic alterations. Meanwhile, women evidenced better sleep quality based on parameters. Additionally, in the sample of patients, we found four separated clinical profiles characterized mainly by differences in the severity of polysomnographic parameters. CONCLUSION: The patients were more obese, older, and had lower SpO2 values than most of those previously reported. Men had greater severity in most of the parameters measured by polysomnography. Polysomnographic variables were different both in the OSA patient profiles and in the gender comparison. However, the REM sleep apnea hypopnea index did not differ between sexes, indicating the importance of this variable in the evaluation of OSA severity in women. In contrast to previous reports, clinical and demographic characteristics showed few differences in both analyses. This result suggests that the behavior of OSA at high altitudes may have particularities with respect to low altitudes.