Subjective cognitive impairment in patients with transformed migraine and the associated psychological and sleep disturbances.

PURPOSE: Migraines are associated with multiple comorbidities like depression, anxiety, poor sleep quality, and subjective cognitive impairment (SCI). This study aimed to evaluate the association of SCI with depression, anxiety, and modalities of sleep in those who have transformed migraines (TM). SUBJECTS AND METHODS: The study was conducted on 120 participants with TM and 41 control group participants. The subjective cognitive decline questionnaire classified the participants as SCI and non-SCI. The Headache Impact Test-6, Migraine Disability Assessment, Montreal Cognitive Assessment, Mini-Mental State Examination, Patient Health Questionnaire-9, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Full Polysomnography, and Beck's Anxiety and the Depression Inventories were used and analyzed between patients with SCI and non-SCI. RESULTS: Patients with TM who had SCI represented 34% with severe headache effects, disability, pain severity, increased depression, and increased anxiety. They showed shorter sleep duration during weekdays, lower sleep quality, less sleep time, lower efficiency, and less REM sleep along with greater sleep latency, periodic limb movements, a higher arousal index, snore index, and percent of NREM3. There was a positive correlation between certain polysomnography parameters like percent NREM3, sleep period, sleep index, sleep latency, sleep arousal index, and periodic limb movements, and an inverse correlation with the percent of REM sleep, total sleep time, and sleep efficiency. CONCLUSION: Subjective cognitive complaints are common in patients with transformed migraine affecting about 34% of cases. TM patients with SCI had more sleep and psychological disturbances. TRIAL REGISTRATION: Clinicaltrials.gov is NCT04413110.