What question did this study set out to answer?

The central aim is to explore how migraine and sleep interventions impact each other.

March 26, 2026Open Access

Interventions for Migraine and Sleep: A Systematic Review Exploring Their Bidirectional Association

Key Points

The central aim is to explore how migraine and sleep interventions impact each other.
Conducted a systematic review following PRISMA 2020 guidelines.
Searched across six databases for relevant clinical trials and observational studies.
Evaluated risk of bias using RoB 2 and ROBINS-E tools.
Included studies assessed both migraine and sleep-targeted interventions in adults.
Pharmacological treatments reduced migraine frequency and pain intensity but had variable impacts on sleep quality.
Non-pharmacological therapies improved both migraine symptoms and sleep.
Digital Cognitive-Behavioral Therapy for Insomnia significantly reduced headache days and enhanced sleep.

Abstract

ABSTRACT Background Migraine and sleep disturbances share a bidirectional relationship, influencing each other's frequency and severity. The aim of this systematic review is to examine the effects of migraine‐targeted interventions on both migraine outcomes and sleep parameters (including sleep quality and insomnia symptoms), as well as the effects of sleep‐focused interventions on both sleep and migraine outcomes. Methods Following PRISMA 2020 guidelines, a systematic search was conducted across six databases (PubMed, Medline, Scopus, Embase, PsycINFO, CINAHL) for studies published until December 5, 2023. Eligible studies included Randomized Clinical Trials, Controlled Clinical Trials, and observational studies assessing migraine and/or sleep‐targeted interventions in adults. The risk of bias was evaluated using RoB 2 and ROBINS‐E tools. Results Twenty‐three studies (1941 participants) were included. Pharmacological treatments such as erenumab, amitriptyline, propranolol, and onabotulinumtoxinA reduced migraine frequency and pain intensity, with variable effects on sleep quality. Melatonin showed no significant impact. Among non‐pharmacological treatments, percutaneous electrical nerve stimulation, greater occipital nerve block, green light therapy, binaural beats, mindfulness, and dietary modifications improved both migraine symptoms and sleep. Digital Cognitive‐Behavioral Therapy for Insomnia (CBT‐I) significantly reduced headache days and improved sleep parameters, whereas evidence on standard CBT‐I was mixed. Limitations Study heterogeneity, small sample sizes, and variability in outcome measures limit generalizability. Few studies focused on sleep‐targeted interventions and their effects on migraine, highlighting a research gap. Conclusions Integrated approaches combining migraine and sleep interventions show promise for symptom management. Further research is needed to refine treatment strategies and assess long‐term effects. Registration CRD42024617217.

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