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Abstract Introduction The relationship between sleep disruption characterized by polysomnography and migraine development remains unclear. This study elucidates this association, examining whether indices of sleep disturbance could serve as predictors of migraine. Methods In this longitudinal study, 132, 705 participants (2000 to 2023) without pre-existing migraines were analyzed. Predictors included Apnea-Hypopnea Index (AHI), Mean SaO2, arousal index, and Epworth Sleepiness Scale (ESS) scores. Covariates for adjustment comprised age, sex, body mass index (BMI), race, neck size, end-tidal CO2, sleep stage percentages, and household income. Migraine incidence was ascertained using ICD diagnosis codes. Analysis employed univariable and multivariable Cox regression models. Results The cohort averaged 50. 2 ± 19. 0 years, was 54% male, and 76% Caucasian. Mean follow-up was 4. 8 ± 4. 1 years until migraine incidence. Adjusted regression showed higher AHI (per 5 units) was associated with a 1% reduction in migraine risk (HR=0. 989, 95% CI 0. 986-0. 992). Also, higher mean SaO2 predicted a 4% increase in migraine incidence (HR=1. 04, 95% CI 1. 03-1. 06). Reduced N1 percentage (HR=0. 993, 95% CI 0. 988-0. 999), lower arousal index (per 1 unit, HR=0. 993, 95% CI 0. 991-0. 996), and higher income (per 10, 000, HR=0. 96, 95% CI 0. 94-0. 98) also decreased migraine development. However, elevated ESS scores (HR=1. 04 per unit increase) and larger neck sizes (HR=1. 005 per 1 cm) augmented migraine risk (both p 0. 001). Conclusion More severe sleep disruption correlated with reduced migraine incidence, contrasting expectations. Apnea-induced vasoconstriction may trigger protective vascular changes in calcitonin gene-related peptide (CGRP) /serotonin pathways. Further study on mediating mechanisms is warranted. Support (if any)
Khazaie et al. (Sat,) studied this question.