Research on sleep disorders in children with episodic idiopathic vertigo provides evidence supporting the connection to migraine

Objectives

Migraine is the most common etiology of episodic vertigo in pediatric populations. The characteristics of migraine headaches in children differ from those in adults, with initial manifestations frequently presenting as periodic syndromes. Sleep disorders are prevalent among individuals with migraines. Headaches may not be present in early childhood, and children may not easily report aura or phono-photophobia. Therefore, it is essential to identify clinical and anamnesic elements that can support the etiopathogenetic hypothesis of migraine in the assessment of episodic idiopathic vertigo. The objective of this study was to assess the validity of research concerning sleep disorders in children experiencing episodic vertigo, with the aim of providing evidence for a connection to migraine.

Methods

The study included 25 participants diagnosed with episodic idiopathic vertigo, including 13 females and 12 males, aged between 5 and 14 years. A range of anamnestic parameters was analyzed, including the presence, type, and age of onset of sleep disorders; the presence, characteristics, and age of onset of headaches; and the presence of a family history of migraine. The data were compared with those of a control group matched for age and sex, which was affected by dysfunctional dysphonia and had no history of vertigo. The comparison of percentage values concerning the parameters under examination was conducted using the chi-square statistic test with Yates correction. A t-test was employed to compare the means and standard deviations. The significance limit is established for p values ≤ 0.05.

Results

Sleep disorders were present in 15 out of 25 patients (60 %) with episodic vertigo, compared to 3 out of 25 (12 %) in the control group (p = 0.001). Somniloquy is the most prevalent disorder. Headache was reported by 12 out of 25 recruited patients (48 %), with 8 cases classified as migraine-type, 1 as tension-type, and 3 as mixed or indefinite-type. In the control group, 4 out of 25 (16 %) reported headaches, including 1 migraine-type, 2 tension-type, and 1 mixed or indefinite-type (p = 0.03). A family history of migraine was identified in 19 (76 %) of the 25 patients and in 7 (28 %) of the 25 subjects in the control group (p = 0.001). The average age of onset for sleep disorders was 6.28 ± 1.67 years, while for headaches it was 9.25 ± 3.01 years (p = 0.01). The comparative analysis of symptom distribution by patient age indicates that all patients with sleep disorders reported this clinical manifestation by the age of eight years. Conversely, only 26.6 % of these patients reported experiencing the headache for the first time at the same age.

Conclusions

Children with episodic idiopathic vertigo exhibit a high prevalence of sleep disorders, alongside a significant correlation with headaches and a familial history of migraine. In younger patients, migraine symptoms, particularly headache, necessary for diagnosing vestibular migraine, are frequently absent or unreported. Studies on sleep disorders in children experiencing episodic idiopathic vertigo indicate a correlation with migraine.