Polysomnographic findings in 90 children with headaches and complaints of sleep problems were correlated with type of headache (migraine in 60, chronic migraine in 11, tension headache (6), and nonspecific headache (13)), headache severity, body mass index, and medical treatment, in a study at St Christopher’s Hospital for Children, Philadelphia, PA. The median age was 11 years (range, 5-19 years). Sleep-disordered breathing occurred in 56% of children with migraine, 54% of nonspecific headache patients, 27% children with chronic migraine, and none with tension headache. Severe and chronic migraine was associated with shorter sleep time, longer sleep latency, and shorter rapid eye movement and slow-wave sleep. Children with nonspecific headache and sleep-disordered breathing had higher body mass indexes (P=0.008). Bruxism occurred in 50% of children with tension headache vs 2.4% of those with nontension headache. Migraine patients taking prophylactic medication showed no differences in sleep parameters vs those not receiving prophylaxis. The results support an association between headaches, especially migraine, and sleep disorders in children. Migraine awoke the child during the night or in early morning in 9 of 60 (15%) patients. 
COMMENT. Children with migraine headache are affected by sleep-disordered breathing more frequently than children with tension headache. Children with tension headache have a twofold higher risk of nocturnal bruxism than children with other types of headache. A higher body mass index in children with nonspecific headache predisposes to sleep-disordered breathing and leads to sleep disorders. Polysomnography may help to clarify the association of headache and sleep disturbances.