Does insomnia modify the association between C-reactive protein and migraine? The Tromsø Study 2015-2016.

• Published in: Cephalalgia
• Main Authors: Hagen, Knut, Hopstock, Laila Arnesdatter, Eggen, Anne Elise, Mathiesen, Ellisiv B., Nilsen, Kristian Bernhard
• Format: Article in Journal/Newspaper
• Language: English
• Published: Sage 2019
• Subjects: Tromsø
• Online Access: http://hdl.handle.net/11250/2590863; https://doi.org/10.1177/0333102418825370

Background The relationship between high sensitivity C-reactive protein and migraine is unclear. The aim of this cross-sectional population-based study was to investigate the association between high sensitivity C-reactive protein and types of headache, and to evaluate the impact of insomnia on this association. Methods A total of 20,486 (63%) out of 32,591 invited, aged ≥40 years or older, participated in the seventh wave of the Tromsø study conducted in 2015–2016 and had valid information on headache, insomnia and high sensitivity C-reactive protein. The influence of insomnia on the association between questionnaire-based diagnoses of headache and elevated high sensitivity C-reactive protein defined as >3.0 mg/L was assessed using multiple logistic regression, estimating prevalence odds ratio with 95% confidence intervals. Results A total of 6290 participants (30.7%) suffered from headache during the last year. Among these, 1736 (8.5%) fulfilled the criteria of migraine, 991 (4.8%) had migraine with aura, 746 (3.6%) migraine without aura (3.8%), and 4554 (22.2%) had non-migrainous headache. In the final multi-adjusted analysis, elevated high sensitivity C-reactive protein was associated with headache (odds ratio 1.10, 95% confidence interval 1.01–1.20), migraine (odds ratio 1.17, 95% confidence interval 1.01–1.35), and migraine with aura (odds ratio 1.23, 95% confidence interval 1.01–1.53). No association was found between elevated high sensitivity C-reactive protein and migraine without aura or non-migrainous headache. The association between high sensitivity C-reactive protein and migraine was strongly dependent on insomnia status. Among individuals with insomnia, elevated high sensitivity C-reactive protein was associated with migraine (odds ratio 1.49, 95% confidence interval 1.02–2.17), and migraine with aura (odds ratio 1.59, 95% confidence interval 1.03–2.45), whereas no such relationship was found among those without insomnia. Conclusions In this cross-sectional study, participants with migraine, in particular migraine with aura, were more likely to have elevated high sensitivity C-reactive protein, evident only among those with insomnia. acceptedVersion © 2019. This is the authors' accepted and refereed manuscript to the article. The final authenticated version is available online at https://journals.sagepub.com/doi/10.1177/0333102418825370.