Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Migraine Comorbidities and Therapeutic Opportunities

Curr Pain Headache Rep; 2019 Jan 12; Klenofsky, et al

A recent investigation reports on factors that may influence migraine (mostly episodic) and its treatment. Therefore, practitioners should be aware of these coexisting conditions as they affect treatment. It is also suggested that physicians seek a multifactorial treatment plan including diet, exercise, and healthy living to reduce migraine frequency. Key points include:

  • Sleep, obstructive sleep apnea (OSA), obesity, and affective disorders, as well as autoimmune diseases can affect migraine and its treatment.
  • Both the quantity (too much or too few hours) and the quality (OSA-related) of sleep may worsen migraine frequency.
  • Obesity, an associated risk factor for OSA, also increases migraine frequency in episodic migraine cases.

Finally, researchers address the topic of migraine and autoimmune diseases, such as rheumatoid arthritis, hypothyroidism, and antiphospholipid antibody. There is also evidence of a link between migraine and vascular diseases, including coronary and cerebral diseases. Researchers suggest that these comorbid conditions be taken into account and individualized for each patient along with their pharmaceutical regimen.


Klenofsky B, Pace A, Natbony LR, Sheikh HU. Episodic migraine comorbidities: Avoiding pitfalls and taking therapeutic opportunities. Curr Pain Headache Rep. 2019;23(1):1. doi:10.1007/s11916-019-0742-8.