Headaches: Effects on Sleep, Sensitization, and Psychological Factors

November 20, 2025 updated by: Nagihan Acet

The Silent Saboteur: The Impact of Headaches on Sleep Disorders, Central Sensitization, Depression, Anxiety and Stress

Headache is one of the most common health problems in the society and negatively affects the quality of life of individuals. Increasing complaints of headache in recent years can be associated with many physiological and psychological factors. Sleep disturbances are one of these factors. Inadequate or non-restful sleep can interfere with the normal course of physical, mental, social and emotional functions. Impaired sleep quality interferes with the body's process of repairing and regenerating itself, which can lead to more serious health problems in the long term. Secondly, headaches can also lead to neurophysiological changes such as central sensitization. Central sensitization causes the nervous system to become hypersensitive, lowering the pain threshold and increasing pain perception. Finally, headache can have psychological effects by increasing levels of depression, anxiety and stress.

This study aimed to determine the effects of headache on sleep disturbances, central sensitization, depression, anxiety and stress.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Headache is one of the most common health problems in the society and types of headache have a significant negative impact on the quality of life of individuals. Headaches can occur in a wide range from temporary discomfort to chronic problems and can negatively affect individuals' work performance, social life and general health . In recent years, complaints of headache have been increasing in the society. This may be associated with factors such as stress factors of modern life, sleep irregularities and increased use of technology.

One of the factors most affected by headache is sleep disturbance. Especially the presence of migraine can lead to sleep disorders. Sleep disorders consist of various conditions that disrupt normal sleep patterns and are one of the most common problems encountered in clinical practice. Inadequate or non-restful sleep may interfere with the normal course of physical, mental, social and emotional functions. Impaired sleep quality inhibits the body's process of self-repair and regeneration, which can lead to more serious health problems in the long term.

Establishing the relationship between sleep and headache can make a significant contribution to the management of headache.

Headaches can also be an important trigger of central sensitization. Central sensitization is an adaptive, activity-dependent and dynamic neurophysiological phenomenon]. This process involves neurobiological changes in neurons in the dorsal horn of the spinal cord.]. These changes include increased excitability, enhanced synaptic transmission and decreased inhibition. In summary, central sensitization is a condition in which the nervous system becomes hypersensitive and pain is perceived as more severe than normal. Especially in individuals with chronic headache, central sensitization may develop as a result of continuous stimulation of the nervous system and this may lead to a decrease in pain threshold and an increase in pain perception. Especially the fact that chronic headache triggers central sensitization is a factor that makes the treatment process very difficult and this situation seriously affects the quality of life of patients.

The psychological effects of headache cannot be ignored. Headache can increase depression, anxiety and stress levels. When pain becomes a constant source of anxiety, it makes it difficult to perform daily activities and negatively affects the general mood of the person. Depression and anxiety can increase the severity of headaches, and headaches can trigger these psychological conditions. Stress can be both a cause and a consequence of headache; especially tension-type headaches are closely related to stress. Therefore, it is important to consider the psychological status in the treatment of headache.

The presence of headache may affect many factors such as sleep disturbance, central sensitization, depression, anxiety and stress, and revealing these effects will contribute to the development of treatment approaches in headache treatment.

In the light of the above information, the aim of the present study was to determine the effect of the presence of headache on sleep disorders, central sensitization, depression, anxiety and stress.

Study Type

Observational

Enrollment (Actual)

132

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Ankara
      • Ankara, Ankara, Turkey (Türkiye), 06560
        • Atılım University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

Individuals aged 18-65 with and without headaches.

Description

Inclusion Criteria:

  • being 18-65 years who agreed to participate

Exclusion Criteria:

  • Neurological disorders
  • Musculoskeletal diseases
  • Chronic pain conditions
  • Psychiatric diseases

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Headache Group
individuals diagnosed with migraine and tension-type headache according to the International Classification of Headache Disorders (International Classification of Headache Disorders, 3rd edition) will be placed in the headache group
Other: Assessment of sleep disorders
: Sleep disturbances will be assessed with the Pittsburgh Sleep Quality Index
Other: Assessment of Central Sensitization
Central sensitization will be assessed with the Central Sensitization Inventory
Other: Assessment of depression, anxiety and stress levels
Depression, anxiety and stress levels will be assessed using the Depression, Anxiety, Stress Scale (DASS-21)
Control Group
Individuals aged 18-65 without headaches will be placed in control group.
Other: Assessment of sleep disorders
: Sleep disturbances will be assessed with the Pittsburgh Sleep Quality Index
Other: Assessment of Central Sensitization
Central sensitization will be assessed with the Central Sensitization Inventory
Other: Assessment of depression, anxiety and stress levels
Depression, anxiety and stress levels will be assessed using the Depression, Anxiety, Stress Scale (DASS-21)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Assessment of sleep disorders
Time Frame: baseline
: Sleep disturbances were assessed with the Pittsburgh Sleep Quality Index (PSQI) . The PSQI is a 19-question questionnaire used to measure sleep habits over the past month and has 7 components. The total score ranges from 0 to 21, with higher scores indicating poor sleep quality. Scores of 5 and above are considered as sleep disturbance.
baseline
Assessment of depression, anxiety and stress levels
Time Frame: baseline
Depression, anxiety and stress levels were assessed using the Depression, Anxiety, Stress Scale (DASS-21). The DASS-21 consists of depression, anxiety and stress subscales, each with 7 questions. A maximum of 42 points can be obtained for each component (the first score is multiplied by two). Higher scores indicate the severity of the respective disorder. Cut-off values are different for each disorder: for depression, 0-9 (normal) to 28 and above (very severe), for anxiety 0-7 (normal) to 20 and above (very severe), and for stress 0-14 (normal) to 34 and above (very severe).
baseline
Assessment of Central Sensitization
Time Frame: baseline
Central sensitization was assessed with the Central Sensitization Inventory (SSI.) The SSE consists of 25 questions. The total score ranges from 0 to 100 and a score of 40 and above indicates the presence of central sensitization.
baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Nagihan Acet

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 19, 2024

Primary Completion (Actual)

November 19, 2024

Study Completion (Actual)

December 19, 2024

Study Registration Dates

First Submitted

September 12, 2024

First Submitted That Met QC Criteria

September 16, 2024

First Posted (Actual)

September 19, 2024

Study Record Updates

Last Update Posted (Actual)

November 25, 2025

Last Update Submitted That Met QC Criteria

November 20, 2025

Last Verified

November 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Atılım Physiotherapy

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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