Headache is one of the diseases that causes a child to be often referred to a child's neurologist. The incidence of headache in children and adolescents ranges from 20% to 55%. The prevalence is increased in pre-adolescent children, 75% in children aged 15 years and 40% in children aged 7 years.
Teenagers and children who experience the above headache incidents, it can be concluded that the prevalence of a higher incidence of migraine, migraine is a common phenomenon in children and adolescents especially those who experience changes in sleep patterns, but still little researched and the relationship between the two cannot be explained certainly. (Pranoto. 2010.)
Some predisposing factors for migraine are family history (genetic), age (often at puberty), menstruation, late eating, excessive stimulation (light beam, strong odor), weather changes, too much or lack of sleep and stress. (Lina. 2010.)
Migraines are described as interrupting the supply of energy because the body seems to be paralyzed, until the attack stops. Lethargy is a common symptom and every job seems to be heavy.
Some people who experience it must lie in a dark and quiet room, until the attack stops. Many sufferers also lose their appetite, but some can get rid of the nausea by eating. Migraine attacks can also make sufferers very worried. Those who experience visual disturbances in the form of light rays (aura), often worry about permanent loss of vision. Stroke and brain tumors, are also a common concern. (Wilkinson, Marcia & Anne Mac Gregor. 2002).
Migraine and changes in sleep patterns are a frequent problem in children. The relationship between the two is not yet fully known and research on the relationship between the two is also still small, even though finding a relationship between the two allows for early detection and early treatment of the two problems.
Sleep disturbance is a condition where a person experiences the risk of changing the amount and quality of resting patterns that cause discomfort.
Sleep disorders are one of the most common complaints found in patients who come to practice. Sleep disturbance can be experienced by all levels of society, whether rich, poor, highly educated and low-educated or young people, and is most often found in old age. In normal people, prolonged sleep disorders will result in changes in the biological sleep cycle, decreased endurance and decreased work performance, irritability, depression, lack of concentration, fatigue, which can ultimately affect the safety of themselves or others. (Japardi, 2002)
The duration of sleep needs varies between people and it is very difficult to judge how long a person needs to sleep to function optimally. In a study proving that sleep less than 6 hours can cause cognitive deficits, also reported adolescents with sleep disorders experiencing emotional disturbances, academic deficits, school attendance, social appearance deficits. (Waty & Lina. 2010)
Everyone's sleep habits are different depending on the habits that are carried during their adult development. At the age of adolescents that affect changes in sleep patterns that are due to work activities, age, emotional stress, health conditions, and so forth. Changes in sleep patterns can be assessed by making a judgment
consists of seven components including the number of hours of sleep (quantity of sleep), the time needed to be able to start sleep, the percentage between sleep time and time spent in bed, disturbance
sleep, the habit of using sleeping pills, daily activities related to sleep, and depth of sleep (sleep quality) subjectively.
Migraine can be described as an episodic headache, lasting for 4 - 72 hours, accompanied by nausea and vomiting. Some migraine attacks are preceded by a ray of light or aura (classic migraine), a symptom of vision. There is a totally limited state of symptoms before another attack. Daily headaches are not migraines. (Wilkinson, Marcia & Anne Mac Gregor,
(2002).)
Migraine without aura (common migraine) is common in children and adolescents (70%). In this type of headache occurs in bilateral or unilateral frontal areas that are throbbing, moderate or severe intensity with an attack duration of 1 to 72 hours, but usually the headache frequency is no more than 6 to 8 times per month. Usually the child is difficult to describe this form of headache appropriately. Clinical such as aura is not specific and manifests as feeling weak, pale, and easily offended for 30 minutes to several hours. This condition is more often accompanied by nausea and abdominal pain than vomiting. Repeated vomiting is often the only manifestation in preschoolers.
The clearest guideline for migraines is that the child looks sick, wants to sleep and can't stand bright lights or loud sounds.
Migraine with aura (classic migraine) is a biphasic process. In the initial phase there is a wave of excitation followed by depressed cortical function and a decrease in local blood flow. In the next phase there is an increase in blood flow in the internal and external carotid arteries, causing headaches, nausea and vomiting. These headache attacks recur at least twice, concurrently or preceded by symptoms of a homonym aura that is reversible gradually in 5 to 20 minutes and lasts less than 60 minutes. Classical migraine is more rarely found in children and adolescents.
Cyclic vomiting, including the type of migraine that is seen in children, especially aged 4 to 8 years in the form of nausea and vomiting continuously, can be 1 hour to 5 days. The attack will subside alone and between attacks the patient under normal circumstances. The diagnosis of cyclic vomiting is made if there is no significant gastrointestinal abnormalities in exploration and there is a family history of migraine. Abdominal migraine also occurs in children, symptoms that occur in the form of pain attacks in the middle of the abdomen in episodic recurrence that lasts for 1 to 72 hours followed by symptoms of nausea and vomiting with the period between attacks children in normal circumstances. (Pranoto. 2010)
A person who experiences migraines rarely checks for health services, because they are considered an ordinary disease. Yet if this happens continuously without being checked it will disrupt their daily activities and make them very worried. If this happens to students, it will affect concentration in learning and health conditions. So students must be able to overcome migraines by recognizing and avoiding triggers, the number of attacks and the severity of migraines can be reduced. There are several trigger factors beyond our ability to be able to control it such as eating nutritious foods, eating regularly, dealing with stress, sleeping and doing regular activities, and healthy lifestyle. There are also things that must be avoided, including foods that can trigger migraines and avoid cigarette smoke either as passive or passive smokers.
The relationship between sleep and headaches has long been known. There are three possible relationships between headache and sleep disorders namely headache causes sleep disorders, sleep disorders cause headaches and both are caused by intrinsic factors. Primary headache (migraine) has not been observed as a direct cause of major sleep disorders except depression in headache or excessive use of analgesics. Sleep disorders that can cause headaches generally occur in obstructive sleep apnea. Both are caused by intrinsic factors that are triggered by changes in neurotransmitters, perhaps because they are influenced by drugs that affect neurotransmitters or due to weather changes.
Serotonin levels affect REM sleep and migraine, where serotonin works to regulate REM sleep. During a migraine attack the breakdown of the product serotonin, 5-hydroxyindoleacetic acid (5-HIAA), sleep disturbance will occur.
The anatomy and physiology of the hypothalamus affect headache and sleep mechanisms, whereas the hypothalamus contains hypocretin synthesizing cells which, if its function is disrupted, can cause narcolepsy. The hypothalamus is also associated with periaqueductal gray matter, spinal noriceptive neurons and the reticular system that play a role in the regulation of pain and headaches.
In a study conducted by Michael et al to look at the prevalence of sleep disorders and symptoms in 64 children with headaches, it was found that children with headaches more often experience sleep disorders such as excessive daytime drowsiness, narcolepsy and insomnia when compared to children without headaches but not found a high prevalence for symptoms of sleep apnoe, restlessness and parasomnia.
In a study conducted by Miller et al in 1008 children aged 2 to 12 years, it was found that children with migraine headaches experience sleep disorders more often than in normal children. Sleep disorders that are often experienced by children with migraine are late sleep onset, more resistance to sleep hours, shorter duration of sleep, often sleepy during the day, often wake up at night, anxiety when going to sleep, parasomnia and breathing problems during sleep. (Waty & Lina. 2010)
(Fathul Liulfa)