Episodic Migraine Comorbidities: Avoiding Pitfalls and Taking Therapeutic Opportunities

  • Britany Klenofsky
  • Anna Pace
  • Lauren R. Natbony
  • Huma U. SheikhEmail author
Episodic Migraine (S. Nahas, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Episodic Migraine


Migraine is a common neurologic disorder. This article will discuss a few factors that influence migraine (mostly episodic) and its treatment, such as sleep, obstructive sleep apnea (OSA), obesity, and affective disorders, as well as autoimmune diseases. Practitioners must be aware of these coexisting conditions (comorbidities) as they affect treatment. It is noted in literature that both the quantity (too much or too few hours) and the quality (OSA related) of sleep may worsen migraine frequency. An associated risk factor for OSA, obesity also increases migraine frequency in episodic migraine cases. A bidirectional relationship with migraine along with depression and anxiety is debated in the literature. Retrospective cohort studies are undecided and lack statistical significance, but prospective studies do show promising results on treatment of anxiety and depression as a means of improving migraine control. Finally, we address the topic of autoimmune diseases and migraine. While few studies exist at this time, there are cohort study groups looking into the association between rheumatoid arthritis, hypothyroidism, and antiphospholipid antibody. There is also evidence for the link between migraine and vascular diseases, including coronary and cerebral diseases. We suggest that these comorbid conditions be taken into account and individualized for each patient along with their pharmaceutical regimen. Physicians should seek a multifactorial treatment plan including diet, exercise, and healthy living to reduce migraine frequency.


Migraine Sleep Anxiety Depression Obesity 


Compliance with Ethical Standards

Conflict of Interest

Britany Klenofsky, Anna Pace, Lauren Natbony, and Huma U. Sheikh declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Britany Klenofsky
    • 1
  • Anna Pace
    • 2
  • Lauren R. Natbony
    • 2
  • Huma U. Sheikh
    • 1
    • 2
    Email author
  1. 1.Mount Sinai Beth IsraelNew YorkUSA
  2. 2.Icahn School of Medicine at Mount SinaiNew YorkUSA

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