Evening Chronotype Associates With Worse Physical and Mental Health and Headache‐Related Disability Among Migraine Patients

Baksa, Dániel and Eszlári, Nóra and Török, Dóra and Hullám, Gábor István and Bagdy, György and Juhász, Gabriella (2025) Evening Chronotype Associates With Worse Physical and Mental Health and Headache‐Related Disability Among Migraine Patients. JOURNAL OF SLEEP RESEARCH. No.-e70066. ISSN 0962-1105 (In Press)

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Abstract

Migraine has been linked to chronotype, but with mixed results. Here, we tested chronotype in association with physical and mental health and headache characteristics in a large database of migraine patients and controls. A sample of the UK Biobank ( n = 360,081; 58.3% female, mean age: 56.38) was used. Data included self‐reported chronotype, mental (neuroticism, depression, stress) and physical (body fat percentage, overall health rating) health factors, and migraine diagnosis based on ICD‐10 G43 diagnosis from healthcare data. Morning type controls ( C morning , n = 210,775), evening type controls ( C evening , n = 129,174), morning type migraine patients ( M morning , n = 12,194), and evening type migraine patients ( M evening , n = 7938) were compared. Additionally, in a subsample of questionnaire‐based migraine ( n = 15,356), chronotype was tested in association with headache‐related features. One‐way ANOVA, Kruskal–Wallis test and chi‐squared test were run in SPSS 28 with Bonferroni correction. Evening chronotype was more frequent among migraine patients with an OR = 1.06, 95% CI [1.03; 1.09] compared to controls ( χ 2 = 16.523, p < 0.001). The M evening group showed the worst level of all mental and physical health variables, while the C morning group reported the best values. Migraine patients with morning or evening chronotype showed a highly similar headache symptom profile, but the M evening subgroup expressed a higher disability ( t = −3.965, p < 0.001). In conclusion, evening chronotype was associated with the worst physical and mental health status and the highest headache‐related disability among migraine patients, suggesting a need for elevated medical attention on chronotype in migraine.

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