To investigate the effect of the spring daylight saving time (DST) transition on sleep and headaches in patients with migraines.

DST starts on the second Sunday in March and ending on the first Sunday in November in the U.S., excluding Hawaii and Arizona. DST results in circadian misalignment by increasing exposure to  darkness in the morning and light in the evening. Migraine, a leading cause of disability, is closely linked to sleep patterns. Given the connection between sleep disturbances and headaches in patients with migraines, we conducted a prospective observational study to investigate their association. 

Twenty-three adults (mean age 42.22 (±11.57 years) with episodic migraine who were not taking sedating medications or hypnotics were included in this 28-day study (2 weeks before and 2 weeks after DST transition in March 2023).  Withings under the mattress sleep tracker was used to capture sleep variables and headache diary to record headache variables.

Total sleep time was normalized after 2 weeks (pre-DST mean 437.79 ± 42.96 min, post DST mean 438.16 ± 35.47 min, p=0.96). A significant reduction in deep sleep was noted (pre-DST 94.26 ± 38.26 min, Post DST 83.97 ± 41.31 min, p=0.015). All other sleep variables (sleep efficiency, latency, and regularity; light NREM and REM sleep) did not show significant changes. A significant increase in migraine incidence (per 100 person days: 7.76 vs 13.35, p=0.029) was noted. Eveningness chronotype was associated with a trend of increased headaches due to DST transition (incidence rate per 100 person days: 26.19 vs 52.38, p=0.058). Migraine preventative medication type did not affect migraines or headaches.

The spring DST transition reduced deep sleep and increased migraine incidence. More research is required to investigate the connection between circadian rhythms and migraines, as this can reveal potential therapeutic strategies for alleviating migraines by stabilizing circadian rhythms.