A time series analysis of daily hassles and mood changes in the 3 days before the migraine attack

Daily hassles, mood changes, and sleep quality in the 3 days preceding migraine attacks were prospectively studied and compared with migraine-free control days. Nineteen female migraine patients, aged 20 to 49 years, kept a 10-week diary four times per day and produced complete data: on daily hassles (incidence and stressfulness), mood (alert, tense, irritable, annoyed, depressed, and tired), sleep quality, and migraine. Significant results indicated increased hassles, particularly in the 24 premigraine hours; psychological arousal (increased irritability, annoyance, and tenseness), predominantly from 60 to 24 hours before the attack; repeated fatigue in the 60 premigraine hours, with a peak immediately before the attack; and a sharp decrease in sleep quality in the night preceding the attack. The authors also found that those attacks that came on during phases of heightened activity-particularly in the afternoon-were preceded by more substantial and more significant elevations of hassles and psychological arousal than were attacks that occurred during unwinding phases, particularly at night.