Poor subjective sleep quality is common in tension-type headache and associated with depressive symptoms
The pooled prevalence of poor sleep quality (PSQI >5) in adults with tension-type headache was 67% (95% CI 53-79%). The mean PSQI score was 9.48, significantly higher than controls (mean difference 3.77, 95% CI 2.32-5.22), and correlated robustly with depression (r=0.51).
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Poor subjective sleep quality is common in tension-type headache and associated with depressive symptoms The current body of evidence comprises 1 study and 1 meta-analysis. EvidenceHub rates the overall confidence at 49/100 (low).
The Claim
Poor subjective sleep quality is common in tension-type headache and associated with depressive symptoms
This conclusion is most relevant to: Adults with tension-type headache (TTH) from 27 observational studies.
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Sleep disturbances in tension-type headache: a systematic review and meta-analysis. (Journal of neurology, 2026) — The pooled prevalence of poor sleep quality (PSQI >5) in adults with tension-type headache was 67% (95% CI 53-79%). The mean PSQI score was 9.48, significantly higher than controls (mean difference 3.77, 95% CI 2.32-5.22), and correlated robustly with depression (r=0.51).
How It Works
The proposed biological pathway:
- ▸Tension-type headache is associated with central sensitization and pain processing abnormalities
- ▸Sleep disturbances may exacerbate pain sensitivity and headache frequency
- ▸Depressive symptoms are strongly correlated with poor sleep quality in TTH patients
- ▸Result: Bidirectional relationship between sleep disturbance and TTH, with depression as a key mediator
Who Might Benefit
Evidence fit by population:
- ▸Adults with tension-type headache (TTH) from 27 observational studies
Recommended Dose
N/A
Limitations & Caveats
Important context when interpreting this evidence:
- ▸High heterogeneity (I²=97%) across studies, partly explained by recruitment settings
- ▸Correlations with headache frequency and intensity were nominal and exploratory, not robust after multiple testing correction
Frequently Asked Questions
What percentage of people with tension-type headache have poor sleep quality?▼
The pooled prevalence is 67% based on PSQI scores, though estimates ranged from 53% to 79% across studies.
Is poor sleep quality in tension-type headache linked to depression?▼
Yes, the correlation between PSQI scores and depressive symptoms was strong (r=0.51) and statistically significant after correction for multiple testing.
Does sleep duration differ between TTH patients and controls?▼
No, mean sleep duration was 6.61 hours and did not differ significantly from non-headache controls.
What sleep disorders are common in tension-type headache?▼
Insomnia was reported in 37%, excessive daytime sleepiness in 13%, and high OSA risk or confirmed OSA in 26% of TTH patients.
References
- 1.Yuan L, Kulachai P, Wu QM, Zhang YX, Niu XY, Liang JT, Zheng H. “Sleep disturbances in tension-type headache: a systematic review and meta-analysis..” Journal of neurology, 2026. PMID: 42493638 DOI: 10.1007/s00415-026-14011-9