More than 64% of migraine sufferers report poor sleep quality, and they are significantly more likely to be evening types than people without headache disorders, according to a nationwide study of 5,311 Polish adults.
The link between sleep and headache is well known clinically, but population-level data comparing sleep quality and chronotype across headache subtypes has been limited. Researchers at Wroclaw Medical University used the HARDSHIP questionnaire and ICHD-3 criteria to classify participants into migraine, tension-type headache (TTH), unclassified headache, and headache-free groups, then assessed sleep via the Pittsburgh Sleep Quality Index (PSQI) and chronotype via the Morningness-Eveningness Questionnaire (MEQ).
What They Found. The migraine group (n = 1,523) reported the poorest sleep quality of any group, with a median PSQI of 7 compared to 5 in controls. Poor sleep (PSQI > 5) was present in 64.1% of migraine participants versus 38.7% of controls (p < 0.001).
The association held after adjustment. Migraine was linked to a beta coefficient of 2.09 for higher PSQI scores (worse sleep), compared to 1.57 for unclassified headache and 0.59 for TTH.
Chronotype analysis revealed a significant shift toward eveningness in the migraine group (adjusted beta = -1.38, p < 0.001). Only 24.9% of migraine participants were morning types, compared to 39.1% of controls.
Within the migraine subgroup, poorer sleep quality correlated moderately with lower quality of life (r = -0.45) and higher perceived stress (r = 0.34). Chronotype showed only weak correlations with clinical outcomes.
Why It Matters. Migraine is one of the most disabling conditions worldwide, and sleep disruption is both a trigger and a consequence. This study confirms at population scale that poor sleep and evening chronotype are not incidental findings in migraine but prominent features that may represent modifiable risk factors. The authors recommend systematic sleep quality assessment and sleep-focused interventions as part of migraine management.
Limits. The cross-sectional design cannot establish whether sleep disruption and eveningness contribute to migraine onset or result from it. Headache classification relied on self-report questionnaires, and the sample was drawn from an online panel, which may not fully represent the general population.
Bottom Line. Over 64% of people with migraine have poor sleep quality, and they skew toward evening chronotype at nearly double the rate of controls. Integrating sleep assessment into headache care could identify patients who would benefit from chronobiological or behavioral sleep interventions.
Source: Marschollek K, et al. “Sleep quality and chronotype in primary headache disorders: a nationwide population-based study of 5,311 Polish adults.” The Journal of Headache and Pain. Published June 19, 2026. DOI: 10.1186/s10194-026-02425-9