Title

Treatment of Insomnia in Migraineurs
Treatment of Insomnia in Migraineurs With Eszopiclone (Lunesta™) and Its Effect on Sleep Time, Headache Frequency, and Daytime Functioning: a Randomized, Double-blind, Placebo-controlled, Parallel-group Pilot Study
  • Phase

    Phase 4
  • Study Type

    Interventional
  • Intervention/Treatment

    eszopiclone ...
  • Study Participants

    113
It is hypothesized that treating insomnia in migraineurs, many of whom also have tension headaches, prolongs total sleep time to the extent that it decreases overall headache frequency. Chronic headache sufferers also feel more tired during the day, undoubtedly affecting daytime functioning, which is hypothesized to improve as well with prolonged total sleep time.
The objective of the study is to determine the effect of prolonging total sleep time in migraineurs with insomnia on overall headache frequency, daytime alertness, fatigue, and functioning. The prolongation of total sleep time is accomplished by bedtime administration of 3 mg eszopiclone (Lunesta™), compared with placebo through a parallel-group design.
Study Started
Apr 30
2007
Primary Completion
Sep 30
2008
Study Completion
Sep 30
2008
Results Posted
Jun 15
2023
Last Update
Jun 15
2023

Drug eszopiclone

3 mg tablet every night at bedtime

  • Other names: Lunesta

Drug placebo

1 tablet every night at bedtime

Eszopiclone (Lunesta) 3mg Experimental

Participants with IHS-II migraine with and/or without aura and with DSM-IV primary insomnia. They were treated for 6 weeks with 3mg eszopiclone, followed by a 2-week runout period. Participants came in for five visits: a screening visit, a randomization visit, a compliance visit, an end-treatment visit, and an exit/early termination visit.

Placebo Placebo Comparator

Participants with IHS-II migraine with and/or without aura and with DSM-IV primary insomnia. They were treated for 6 weeks with placebo, followed by a 2-week runout period. Participants came in for five visits: a screening visit, a randomization visit, a compliance visit, an end-treatment visit, and an exit/early termination visit.

Criteria

Inclusion criteria:

Men and women, 18 to 64 years of age (inclusive) with International Headache Society (IHS)-II migraine with/without aura and Diagnostic and Statistical Manual (DSM)-IV primary insomnia (sleep onset/sleep maintenance).
Migraine frequency is 4-12 times per month, with a maximum of 20 days with headache per month, for 1 month or longer prior to screening.
A usual, estimated total sleep time of 6½ hours per night or less, for 1 month or longer prior to screening, due to problems falling asleep, waking up during the night, or waking up early.

Exclusion criteria:

Abortive migraine treatment with schedule II-III opioids.
Use of caffeine-containing medications, prescription and non-prescription, not exceeding 10 days per month.
Preventive migraine treatment with tricyclics or anticonvulsants.
Treatment of insomnia with non-prescription medications, such as diphenhydramine, melatonin, or valerian, and prescription medications, such as hypnotics, barbiturates, benzodiazepines, sedating antihistamines, antidepressants, and antipsychotics.

Summary

Eszopiclone 3mg

Placebo

All Events

Event Type Organ System Event Term

Total Sleep Time

Participants were asked to record an estimated total time asleep on a daily basis. Nightly estimates were averaged over a 2 week period for baseline and 6 week period so that the total sleep time represents the average total time asleep each night.

Eszoplicone 3mg

6 week average

6.3
hours (Mean)
Standard Deviation: 0.9

Baseline

5.4
hours (Mean)
Standard Deviation: 0.8

Placebo

6 week average

6.1
hours (Mean)
Standard Deviation: 0.8

Baseline

5.5
hours (Mean)
Standard Deviation: 1.0

Nighttime Awakenings

Participants were asked to keep a daily record. 6 week data were averaged over the 6 week period

Eszopiclone 3mg

6 weeks

1.5
awakenings/night (Mean)
Standard Deviation: 1.1

Baseline

2.4
awakenings/night (Mean)
Standard Deviation: 1.5

Placebo

6 weeks

2.2
awakenings/night (Mean)
Standard Deviation: 1.4

Baseline

2.7
awakenings/night (Mean)
Standard Deviation: 1.3

Nighttime Awakenings

Participants were asked to keep a daily record. The average among weeks 1 and 2, weeks 3 and 4, and weeks 5 and 6 were taken, resulting in 3 averages, where the lowest average is reported as the minimum value of the full range, the middle average is reported as the median, and the highest average is reported as the maximum value of the full range

Eszopiclone 3mg

1.5
awakenings/night (Median)
Full Range: 1.5 to 1.6

Placebo

2.1
awakenings/night (Median)
Full Range: 2.1 to 2.2

Quality of Sleep

Participants were asked to keep a daily record. 6 week data were averaged over the 6 week period Overall sleep quality was measured on a scale of 1=poor to 10=excellent. Daytime alertness was measured on a scale of 1=not alert to 10=extremely alert. Daytime fatigue was measured on a scale of 1=not tired to 10=extremely tired. Daytime functioning was measured on a scale of 1=poor to 10=excellent.

Eszopiclone 3mg

Daytime alertness, 6 weeks

6.9
score on a scale (Mean)
Standard Deviation: 1.3

Daytime alertness, Baseline

6.1
score on a scale (Mean)
Standard Deviation: 1.1

Daytime fatigue, 6 weeks

4.3
score on a scale (Mean)
Standard Deviation: 1.4

Daytime fatigue, Baseline

5.2
score on a scale (Mean)
Standard Deviation: 1.4

Daytime functioning, 6 weeks

7.0
score on a scale (Mean)
Standard Deviation: 1.3

Daytime functioning, Baseline

6.5
score on a scale (Mean)
Standard Deviation: 1.2

Overall sleep quality, 6 weeks

6.7
score on a scale (Mean)
Standard Deviation: 1.2

Overall sleep quality, Baseline

5.1
score on a scale (Mean)
Standard Deviation: 1.1

Placebo

Daytime alertness, 6 weeks

6.6
score on a scale (Mean)
Standard Deviation: 1.2

Daytime alertness, Baseline

6.0
score on a scale (Mean)
Standard Deviation: 1.4

Daytime fatigue, 6 weeks

5.0
score on a scale (Mean)
Standard Deviation: 1.5

Daytime fatigue, Baseline

5.5
score on a scale (Mean)
Standard Deviation: 1.5

Daytime functioning, 6 weeks

6.9
score on a scale (Mean)
Standard Deviation: 1.3

Daytime functioning, Baseline

6.3
score on a scale (Mean)
Standard Deviation: 1.5

Overall sleep quality, 6 weeks

6.2
score on a scale (Mean)
Standard Deviation: 1.0

Overall sleep quality, Baseline

4.9
score on a scale (Mean)
Standard Deviation: 1.1

Daytime Fatigue

Participants were asked to keep a daily record. Daytime fatigue was measured on a scale of 1=not tired to 10=extremely tired. The average among weeks 1 and 2, weeks 3 and 4, and weeks 5 and 6 were taken, resulting in 3 averages, where the lowest average is reported as the minimum value of the full range, the middle average is reported as the median, and the highest average is reported as the maximum value of the full range

Eszopiclone 3mg

4.3
score on a scale (Median)
Full Range: 4.2 to 4.4

Placebo

4.8
score on a scale (Median)
Full Range: 4.8 to 5.2

Headache Frequency

Number of days per week in which a participant had a headache. Participants were asked to keep a daily record. 6 week data were averaged over the 6 week period

Eszopiclone 3mg

6 weeks

2.5
days/week (Mean)
Standard Deviation: 1.3

Baseline

2.9
days/week (Mean)
Standard Deviation: 1.2

Placebo

6 weeks

2.5
days/week (Mean)
Standard Deviation: 1.4

Baseline

3.1
days/week (Mean)
Standard Deviation: 1.2

Headache Duration

Participants were asked to keep a daily record. 6 week data were averaged over the 6 week period

Eszopiclone 3mg

6 weeks

3.9
hours (Mean)
Standard Deviation: 1.8

Baseline

4.0
hours (Mean)
Standard Deviation: 2.3

Placebo

6 weeks

3.8
hours (Mean)
Standard Deviation: 2.2

Baseline

3.7
hours (Mean)
Standard Deviation: 2.2

Headache Intensity

Participants were asked to keep a daily record. 6 week data were averaged over the 6 week period Headache intensity was measured on a scale of 1=not intense to 10=worst headache possible

Eszopiclone 3mg

6 weeks

5.5
score on a scale (Mean)
Standard Deviation: 2.0

Baseline

5.6
score on a scale (Mean)
Standard Deviation: 2.3

Placebo

6 weeks

5.6
score on a scale (Mean)
Standard Deviation: 1.8

Baseline

5.3
score on a scale (Mean)
Standard Deviation: 1.6

Total

79
Participants

Age, Continuous

44.4
years (Mean)
Standard Deviation: 10.8

Age, Categorical

Race/Ethnicity, Customized

Region of Enrollment

Sex: Female, Male

Overall Study

Eszopiclone 3 mg

Placebo

Drop/Withdrawal Reasons

Eszopiclone 3 mg

Placebo