Sleep quality, circadian rhythms and melatonin in headache; facts and perspectives

Several pieces of evidence indicate that headache and sleep are strictly related. Melatonin nocturnal secretory patterns were reportedly blunted in various forms of headache during and out of the attacks. The hypothalamic dysfunction underppining headache attacks in migraine as well as in cluster headache, headacherelated life style changes and pharmachological treatments, all may account for altered melatonin secretion in headache sufferers. The altered melatonin secretory patterns may in turn play a role in the genesis of the headache attacks and of sleep disorders which are frequently comorbid wih headache. The potential benefit of melatonin and melatoninergic agonists in migraine and cluster headache pave the way to new, interesting therapeutic options in these forms of headache.