Phyllis Zee, MD, PhD, Benjamin and Virginia T. Boshes Professor of Neurology, and Leon Epstein, MD, Derry A. and Donald L. Shoemaker Professor of Pediatric Neurology, co-authored an editorial in JAMA discussing the potential link between sleep cycles and colic.
An infant’s inconsolable crying could be a form of migraine headache, and Leon Epstein, MD, Derry A. and Donald L. Shoemaker Professor of Pediatric Neurology, and Phyllis Zee, MD, PhD, Benjamin and Virginia T. Boshes Professor of Neurology, believe sleep cycles may be the cause.
In an accompanying editorial to research published in the Journal of the American Medical Association (JAMA), the pair build upon the work of Italian and French scientists linking colic with migraines later in childhood.
A baby is considered colicky if it cries at least three hours a day, three days a week for three weeks, and the crying is not due to a medical problem. The exact cause of the condition remains unknown, but infant colic usually subsides by 12 weeks of age.
Epstein, a member of the Ann & Robert H. Lurie Children’s Hospital of Chicago Research Center and lead author of the editorial, pointed out how the study raises questions about basic assumptions regarding colic.
The well-accepted criteria of colic cannot distinguish whether an infant is “crying and fussing” because of abdominal pain (commonly considered to be the underlying cause), head pain, nausea, or some combination of these symptoms that are all known to occur in older patients with migraine.
The editorial goes on to say that if colic is an early manifestation of migraine, this may explain the consistent lack of efficacy of treatments directed at a gastrointestinal cause.
“The research published in JAMA found evidence of a link between migraine and infantile colic and we proposed that the lack of consolidation of sleep cycles in the first months of life may trigger it in those infants who are genetically susceptible to migraine,” Epstein said. “What we believe this helps demonstrate is that colic is likely part of the spectrum of migraine disorders.”
Zee, director of the Circadian Rhythms and Sleep Research Laboratory and Sleep Disorders Center, notes that maturation of circadian rhythms and consolidation of the sleep-wake cycle occur at approximately 12 weeks of age, when colic also subsides.
Clinicians have long suspected an association between migraine and colic and previous studies have linked maternal migraine with infantile colic.
Both are common conditions with colic occurring in approximately 16 to 20 percent of infants and the prevalence of migraine headache by age groups ranging from 1-2 percent in 3 year olds to 23 percent for 11 to 15 years old.
Because Zee and Epstein suspect that disrupted sleep cycles may play a role in both colic and migraines, the two hope to collaborate to further examine that relationship.
“If colic is an early form of migraine, this suggests that migraine disorders may represent a continuum, from colic in infancy, to cyclic vomiting syndrome in young children, to childhood and adult migraine,” the pair wrote in the editorial. “It opens up an area where we can begin to think about treatments for colic more similar to treatments for migraine.”
