Sleep and anti-calcitonin gene related (CGRP) drugs: current evidence and perspectives - PubMed

2 days ago

Migraine and sleep have a bidirectional relationship, with sleep disruption triggering migraines and migraines impairing sleep.
CGRP is central to migraine pathophysiology and also plays a role in sleep regulation through hypothalamic and brainstem circuits.
Anti-CGRP therapies, such as monoclonal antibodies (mAbs) and gepants, may impact sleep quality, with some evidence suggesting improvements in subjective and objective sleep measures.
Erenumab, galcanezumab, and atogepant show potential in improving sleep efficiency, while data on fremanezumab and eptinezumab is limited.
Large-scale pharmacovigilance data indicate low rates of sleep-related side effects like insomnia, somnolence, or abnormal dreams with anti-CGRP therapies.
The mechanisms of how CGRP inhibition affects sleep are not fully understood, presenting an area for future research.
Standardized sleep endpoints in future studies are needed to differentiate direct neuropharmacological effects from indirect benefits due to reduced migraine burden.

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