SYSTEMIC OZONE THERAPY FOR CHRONIC MIGRAINE: IMPACT ON DISABILITY, MEDICATION USE, AND SLEEP QUALITY IN A FEMALE PATIENT GROUP

S. Sorrenti¹, M. Ciuffreda¹, E. Pisello¹, L. Brugiaferri², A. Federici², C. Piangatelli³, D. Galante⁴ | ¹U.O.C. Anesthesia Resuscitation Pain Therapy, AST Ancona, Fabriano (AN); ²Residency School. Anesthesia, Resuscitation, Intensive and Pain Therapy, Università Politecnica delle Marche, Ancona; ³U.O.C. Anesthesia, Resuscitation, Pain Therapy, Director, AST Ancona, Fabriano (AN); ⁴U.O.C. Anesthesia and Resuscitation, Director, Cerignola (FG)

INTRODUCTION
Chronic migraine is a highly disabling neurological condition that significantly affects patients' quality of life and daily functioning. It often requires frequent use of symptomatic medications, particularly NSAIDs and triptans, increasing the risk of medication overuse headache (MOH) and other adverse effects. In recent years, there has been growing interest in non-pharmacological or complementary therapies aimed at reducing the symptomatic burden. This study investigates the potential benefits of systemic ozone therapy, specifically autohemotherapy (AHT), in reducing migraine-related disability and reliance on symptomatic drugs in a group of female patients with chronic migraine.
METHODS
Ten female patients aged 30 to 50 years with a diagnosis of chronic migraine without aura and not associated with the menstrual cycle were enrolled. All patients were on stable symptomatic pharmacological treatment with no recent changes in migraine management. The therapeutic protocol included six AHT sessions: three weekly sessions followed by three biweekly sessions. During each session, 150 ml of autologous blood were drawn, ozonated, and reinfused; ozone concentrations were 25 mcg/ml for the first three sessions and 30 mcg/ml for the final three. Before treatment, a complete blood count and glucose-6-phosphate dehydrogenase (G6PDH) levels were tested to rule out contraindications. Migraine-related disability was assessed using the Migraine Disability Assessment Scale (MIDAS) at baseline (T0), after the third session (T1), and after the sixth session (T2).
RESULTS
At T0, six patients showed moderate disability (MIDAS grade 3), and four showed severe disability (grade 4). At T1, five patients improved to mild disability (grade 2), while the remaining five showed moderate disability. These improvements were sustained at T2. All participants reported a subjective reduction in the use of symptomatic medications and noted improved sleep quality throughout the treatment period.
CONCLUSIONS
Preliminary findings suggest that systemic ozone therapy may represent a safe and effective adjunctive strategy in managing chronic migraine, contributing to reduced disability levels and decreased dependence on symptomatic medications, as well as improved sleep quality. Larger randomized trials are required to confirm these results and assess long-term efficacy.