OBJECTIVES: To estimate the burden of nausea and/or vomiting (N/V) on sleep, depressive symptoms and health care resource use (HRU) in migraine patients. METHODS: Study data came from cross sectional, internet-based 2013 US National Health and Wellness Survey (NHWS). Survey participants self-reported their migraine frequency with or without N/V along with demographics, HRU in the previous 6 months (physician, emergency and hospital visits), sleep problems, and depressive symptoms. Sleep and depression outcomes were compared between migraineurs with or without N/V using Chi-square test. Adjusting for demographic and comorbidity differences, generalized linear models were conducted to compare HRU. RESULTS: Of the N=7855 migraine participants, 58% reported N/V symptoms, female= 73%, white= 72%, mean age= 41.8 (SD=14.0), mean Charlson-comorbidity index=0.55 (SD= 1.26) and mean migraine episodes (past 30 days)= 3.27(SD=5.33).  Compared with migraineurs without N/V, significantly greater proportion of migraneurs with N/V reported depressive symptoms (39.2% vs 45.2%, p<0.001 ), sleep problems (e.g. sleep difficulty, 43.6% vs 54.1%; daytime sleepiness, 30.9% vs 40.4%; poor sleep quality, 28.9% vs 38.9%; nighttime awakening, 33.9% vs 44.2%, all p<0.001). Mean emergency room (ER) visits increased significantly by about 20% in migraneurs with N/V than without N/V [0.48 (95% CI = 0.41, 0.57) vs 0.38, [95% CI= 0.32, 0.45]; p<0.01).  Between migraineurs with and without N/V, no significant increase in the mean number of physician [5.24 (95% CI = 4.82, 5.69) vs 4.93 (95% CI= 4.54, 5.35); p=0.06] and hospital visits [0.20 (95% CI = 0.16, 0.25) vs 0.19 (95% CI= 0.15, 0.24), p=0.65] were detected. CONCLUSIONS: Migraineurs with N/V reported worsened sleep and depressive symptom outcomes, and higher ER visits than those without N/V.  Future research must evaluate the relationship of N/V severity on these outcomes. Study findings highlight opportunities for treatment options that may alleviate these unmet medical needs in migraineurs with N/V.