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Cha C, Kim O, Pang Y, Jeong H, Lee JE, Lee H, Dan H. Migraine incidence and coffee consumption among child-bearing age women: the Korea Nurses' Health Study. Sci Rep 2024; 14:12760. [PMID: 38834559 DOI: 10.1038/s41598-024-53302-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 01/30/2024] [Indexed: 06/06/2024] Open
Abstract
This longitudinal study aimed to identify factors that influence migraines in Korean women nurses using data from the Korea Nurses' Health Study. Among those who participated in Survey 1 (2013-2014) and the follow-up survey (2015-2019), we selected 2605 participants for Cox proportional hazard regression analysis, 521 participants who were newly diagnosed with migraine and 2084 controls using a 1:4 incidence density sampling approach. Consuming coffee (≥ 3 cups: RR = 1.666; 95% CI = 1.175-2.362, < 3 cups: RR = 1.439; 95% CI = 1.053-1.966), being obese (BMI ≥ 25: RR = 1.341, 95% CI = 1.003-1.793), and engaging in vigorous physical activity (RR = 1.010; 95% CI = 1.000-1.019) increased the risk of developing a migraine. Nurses with an annual salary greater than $3500 were less likely to develop migraines (RR = 0.786, 95% CI = 0.631-0.979). The results imply that lifestyle factors, such as the amount of coffee consumption, BMI level, and degree of physical activity could be considered when formulating treatment plans for women who have newly developed migraines.
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Grants
- 2013-E63006-00, 2016-ER-6305-00, 2016-ER-6305-02, 2019-ER-7101-02 Research of the Korea National Institute of Health
- 2013-E63006-00, 2016-ER-6305-00, 2016-ER-6305-02, 2019-ER-7101-02 Research of the Korea National Institute of Health
- 2013-E63006-00, 2016-ER-6305-00, 2016-ER-6305-02, 2019-ER-7101-02 Research of the Korea National Institute of Health
- 2013-E63006-00, 2016-ER-6305-00, 2016-ER-6305-02, 2019-ER-7101-02 Research of the Korea National Institute of Health
- 2013-E63006-00, 2016-ER-6305-00, 2016-ER-6305-02, 2019-ER-7101-02 Research of the Korea National Institute of Health
- 2013-E63006-00, 2016-ER-6305-00, 2016-ER-6305-02, 2019-ER-7101-02 Research of the Korea National Institute of Health
- 2013-E63006-00, 2016-ER-6305-00, 2016-ER-6305-02, 2019-ER-7101-02 Research of the Korea National Institute of Health
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Affiliation(s)
- Chiyoung Cha
- College of Nursing, Ewha Womans University, Seoul, Korea
- System Health and Engineering Major in Graduate School, Ewha Research Institute of Nursing Science, Ewha Womans University, Seoul, Korea
| | - Oksoo Kim
- College of Nursing, Ewha Womans University, Seoul, Korea
| | - Yanghee Pang
- Department of Nursing, Seoil University, Seoul, Korea
| | - Hyunseon Jeong
- College of Nursing, Seoul Woman's College of Nursing, Seoul, Korea
| | - Jung Eun Lee
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Korea
- Research Institute of Human Ecology, Seoul National University, Seoul, Korea
| | - Heayoung Lee
- Department of Nursing, Doowon Technical University, AnSung-Si, Korea
| | - Hyunju Dan
- Department of Nursing, Hwasung Medi-Science University, 400-5, Namyangchungang-Ro, Namyang-Eup, Hwasung-Si, 18274, Kyunggi-Do, Korea.
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Klan T, Bräscher AK, Seng EK, Gaul C, Witthöft M. German language adaptation of the Cogniphobia Scale for Headache Disorders (CS-HD) and development of a new short form (CS-HD-6). Headache 2024. [PMID: 38785395 DOI: 10.1111/head.14735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE This study is part of the ODIN-migraine (Optimization of Diagnostic Instruments in migraine) project. It is a secondary, a priori analysis of previously collected data, and aimed to assess the psychometric properties and factor structure of the Cogniphobia Scale for Headache Disorders (CS-HD). We aimed to construct a German-language version and a short version. BACKGROUND Cogniphobia is the fear and avoidance of cognitive exertion, which the patient believes triggers or exacerbates headache. High cogniphobia may worsen the course of a headache disorder. METHODS The 15-item CS-HD was translated into German and back translated in a masked form by a professional translator. Modifications were discussed and carried out in an expert panel. A cross-sectional online survey including the CS-HD and further self-report questionnaires was conducted in a sample of N = 387 persons with migraine (364/387 [94.1%] female, M = 41.0 [SD = 13.0] years, migraine without aura: 152/387 [39.3%], migraine with aura: 85/387 [22.0%], and chronic migraine: 150/387 [38.8%]). RESULTS Exploratory factor analysis resulted in two clearly interpretable factors (interictal and ictal cogniphobia). Confirmatory factor analysis yielded an acceptable to good model fit (χ2(89) = 117.87, p = 0.022, χ2/df = 1.32, RMSEA = 0.029, SRMR = 0.055, CFI = 0.996, TLI = 0.995). Item response theory-based analysis resulted in the selection of six items for the short form (CS-HD-6). Reliability was acceptable to excellent (interictal cogniphobia subscale: ω = 0.92 [CS-HD] or ω = 0.77 [CS-HD-6]; ictal cogniphobia subscale: ω = 0.77 [CS-HD] or ω = 0.73 [CS-HD-6]). The pattern of correlations with established questionnaires confirmed convergent validity of both the CS-HD and the CS-HD-6. CONCLUSION Both the CS-HD and the CS-HD-6 have good psychometric properties and are suitable for the assessment of cogniphobia in migraine.
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Affiliation(s)
- Timo Klan
- Department of Psychology, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | | | - Elizabeth K Seng
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Charly Gaul
- Headache Center Frankfurt, Frankfurt, Germany
| | - Michael Witthöft
- Department of Psychology, Johannes Gutenberg-University of Mainz, Mainz, Germany
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Mittleman MR, Mostofsky E, Vgontzas A, Bertisch S. Habitual caffeinated beverage consumption and headaches among adults with episodic migraine: A prospective cohort study. Headache 2024; 64:299-305. [PMID: 38318677 PMCID: PMC10954400 DOI: 10.1111/head.14673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/06/2023] [Accepted: 12/08/2023] [Indexed: 02/07/2024]
Abstract
OBJECTIVE To examine the relationship between habitual caffeinated beverage consumption and headache frequency, duration, and intensity in a prospective cohort of adults with episodic migraine. BACKGROUND Caffeine is a commonly ascribed headache trigger in adults with migraine and clinicians may counsel patients to avoid caffeinated beverages; however, few studies have examined this association. METHODS From March 2016 to August 2017, 101 adults with physician-confirmed episodic migraine completed baseline questionnaires, including information about caffeinated beverage consumption. For 6 weeks, they reported headache onset, duration, and pain intensity (scale 0-100) on twice-daily electronic diaries. Ninety-seven participants completed data collection. We examined associations between self-reported habitual caffeinated beverage consumption at baseline and headache outcomes prospectively captured over the following 6 weeks, adjusting for age, sex, and oral contraceptive use. RESULTS The adjusted mean headache days per month was similar among the 20 participants reporting no habitual intake (7.1 days, 95% confidence interval [CI] 5.1-9.2), the 65 participants reporting 1-2 servings/day (7.4 days, 95% CI 6.1-8.7), and the 12 participants reporting 3-4 servings/day (5.9 days, 95% CI 3.3-8.4). Similarly, mean headache duration (no servings/day: 8.6 h, 95% CI 3.8-13.3; 1-2 servings/day: 8.5 h, 95% CI 5.5-11.5; 3-4 servings/day: 8.8 h, 95% CI 2.3-14.9) and intensity (no servings/day: 43.8, 95% CI 37.0-50.5; 1-2 servings/day: 43.1, 95% CI 38.9-47.4; 3-4 servings/day: 46.5, 95% CI 37.8-55.3) did not differ across levels of caffeinated beverage intake, though estimates were imprecise. CONCLUSIONS We found no association between habitual caffeinated beverage intake and headache frequency, duration, or intensity. These data do not support a recommendation that patients with episodic migraine should avoid consuming caffeine. Further research is needed to understand whether deviating from usual caffeine intake may trigger migraine attacks.
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Affiliation(s)
| | | | - Angeliki Vgontzas
- Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Suzanne Bertisch
- Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
- Beth Israel Deaconess Medical Center, Boston, MA
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Vgontzas A. Examining substance use patterns in adults with migraine: A changing landscape. Headache 2024; 64:129-130. [PMID: 38235829 DOI: 10.1111/head.14660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 11/30/2023] [Indexed: 01/19/2024]
Affiliation(s)
- Angeliki Vgontzas
- John R. Graham Headache Center, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Vgontzas A, Pavlović J, Bertisch S. Sleep Symptoms and Disorders in Episodic Migraine: Assessment and Management. Curr Pain Headache Rep 2023; 27:511-520. [PMID: 37665530 DOI: 10.1007/s11916-023-01160-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 09/05/2023]
Abstract
PURPOSE OF REVIEW We review research on sleep symptoms and disorders in patients with episodic migraine and propose a framework for evaluating sleep symptoms in this patient population. RECENT FINDINGS Patients with episodic migraine consistently report poorer sleep on validated self-reports compared to those without migraine. In polysomnographic studies, children with migraine have objectively shorter sleep duration and lower percentage of REM sleep interictally. Prospective actigraphy studies in adults and children suggest that there are no significant changes in sleep duration, efficiency, or quality in the night before or after a migraine attack. The relationship between sleep and migraine is multifaceted. Patients with episodic migraine report poorer sleep and have higher risk of some sleep disorders, including insomnia, sleep-related bruxism, and restless legs syndrome. Sleep screening questions may be incorporated into headache evaluations. Care should be taken to avoid headache medications that may exacerbate sleep symptoms. Evidence-based treatments for insomnia may be initiated while patients await CBT-I. Further studies are needed to assess whether treatment of comorbid sleep disorders results in improvement in migraine-related burden in those with episodic migraine.
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Affiliation(s)
- Angeliki Vgontzas
- Division of Headache Medicine, Department of Neurology, John R. Graham Headache Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Jelena Pavlović
- Montefiore Headache Center, Department of Neurology, Albert Einstein College of Medicine, NY, Bronx, USA
| | - Suzanne Bertisch
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Sudershan A, Pushap AC, Younis M, Sudershan S, Bhagat S, Kumar H, Panjalyia RK, Kumar P. Neuroepidemiology study of headache in the region of Jammu of north Indian population: A cross-sectional study. Front Neurol 2023; 13:1030940. [PMID: 36686511 PMCID: PMC9850838 DOI: 10.3389/fneur.2022.1030940] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 12/01/2022] [Indexed: 01/07/2023] Open
Abstract
Background Headache disorders now represent a major public health problem globally. It is more prevalent in developing countries with the rising trends of headache disorders observed in young adults affecting their quality of life negatively. Very little information is available on the epidemiology of headache disorders in the Jammu Division of the north Indian population. Aim The aim of the present study was to find out the prevalence of headache and its two major types, i.e., migraine and tension-type headache (TTH), in the population of the Jammu Division. Methods The present study was conducted in two phases: (Phase I: face-to-face interview and Phase II: E-based sampling) and the sufferers of headaches were incorporated into the study based on the International Classification of Headache Disorder-3 (ICHD-3) criteria for a representative sample. Frequency distribution and mean ± standard deviation were used in descriptive statistics to describe the data sets, while a t-test, chi-square test, multiple logistic regression, and prevalence ratio were used in inferential statistics. Results In the present study, a total of 3,148 patients were recruited, with an overall prevalence of headache of 53.84%, with a majority of females (38.18%) over males (15.66%). As regards the type of headache, migraine was found to be of the more prevalent (33.25%) type than the TTH (20.58%). Females suffering from migraine showed the highest prevalence (25.28%), in contrast to females suffering from the TTH (12.89%). Sociodemographic variables, such as gender [female; AOR = 2.46, 95% CI (2.12-2.85), p-value < 0.0001] and marital status [married; AOR: 1.46, 95% CI (1.11-1.92) p-value = 0.006], showed a significant association with the headache. Conclusion The present study shows that the prevalence of headache is high in the Jammu Division of Jammu and Kashmir (J&K) India, with migraine being the highly prevalent type.
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Affiliation(s)
- Amrit Sudershan
- Institute of Human Genetics, University of Jammu, Jammu, Jammu and Kashmir, India,Department of Human Genetics, Sri Pratap College Srinagar, Cluster University Srinagar, Srinagar, Jammu and Kashmir, India
| | - Agar Chander Pushap
- Department of Education, University Wing, Dakshina Bharat Hindi Prachar Sabha, Chennai, India
| | - Mohd Younis
- Department of Zoology, University of Jammu, Jammu, Jammu and Kashmir, India
| | - Srishty Sudershan
- Department of Zoology, University of Jammu, Jammu, Jammu and Kashmir, India
| | - Sheetal Bhagat
- Department of Psychology, University of Jammu, Jammu, Jammu and Kashmir, India
| | - Hardeep Kumar
- Department of Neurology, Super Speciality Hospital, GMC, Jammu, Jammu and Kashmir, India
| | | | - Parvinder Kumar
- Institute of Human Genetics, University of Jammu, Jammu, Jammu and Kashmir, India,Department of Zoology, University of Jammu, Jammu, Jammu and Kashmir, India,*Correspondence: Parvinder Kumar ✉
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Seng EK, Martin PR, Houle TT. Lifestyle factors and migraine. Lancet Neurol 2022; 21:911-921. [PMID: 36115363 DOI: 10.1016/s1474-4422(22)00211-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 04/11/2022] [Accepted: 04/29/2022] [Indexed: 01/19/2023]
Abstract
Migraine, a common and disabling neurological disorder, is among the top reasons for outpatient visits to general neurologists. In addition to pharmacotherapy, lifestyle interventions are a mainstay of treatment. High-quality daily diary studies and intervention studies indicate intraindividual variations in the associations between lifestyle factors (such as stress, sleep, diet, and physical activity) and migraine attack occurrence. Behaviour change interventions can directly address overlapping lifestyle factors; combination approaches could capitalise on multiple mechanisms. These findings provide useful directions for integration of lifestyle management into routine clinical care and for future research.
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Affiliation(s)
- Elizabeth K Seng
- Albert Einstein College of Medicine, Montefiore Medical Center and Yeshiva University, Bronx, NY, USA.
| | - Paul R Martin
- Department of Psychiatry, Monash Medical Centre, Monash University, Melbourne, VIC, Australia; School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
| | - Timothy T Houle
- Massachusetts General Hospital, Harvard School of Medicine, Boston, MA, USA
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Gaul C, Gräter H, Weiser T, Michel MC, Lampert A, Plomer M, Förderreuther S. Impact of the Neck and/or Shoulder Pain on Self-reported Headache Treatment Responses – Results From a Pharmacy-Based Patient Survey. Front Neurol 2022; 13:902020. [PMID: 35923833 PMCID: PMC9339896 DOI: 10.3389/fneur.2022.902020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/21/2022] [Indexed: 01/10/2023] Open
Abstract
Neck and/or shoulder pain (NSP) frequently occurs together with headache. Therefore, we explored how patients with and without concomitant NSP differ in their baseline characteristics and in perceived treatment responses to an analgesic. An anonymous survey was performed among 895 patients with headache (735 self-reported tension-type headache [TTH]) who used an analgesic fixed-dose combination containing 400 mg ibuprofen and 100 mg caffeine as a non-prescription treatment. NSP was abundant among patients in our survey (60%) and was associated with >1 additional day of headache per month. Patients with NSP reported predominantly sedentary work more frequently than those without (40 vs. 29%); they also reported physical tension/poor posture as a perceived trigger factor more frequently (70 vs. 16%). The reported pain reduction was comparable in those with and without concomitant NSP regardless of whether assessed as mean pain rating (from about 6 to 1.5 on a 10-point rating scale), patients experiencing a ≥50% in pain reduction (89.6 vs. 88.8%) or becoming pain-free within 2 h (57 vs. 64%). However, recurrence of pain and use of another dose within the same day were more frequent with than without NSP. We conclude that concomitant NSP is frequent in patients with headache but does not substantially alter responses to a non-prescription medication.
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Affiliation(s)
- Charly Gaul
- Headache Center Frankfurt, Frankfurt am Main, Germany
| | - Heidemarie Gräter
- Medical Consumer Healthcare, Sanofi-Aventis Deutschland GmbH, Frankfurt am Main, Germany
| | - Thomas Weiser
- Medical Consumer Healthcare, Sanofi-Aventis Deutschland GmbH, Frankfurt am Main, Germany
| | - Martin C. Michel
- Department of Pharmacology, Johannes Gutenberg University, Mainz, Germany
- *Correspondence: Martin C. Michel
| | - Anette Lampert
- Medical Consumer Healthcare, Sanofi-Aventis Deutschland GmbH, Frankfurt am Main, Germany
| | - Manuel Plomer
- Medical Consumer Healthcare, Sanofi-Aventis Deutschland GmbH, Frankfurt am Main, Germany
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Aladdin YS, Alsharif R, Mattar W, Alturki M, Malli IA, Alghamdi Y, Ismail A, Shirah B. Migraine Prevalence and Analysis of Dietary Habits in Relation to Headache in the Female Population: A Single-Center Study From Jeddah, Saudi Arabia. Cureus 2022; 14:e24848. [PMID: 35693360 PMCID: PMC9176293 DOI: 10.7759/cureus.24848] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction Lifestyle-related factors including dietary intake can significantly increase the chances of developing migraine. Some components of food items are thought to induce the release of vasoactive substances leading to the dilation of blood vessels, which in turn results in migraine episodes. This research aimed to assess the prevalence of migraine and examine the relation of the headache to the dietary patterns of female students and employees of King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) - Jeddah experiencing migraine attacks as well as to assess the relationship between the migraine attacks and the available dietary items served at the food outlets within the campus. Methods Two questionnaires were developed for this study. The first questionnaire was a short survey asking about the characteristics of headaches. This survey aimed to estimate the prevalence of migraine among female students and employees in KSAU-HS. Of the participants who filled the first questionnaire, those who met the International Classification of Headache Disorders (ICDH-III) criteria for migraine were given a second questionnaire to further understand the characteristics of their migraine headaches and to assess lifestyle and diet-related aggravating factors. Results The final sample size for the calculated prevalence was 410; 352 were students and 58 were faculty members. It has been found that 165 (40.24%) participants of the KSAU-HS female population met the criteria for migraine. Two (2.2%) reported an association between chocolate consumption and headaches and seven (7.8%) reported a significant association between caffeine and headaches. No specific association was perceived by the respondents between migraine attacks and the following food items: citrus fruits, pickles, cheese, and dairy products. Conclusion Our study revealed that the widespread trends for excessive consumption of coffee and caffeinated beverages at food outlets within the educational institution are occult triggers for headache attacks in a significant portion of students with migraine. The recent shift in dietary habits in our community for excessive consumption of coffee and other tyramine-rich food items has negative consequences on productivity and the economy. Our results can be conceivably extrapolated to reflect the effect of dietary habits on other streams of society, including companies, firms, schools, and workplaces that are driven by the new dietary trends.
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Behavioral Management of Episodic Migraine: Maintaining a Healthy Consistent Lifestyle. Curr Pain Headache Rep 2022; 26:247-252. [PMID: 35212864 DOI: 10.1007/s11916-022-01023-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW To describe the most recent findings related to lifestyle behaviors and migraine. RECENT FINDINGS An individualized conceptualization of how lifestyle factors impact migraine activity has increased our understanding of the role of behavioral interventions for episodic migraine. Healthy diets of several types have been associated with migraine attack reduction, whereas disruptions in diet like skipping meals are associated with migraine attack onset. Both aerobic activity and lower intensity yoga interventions show promise for migraine prevention. Sleep disruption has been associated with migraine day and may have a bi-directional relationship. Both increases and decreases in stress have been associated with migraine activity. Evidence is converging around the principle that highly unusual disruptions in daily routine are particularly associated with migraine attack onset and that a consistent healthy lifestyle is a key feature of effective behavioral migraine prevention strategies.
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Alcohol, coffee consumption, and smoking in relation to migraine: a bidirectional Mendelian randomization study. Pain 2022; 163:e342-e348. [PMID: 35029599 DOI: 10.1097/j.pain.0000000000002360] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/25/2021] [Indexed: 11/27/2022]
Abstract
ABSTRACT We conducted a Mendelian randomization study to assess whether alcohol and coffee consumption and smoking are causally associated with risk of developing migraine. Independent single-nucleotide polymorphisms associated with the potential risk factors at P < 5 × 10-8 in large-scale genome-wide association studies were selected as instrumental variables. Summary-level data for the associations of the selected single-nucleotide polymorphisms with migraine were obtained from the FinnGen consortium comprising 6687 cases and 144,780 noncases and the UK Biobank study comprising 1072 cases and 360,122 noncases. Estimates derived from the FinnGen and UK Biobank cohorts were combined using fixed-effects meta-analysis. We found evidence for associations of genetically predicted alcohol consumption (odds ratio [OR] 0.54 per SD increase in log-transformed alcoholic drinks per week, 95% confidence interval [CI], 0.35-0.82; P = 0.004), coffee consumption (OR 0.56 per 50% increase in coffee consumption, 95% CI, 0.45-0.70; P < 0.001), and smoking initiation (OR 1.15 for one SD increase in the prevalence of smoking initiation, 95% CI, 1.01-1.31; P = 0.038). These associations persisted in sensitivity analyses, including mutual adjustment in multivariable Mendelian randomization analyses. In reverse Mendelian randomization analyses, genetic liability to migraine was inversely associated with alcohol consumption but was not associated with coffee consumption or smoking initiation. This study provides genetic evidence in support of a protective role of moderate coffee consumption and a detrimental role of cigarette smoking in the etiology of migraine. The inverse association between alcohol consumption and migraine risk may be attributable to reverse causality.
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CHANG HY, YANG CC, JENSEN MP, LAI YH. The Frequency and Perceived Effectiveness of Pain Self-Management Strategies Used by Individuals With Migraine. J Nurs Res 2021; 29:e154. [PMID: 33840771 PMCID: PMC8126499 DOI: 10.1097/jnr.0000000000000429] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Migraine is ranked among the most important causes of disability worldwide. Some effective migraine treatments have been identified. However, little is known regarding the treatment strategies used by patients with migraine to manage pain or their efficacy. PURPOSE This study was designed to (a) investigate the pain management strategies used by migraineurs and their perceived effectiveness and (b) evaluate the association between the number of strategies used and their overall perceived effectiveness. METHODS A cross-sectional design with consecutive sampling was used in a medical center in Taiwan. Individuals with migraine (N = 174) completed self-administered questionnaires and in-depth interviews to assess the frequency and perceived effectiveness of a variety of pain management strategies. RESULTS Most participants reported using prescription medications (56%) and over-the-counter medications (51%), which were rated as having good efficacy rates of 78% and 81%, respectively. Traditional Chinese medicine (17%) and folk remedies (13%) were used less frequently and rated as relatively less effective at 65% and 48%, respectively. About half (47%) reported using more than one pain management strategy. Significantly more of those who reported using multiple pain management strategies reported at least "some effect" than those who reported using one strategy only (73% vs. 27%, p = .001). CONCLUSIONS Prescription medications showed good usage rate and good perceived efficacy. However, about half of the participants used multiple pain management strategies, supporting the need for further research to evaluate the efficacy of combination treatments and to identify those combinations that may have the most additive and/or synergistic effects. Furthermore, the findings indicate that continued use of medications for migraine management is appropriate for many individuals because of the relatively high rates of perceived efficacy for this strategy found in this study.
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Affiliation(s)
- Hao-Yuan CHANG
- PhD, RN, Assistant Professor, School of Nursing, College of Medicine, National Taiwan University, and Adjunct Supervisor, Department of Nursing, National Taiwan University Hospital, Taiwan, ROC
| | - Chih-Chao YANG
- MD, Attending Physician, Department of Neurology, National Taiwan University Hospital, Taiwan, ROC
| | - Mark P. JENSEN
- PhD, Professor, Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Yeur-Hur LAI
- PhD, RN, FAAN, Professor, School of Nursing, College of Medicine, National Taiwan University, and Director, Department of Nursing, National Taiwan University Cancer Center, Taipei, Taiwan, ROC
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Hagan KK, Li W, Mostofsky E, Bertisch SM, Vgontzas A, Buettner C, Mittleman MA. Prospective cohort study of routine exercise and headache outcomes among adults with episodic migraine. Headache 2020; 61:493-499. [PMID: 33349935 DOI: 10.1111/head.14037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 10/09/2020] [Accepted: 10/09/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the association of routine exercise with headache frequency, intensity, and duration among adults with episodic migraine (EM). BACKGROUND A comprehensive management plan for EM must aim at reducing disability and cost of care; to do so requires optimizing acute and preventive medications, and behavior changes. Prophylactic medication use is associated with adverse events and contraindications with comorbidities. Aerobic exercise is reported to decrease migraine frequency. However, no study has evaluated a potential synergistic relation between regular exercise and preventive medication use among patients with EM. DESIGN AND METHODS This was a secondary analysis of data from a prospective cohort study of adults with EMs. In that study, adults with EM (using International Classification of Headache Disorders-3 criteria confirmed by study physicians) were recruited from three academic medical centers in Boston, MA. At baseline, participants provided information on exercise, clinical and demographic characteristics, and lifestyle behaviors. We prospectively collected daily information on headaches and health behavior over at least 6 weeks using electronic questionnaires from 94 participants. We assessed the association between baseline self-reported moderate-vigorous exercise at least three times per week, at baseline, and prospectively recorded headache frequency, intensity, and duration. We further assessed whether these associations differed by the prevalent use of prophylactic migraine medication. RESULTS Data from 94 of 98 eligible participants were used in the analysis as 4 participants had missing data on routine exercise frequency or intensity at baseline. On average, patients who reported moderate-vigorous exercise at least three times per week at enrollment had 1.5 fewer headache days per month (-1.5 headache days/month; 95% confidence interval [CI] -3.1 to 0.1) compared to less exercise; this was not statistically significant (p = 0.066). The association between exercise and headache days per month varied by baseline use of migraine prophylaxis (p-value of interaction = 0.009). Among those who reported regular use of migraine prophylaxis, a report of moderate-vigorous exercise at least three times per week was associated with 5.1 fewer headache days (-5.1: 95% CI -8.2 to -2.0; p = 0.001) compared to those who reported lower levels of exercise. However, among those not using migraine prophylaxis, we observed only 0.4 fewer headache days per month (-0.4: 95% CI -2.2 to 1.3; p = 0.636) associated with moderate-vigorous exercise at least three times/week, a result that was not statistically significant. There was no association of self-reported moderate-vigorous exercise at least three times a week with headache intensity or duration. CONCLUSION In patients with EM, those who reported moderate-vigorous exercise at least three times per week had fewer headache days per month, though not statistically significant. This association was significantly stronger in those who used prophylactic medication for migraines. Exercise appeared not to be associated with the severity or duration of headaches. Routine moderate-vigorous exercise may be an important adjunctive strategy for improving headache burden in patients eligible for migraine prophylaxis.
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Affiliation(s)
- Kobina K Hagan
- Harvard University T.H. Chan School of Public Health, Boston, MA, USA
| | - Wenyuan Li
- Department of Epidemiology, Harvard University T.H. Chan School of Public Health, Boston, MA, USA.,Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Elizabeth Mostofsky
- Department of Epidemiology, Harvard University T.H. Chan School of Public Health, Boston, MA, USA.,Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Suzanne M Bertisch
- Harvard Medical School, Boston, MA, USA.,Program in Sleep Medicine Epidemiology, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
| | - Angeliki Vgontzas
- Harvard Medical School, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - Catherine Buettner
- Harvard Medical School, Boston, MA, USA.,Department of Medicine, Mount Auburn Hospital, Cambridge, MA, USA
| | - Murray A Mittleman
- Department of Epidemiology, Harvard University T.H. Chan School of Public Health, Boston, MA, USA.,Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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Alstadhaug KB, Ofte HK, Müller KI, Andreou AP. Sudden Caffeine Withdrawal Triggers Migraine-A Randomized Controlled Trial. Front Neurol 2020; 11:1002. [PMID: 33013662 PMCID: PMC7512113 DOI: 10.3389/fneur.2020.01002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/30/2020] [Indexed: 01/03/2023] Open
Abstract
Objective: Assessing the effects of caffeine withdrawal on migraine. Background: The effects of caffeine withdrawal on migraineurs are at large unknown. Methods: This was a randomized, double-blind, crossover study (NCT03022838), designed to enroll 80 adults with episodic migraine and a daily consumption of 300–800 mg caffeine. Participants substituted their estimated dietary caffeine with either placebo capsules or capsulated caffeine tablets for 5 weeks before switching the comparators for 5 more weeks. Results: The study was terminated due to low recruitment. Ten subjects with a mean age of 46.3 ± 9.9 years, BMI of 24.9 ± 3.7, and a mean blood pressure of 134/83 ± 17/12 mmHg were enrolled. The average consumption of caffeine per day was 539 ± 196.3 mg. The average monthly headache days and migraine attack frequency at baseline was 11.5 ± 4.9 and 5.2 ± 1.2, respectively. At baseline Pittsburgh Sleep Quality Index was 5.8 ± 2.5 and HIT-6 was 62.8 ± 3.9. There were no differences in these or in parameters from actigraphy during the caffeine period compared with the placebo period. One subject withdrew just after entering the study. In the remaining nine, withdrawal triggered severe migraine attacks in seven, causing one more drop-out, and a typical caffeine withdrawal syndrome in two. Caffeine continuation did not trigger migraines, but one attack occurred in the wake of caffeine reintroduction. Conclusions: The study failed to answer how caffeine withdrawal affects migraineurs over time, but showed that abrupt withdrawal of caffeine is a potent trigger for migraine attacks.
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Affiliation(s)
- Karl B Alstadhaug
- Nordland Hospital Trust, Bodø, Norway.,Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway
| | | | - Kai Ivar Müller
- Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway.,University Hospital of Tromsø, Tromsø, Norway
| | - Anna P Andreou
- Headache Research, Wolfson CARD, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,The Headache Centre, Guy's and St Thomas', NHS Foundation Trust, London, United Kingdom
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15
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Pavkovic IM, Kothare SV. Migraine and Sleep in Children: A Bidirectional Relationship. Pediatr Neurol 2020; 109:20-27. [PMID: 32165029 DOI: 10.1016/j.pediatrneurol.2019.12.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/05/2019] [Accepted: 12/24/2019] [Indexed: 01/03/2023]
Abstract
Migraine and sleep disorders in children exhibit a bidirectional relationship. This relationship is based on shared pathophysiology. Migraine involves activation of the trigeminal vascular system. Nociceptive neurons that innervate the dura release various vasoactive peptides. Calcitonin gene-related peptide is the most active of these peptides. Neural pathways that are involved in sleep generation are divided into those responsible for circadian rhythm, wake promotion, non-rapid eye movement, and rapid eye movement sleep activation. Sleep state switches are a critical component of these systems. The cerebral structures, networks, and neurochemical systems that are involved in migraine align closely with those responsible for the regulation of sleep. Neurochemical systems that are involved with both the pathogenesis of migraine and regulation of sleep include adenosine, melatonin, orexin, and calcitonin gene-related peptide. Sleep disorders represent the most common comorbidity with migraine in childhood. The prevalence of parasomnias, obstructive sleep apnea, and sleep-related movement disorders is significantly greater in children migraineurs. Infantile colic is a precursor of childhood migraine. Treatment of comorbid sleep disorders is important for the appropriate management of children with migraine. Sleep-based behavioral interventions can be of substantial benefit. These interventions are particularly important in children due to limited evidence for effective migraine pharmacotherapy.
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Affiliation(s)
- Ivan M Pavkovic
- Division of Pediatric Neurology, Department of Pediatrics, Cohen Children's Medical Center, Lake Success, New York; Pediatrics, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Sanjeev V Kothare
- Divison of Pediatric Neurology, Department of Pediatircs, Cohen Children's Medical Center, Lake Success, New York; Pediatric Sleep Program (Neurology), Department of Pediatircs, Cohen Children's Medical Center, Lake Success, New York; Pediatric Neurology Service Line for Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; Pediatrics & Neurology, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.
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16
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Nowaczewska M, Wiciński M, Kaźmierczak W. The Ambiguous Role of Caffeine in Migraine Headache: From Trigger to Treatment. Nutrients 2020; 12:nu12082259. [PMID: 32731623 PMCID: PMC7468766 DOI: 10.3390/nu12082259] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/25/2020] [Accepted: 07/26/2020] [Indexed: 02/06/2023] Open
Abstract
Migraine is a chronic disorder, and caffeine has been linked with migraine for many years, on the one hand as a trigger, and on the other hand as a cure. As most of the population, including migraineurs, consume a considerable amount of caffeine daily, a question arises as to whether it influences their headaches. Indeed, drinking coffee before a migraine attack may not be a real headache trigger, but a consequence of premonitory symptoms, including yawning, diminished energy levels, and sleepiness that may herald a headache. Here, we aim to summarize the available evidence on the relationship between caffeine and migraines. Articles concerning this topic published up to June 2020 were retrieved by searching clinical databases, and all types of studies were included. We identified 21 studies investigating the prevalence of caffeine/caffeine withdrawal as a migraine trigger and 7 studies evaluating caffeine in acute migraine treatment. Among them, in 17 studies, caffeine/caffeine withdrawal was found to be a migraine trigger in a small percentage of participants (ranging from 2% to 30%), while all treatment studies found caffeine to be safe and effective in acute migraine treatment, mostly in combination with other analgesics. Overall, based on our review of the current literature, there is insufficient evidence to recommend caffeine cessation to all migraine patients, but it should be highlighted that caffeine overuse may lead to migraine chronification, and sudden caffeine withdrawal may trigger migraine attacks. Migraine sufferers should be aware of the amount of caffeine they consume and not exceed 200 mg daily. If they wish to continue drinking caffeinated beverages, they should keep their daily intake as consistent as possible to avoid withdrawal headache.
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Affiliation(s)
- Magdalena Nowaczewska
- Department of Otolaryngology, Head and Neck Surgery, and Laryngological Oncology, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, M. Curie 9, 85-090 Bydgoszcz, Poland
- Correspondence: ; Tel.: +48-52-585-4716
| | - Michał Wiciński
- Department of Pharmacology and Therapeutics, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, M. Curie 9, 85-090 Bydgoszcz, Poland;
| | - Wojciech Kaźmierczak
- Department of Sensory Organs Examination, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, M. Curie 9, 85-090 Bydgoszcz, Poland;
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Li W, Bertisch SM, Mostofsky E, Vgontzas A, Mittleman MA. Associations of daily weather and ambient air pollution with objectively assessed sleep duration and fragmentation: a prospective cohort study. Sleep Med 2020; 75:181-187. [PMID: 32858358 DOI: 10.1016/j.sleep.2020.06.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/17/2020] [Accepted: 06/22/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Given the lack of studies examining the associations between daily weather and air pollution with nightly objective sleep over multiple weeks, we quantified these associations in a prospective cohort of healthy participants with episodic migraine. METHODS Ninety-eight participants completed daily electronic diaries and wore an actigraph for an average of 45 ds, and a total 4406 nights of data were collected. Nightly sleep characteristics including duration, wake after sleep onset (WASO), and efficiency were assessed using wrist actigraphy. Daily weather parameters and air pollution levels were collected from local weather station and ground-level air quality monitors. We used linear fixed effects models adjusting for participant, day of the week, and day of the year (for weather analysis), and additionally adjusted for temperature and relative humidity (for air pollution analysis). RESULTS The participants were 35 ± 12 yrs old and 86 were women. A 10 °F higher daily average temperature was associated with 0.88 (95% CI: 0.06, 1.70) minutes longer WASO and 0.14% (95% CI: -0.01%, 0.30%) lower sleep efficiency on that night. A 14 parts per billion (ppb) (interquartile range) higher daily maximum eight-h ozone was associated with 7.51 (95% CI: 3.23, 11.79) minutes longer sleep duration on that night. Associations did not differ between cold (October-March) and warm (April-September) seasons. CONCLUSIONS Higher daily ozone was associated with longer sleep duration and modest associations were observed between higher temperature and lower WASO and lower efficiency.
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Affiliation(s)
- Wenyuan Li
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, USA; Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Suzanne M Bertisch
- Program in Sleep Medicine Epidemiology, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Elizabeth Mostofsky
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, USA; Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Angeliki Vgontzas
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Murray A Mittleman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, USA; Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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