Editorial: Lifestyle modifications to manage migraine

Health-related lifestyle behaviors in patients with vestibular migraine and migraine only: A cross-sectional comparative study

OBJECTIVE

There is an increasing interest in lifestyle modification in the disease management of patients with vestibular migraine (VM) and migraine only (MO) without vertiginous complaints. The primary aim of this study was to compare health-related lifestyle factors, including sedentary behavior, sleep quality, mood, and nutrition habits, between patients with VM, MO, and healthy controls (HCs). The secondary aim was to explore the association between health-related lifestyle factors and disability status in VM and MO groups.

METHODS

This cross-sectional case-control study included 21 patients with VM, 30 patients with MO, and 33 HCs. Vertigo and headache severity caused by migraine-triggering foods with Numeric Rating Scale-NRS, disability status with Migraine Disability Assessment-MIDAS, sedentary behavior with Sedentary Behavior Questionnaire-SBQ, sleep quality with Pittsburgh Sleep Quality Index-PSQI and mood with Hospital Anxiety and Depression Scale-HADS were recorded in 3 groups.

RESULTS

While the exercising, smoking, SBQ, PSQI, HADS-anxiety, and HADS-depression were similar for patients with VM and MO, a higher rate of alcohol consumption was found for patients with VM compared to the MO group (p < 0.05). The VM and MO groups demonstrated significant correlations between the headache severity caused by migraine-triggering foods and disability status (p < 0.05).

CONCLUSION

Adapting new lifestyle interventions and dietary counseling should be encouraged to improve the disease management of patients with VM and MO.

Lifestyle Factors Associated With Frequent Recurrent Headaches in Children and Adolescents: A Canadian Population-Based Study

BACKGROUND AND OBJECTIVES

Lifestyle behaviors have been postulated to affect headache frequency in youth and are often the primary target of self-management recommendations. Our study aimed to assess the association between various lifestyle factors and frequent recurrent headaches in children and youth.

METHODS

Children and adolescents aged 5-17 years were enrolled in a large cross-sectional Canadian population-based health survey, completed on January 31, 2019. Headache frequency was dichotomized into "approximately once/week or less" or ">once/week" (defined as frequent recurrent headaches). The association between frequent headaches and meal schedules, screen exposure, physical activity, chronotype, and frequent substance use/exposure (alcohol, cigarettes, electronic cigarettes, and cannabis) was assessed using both unadjusted logistic regression models and models adjusted for age/sex. Fully adjusted models examined the odds of frequent headaches according to all exposures. Survey design effects were accounted for using bootstrap replicate weighting.

RESULTS

There were an estimated nweighted = 4,978,370 eligible participants in the population. The mean age was 10.9 years (95% CI 10.9-11.0); 48.8% were female; 6.1% had frequent headaches. Frequent headaches were associated with older age (odds ratio [OR] = 1.31, 95% CI 1.28-1.34, p < 0.001) and female sex (OR = 2.39, 95% CI 2.08-2.75, p < 0.001). In models adjusted for age/sex, the odds of frequent headaches decreased with meal regularity (adjusted OR [aOR] = 0.90, 95% CI 0.89-0.92, p < 0.001) and increased with later chronotype (aOR = 1.10, 95% CI 1.05-1.15, p < 0.001) and excess screen exposure (≥21 hours vs none in past week: aOR = 2.97, 95% CI 1.53-5.77, p = 0.001); there was no significant association with reported physical activity (aOR = 0.95, 95% CI 0.67-1.34, p = 0.77). In 12- to 17-year-olds, frequent headaches were associated with frequent alcohol use (≥1/wk vs never: aOR = 3.50, 95% CI 2.18-5.62, p < 0.001), binge drinking (≥5 times in past month vs never: aOR = 5.52, 95% CI 2.95-10.32, p < 0.001), smoking cigarettes (daily vs never: aOR = 3.81, 95% CI 1.91-7.62, p < 0.001), using e-cigarettes (daily vs never: aOR = 3.10, 95% CI 2.29-4.20, p < 0.001), and cannabis use (daily vs never: aOR = 3.59, 95% CI 2.0-6.45, p < 0.001). In the entire sample, daily exposure to smoking inside the house was associated with frequent headaches (aOR = 2.00, 95% CI 1.23-3.27, p = 0.005).

DISCUSSION

Several lifestyle behaviors were associated with frequent headaches in children and youth, such as meal irregularity, late chronotype, prolonged screen exposure, and frequent substance use/exposure, suggesting that these are potential modifiable risk factors to target in this population.