The impact of lifestyle factors and chronic stress on frequency and intensity of migraine and tension-type headache among Austrian women
Lifestyle impacts duration and intensity of headaches
Keywords:migraine, tension-type headache, lifestyle factors, chronic stress
Background Primary headache disorders such as migraine and tension-type headaches represent an important public health problem. Besides genetic factors, environmental parameters, and, in particular, recent lifestyle patterns may contribute to the increasing prevalence of headache disorders.
Sample and methods 173 women, between the ages of 18 and 65 years, were enrolled in the present study. The present study focuses on the association between recent lifestyle patterns such as physical activity, time spent outdoors, time spent in front of TV or computer screens, nicotine consumption, weight status as well as chronic stress exposure, and the duration and intensity of migraine and tension-type headaches (TTHs) in a female sample from Austria. An extensive online questionnaire, consisting of 72 questions regarding sociodemographic background, headache anamnesis, lifestyle factors, such as sleep, and physical activity patterns, was distributed via online platforms by means of a snowball sampling system. Additionally, chronic stress was measured using the Trier Inventory for Chronic Stress.
Results Participants suffering from migraine were significantly older than women suffering from tension-type headaches (TTHs) and migraine. Age was significantly associated with migraine attack frequency. Women suffering from tension-type headaches (TTH) intensity showed significant associations with physical exercise, sleep, and chronic stress. Fewer hours of exercise and higher stress were connected with higher pain intensity. Migraine frequency, in contrast, correlated with daily hours spent in front of computer screen, while stress and physical exercise did not show associations with migraines.
Conclusion The study showed that lifestyle factors may be associated with and may have effects on primary headache disorders, especially tension-type headaches.
Alberti, A. (2006). Headache and sleep. Sleep Medicine Reviews 10 (6), 431–437. https://doi.org/10.1016/j.smrv.2006.03.003.
Altura, B. M./Altura, B. T. (2001). Tension headaches and muscle tension: is there a role for magnesium? Medical Hypotheses 57 (6), 705–713. https://doi.org/10.1054/mehy.2001.1439.
Antonov, K./Isacson, D. (1997). Headache in Sweden: the importance of working conditions. Headache 37 (4), 228–234. https://doi.org/10.1046/j.1526-4610.1997.3704228.x.
Arjona, A./Rubi-Callejon, J./Guardado-Santervas, P./Serrano-Castro, P./Olivares, J. (2007). Menstrual tension-type headache: evidence for its existence. Headache 47 (1), 100–103. https://doi.org/10.1111/j.1526-4610.2007.00656.x.
Baltar, F./Brunet, I. (2012). Social research 2.0: virtual snowball sampling method using Facebook. Internet Research 22 (1), 57–74. https://doi.org/10.1108/10662241211199960.
Bennett, K. (2020). Environment of evolutionary adaptedness (EEA). In: V. Zeigler-Hill/T. K. Shackelford (Eds.). Encyclopedia of personality and individual differences. Cham, Springer International Publishing, 1388–1391.
Boardman, H. F./Thomas, E./Millson, D. S./Croft, P. R. (2005). Psychological, sleep, lifestyle, and comorbid associations with headache. Headache 45 (6), 657–669. https://doi.org/10.1111/j.1526-4610.2005.05133.x.
Brenner, S. L./Jones, J. P./Rutanen-Whaley, R. H./Parker, W./Flinn, M. V./Muehlenbein, M. P. (2015). Evolutionary mismatch and chronic psychological stress. Journal of Evolutionary Medicine 3, 1–11. https://doi.org/10.4303/jem/235885.
Campelo, A. G. D./Lima, D. A./Britto, G. R. C./Moraes, I. S. L./Almeida, R. M./Silva-Néto, R. P. (2021). Does menstruation-related headache occur exclusively in women with migraine? Acta Neurologica Belgica 121 (4), 1035–1038. https://doi.org/10.1007/s13760-021-01646-w.
Cathcart, S./Bhullar, N./Immink, M./Della Vedova, C./Hayball, J. (2012). Pain sensitivity mediates the relationship between stress and headache intensity in chronic tension-type headache. Pain Research & Management 17 (6), 377–380. https://doi.org/10.1155/2012/132830.
Cathcart, S./Winefield, A. H./Lushington, K./Rolan, P. (2010). Stress and tension-type headache mechanisms. Cephalalgia 30 (10), 1250–1267. https://doi.org/10.1177/0333102410362927.
Engstrøm, M./Hagen, K./Bjørk, M. H./Stovner, L. J./Sand, T. (2014a). Sleep quality and arousal in migraine and tension-type headache: the headache-sleep study. Acta Neurologica Scandinavica. Supplementum (198), 47–54. https://doi.org/10.1111/ane.12237.
Engstrøm, M./Hagen, K./Bjørk, M./Stovner, L. J./Stjern, M./Sand, T. (2014b). Sleep quality, arousal and pain thresholds in tension-type headache: a blinded controlled polysomnographic study. Cephalalgia 34 (6), 455–463. https://doi.org/10.1177/0333102413515339.
Goodman, L. A. (1961). Snowball Sampling. The Annals of Mathematical Statistics 32 (1), 148–170. https://doi.org/10.1214/aoms/1177705148.
Hagen, K./Åsberg, A. N./Stovner, L./Linde, M./Zwart, J.-A./Winsvold, B. S./Heuch, I. (2018). Lifestyle factors and risk of migraine and tension-type headache. Follow-up data from the Nord-Trøndelag Health Surveys 1995-1997 and 2006-2008. Cephalalgia 38 (13), 1919–1926. https://doi.org/10.1177/0333102418764888.
Hamelsky, S. W./Lipton, R. B./Stewart, W. F. (2005). An assessment of the burden of migraine using the willingness to pay model. Cephalalgia 25 (2), 87–100. https://doi.org/10.1111/j.1468-2982.2005.00797.x.
Headache Classification Committee of the International Headache Society (2018). The international classification of headache disorders, 3rd edition. Cephalalgia 38 (1), 1–211. https://doi.org/10.1177/0333102417738202.
Irons, W. (1998). Adaptively relevant environments versus the environment of evolutionary adaptedness. Evolutionary Anthropology: Issues, News, and Reviews 6 (6), 194–204. https://doi.org/10.1002/(SICI)1520-6505(1998)6:6<194::AID-EVAN2>3.0.CO;2-B.
Jensen, R./Stovner, L. J. (2008). Epidemiology and comorbidity of headache. The Lancet Neurology 7 (4), 354–361. https://doi.org/10.1016/S1474-4422(08)70062-0.
Kelman, L./Rains, J. C. (2005). Headache and sleep: examination of sleep patterns and complaints in a large clinical sample of migraineurs. Headache 45 (7), 904–910. https://doi.org/10.1111/j.1526-4610.2005.05159.x.
Kikuchi, H./Yoshiuchi, K./Ohashi, K./Yamamoto, Y./Akabayashi, A. (2007). Tension-type headache and physical activity: an actigraphic study. Cephalalgia 27 (11), 1236–1243. https://doi.org/10.1111/j.1468-2982.2007.01436.x.
Kjaergaard, M./Eggen, A. E./Mathiesen, E. B./Jorde, R. (2012). Association between headache and serum 25-hydroxyvitamin D: the Tromsø Study: Tromsø 6. Headache 52 (10), 1499–1505. https://doi.org/10.1111/j.1526-4610.2012.02250.x.
Leiner, D. J. (2019). SoSci Survey. Version 3.1.06.
Linde, M./Dahlöf, C. (2004). Attitudes and burden of disease among self-considered migraineurs: a nation-wide population-based survey in Sweden. Cephalalgia 24 (6), 455–465. https://doi.org/10.1111/j.1468-2982.2004.00703.x.
Lipton, R. B./Bigal, M. E./Kolodner, K./Stewart, W. F./Liberman, J. N./Steiner, T. J. (2003). The family impact of migraine: population-based studies in the USA and UK. Cephalalgia 23 (6), 429–440. https://doi.org/10.1046/j.1468-2982.2003.00543.x.
Lipton, R. B./Hamelsky, S. W./Kolodner, K. B./Steiner, T. J./Stewart, W. F. (2000). Migraine, quality of life, and depression: a population-based case-control study. Neurology 55 (5), 629–635. https://doi.org/10.1212/wnl.55.5.629.
Loder, E. (2002). What is the evolutionary advantage of migraine? Cephalalgia 22 (8), 624–632. https://doi.org/10.1046/j.1468-2982.2002.00437.x.
Lyngberg, A. C./Rasmussen, B. K./Jørgensen, T./Jensen, R. (2005). Incidence of primary headache: a Danish epidemiologic follow-up study. American Journal of Epidemiology 161 (11), 1066–1073. https://doi.org/10.1093/aje/kwi139.
Maleki, N./Becerra, L./Borsook, D. (2012). Migraine: maladaptive brain responses to stress. Headache 52 Suppl 2, 102–106. https://doi.org/10.1111/j.1526-4610.2012.02241.x.
Marrelli, A./Marini, C./Prencipe, M. (1988). Seasonal and meteorological factors in primary headaches. Headache 28 (2), 111–113. https://doi.org/10.1111/j.1526-4610.1988.hed2802111.x.
Meyer, B./Keller, A./Wöhlbier, H.-G./Overath, C. H./Müller, B./Kropp, P. (2016). Progressive muscle relaxation reduces migraine frequency and normalizes amplitudes of contingent negative variation (CNV). The Journal of Headache and Pain 17, 37. https://doi.org/10.1186/s10194-016-0630-0.
Molarius, A./Tegelberg, A./Ohrvik, J. (2008). Socio-economic factors, lifestyle, and headache disorders - a population-based study in Sweden. Headache 48 (10), 1426–1437. https://doi.org/10.1111/j.1526-4610.2008.01178.x.
Mukamal, K. J./Wellenius, G. A./Suh, H. H./Mittleman, M. A. (2009). Weather and air pollution as triggers of severe headaches. Neurology 72 (10), 922–927. https://doi.org/10.1212/01.wnl.0000344152.56020.94.
Mukherjee, S./Patel, S. R./Kales, S. N./Ayas, N. T./Strohl, K. P./Gozal, D./Malhotra, A. (2015). An official American thoracic society statement: the importance of healthy sleep. recommendations and future priorities. American Journal of Respiratory and Critical Care Medicine 191 (12), 1450–1458. https://doi.org/10.1164/rccm.201504-0767ST.
Ødegård, S. S./Engstrøm, M./Sand, T./Stovner, L. J./Zwart, J.-A./Hagen, K. (2010). Associations between sleep disturbance and primary headaches: the third Nord-Trøndelag Health Study. The Journal of Headache and Pain 11 (3), 197–206. https://doi.org/10.1007/s10194-010-0201-8.
Ohlmann, K. K./O'Sullivan, M. I. (2009). The costs of short sleep. AAOHN Journal 57 (9), 381-5; quiz 386-7. https://doi.org/10.3928/08910162-20090817-02.
Pellegrino, A. B. W./Davis-Martin, R. E./Houle, T. T./Turner, D. P./Smitherman, T. A. (2018). Perceived triggers of primary headache disorders: A meta-analysis. Cephalalgia 38 (6), 1188–1198. https://doi.org/10.1177/0333102417727535.
Rafique, N./Al-Asoom, L. I./Latif, R./Alsunni, A. A./Salem, A. M./Alkhalifa, Z. H./Almaharfi, R. M./Alramadan, R. S./Aldajani, Z. F./Alghadeer, F. A. T./Albaghli, L. A. (2020). Prevalence of Migraine and its Relationship with Psychological Stress and Sleep Quality in Female University Students in Saudi Arabia. Journal of pain research 13, 2423–2430. https://doi.org/10.2147/JPR.S270847.
Rasmussen, B. K. (1993). Migraine and tension-type headache in a general population: precipitating factors, female hormones, sleep pattern and relation to lifestyle. Pain 53 (1), 65–72. https://doi.org/10.1016/0304-3959(93)90057-V.
Schulz, P./Schlotz, W./Becker, P. (2004). Trierer Inventar zum Chronischen Stress. Hogrefe.
Steiner, T. J./Stovner, L. J./Katsarava, Z./Lainez, J. M./Lampl, C./Lantéri-Minet, M./Rastenyte, D./La Ruiz de Torre, E./Tassorelli, C./Barré, J./Andrée, C. (2014). The impact of headache in Europe: principal results of the Eurolight project. The Journal of Headache and Pain 15, 31. https://doi.org/10.1186/1129-2377-15-31.
Stovner, Lj/Hagen, K./Jensen, R./Katsarava, Z./Lipton, Rb/Scher, Ai/Steiner, Tj/Zwart, J-A (2007). The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia 27 (3), 193–210. https://doi.org/10.1111/j.1468-2982.2007.01288.x.
Sutherland, H. G./Albury, C. L./Griffiths, L. R. (2019). Advances in genetics of migraine. The Journal of Headache and Pain 20 (1), 72. https://doi.org/10.1186/s10194-019-1017-9.
Tolentino, G. A./Bevilaqua-Grossi, D./Carvalho, G. F./Carnevalli, A. P. O./Dach, F./Florencio, L. L. (2018). Relationship between headaches and neck pain characteristics with neck muscle strength. Journal of Manipulative and Physiological Therapeutics 41 (8), 650–657. https://doi.org/10.1016/j.jmpt.2018.04.003.
van Casteren, D. S./Verhagen, I. E./van der Arend, B. W. H./van Zwet, E. W./Maassen van den Brink, A./Terwindt, G. M. (2021). Comparing perimenstrual and nonperimenstrual migraine attacks using an e-diary. Neurology 97 (17), e1661-e1671. https://doi.org/10.1212/WNL.0000000000012723.
Vos et al./GBD 2019 Diseases and Injuries Collaborators (2020). Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet 396 (10258), 1204–1222. https://doi.org/10.1016/S0140-6736(20)30925-9
Walker, A. R. P./Walker, B. F./Adam, F. (2003). Nutrition, diet, physical activity, smoking, and longevity. Nutrition 19 (2), 169–173. https://doi.org/10.1016/s0899-9007(02)00948-6.
Walters, A. B./Hamer, J. D./Smitherman, T. A. (2014). Sleep disturbance and affective comorbidity among episodic migraineurs. Headache 54 (1), 116–124. https://doi.org/10.1111/head.12168.
Winter, A. C./Hoffmann, W./Meisinger, C./Evers, S./Vennemann, M./Pfaffenrath, V./Fendrich, K./Baumeister, S. E./Kurth, T./Berger, K. (2011). Association between lifestyle factors and headache. The Journal of Headache and Pain 12 (2), 147–155. https://doi.org/10.1007/s10194-010-0286-0.
Wöber, C./Holzhammer, J./Zeitlhofer, J./Wessely, P./Wöber-Bingöl, C. (2006). Trigger factors of migraine and tension-type headache: experience and knowledge of the patients. The Journal of Headache and Pain 7 (4), 188–195. https://doi.org/10.1007/s10194-006-0305-3.
Wöber, C./Wöber-Bingöl, Ç. (2010). Triggers of migraine and tension-type headache. In: Nappi G./M. A. Muskowitz (Eds.). Headache. Elsevier, 161–172.
Yang, A. C./Fuh, J.-L./Huang, N. E./Shia, B.-C./Peng, C.-K./Wang, S.-J. (2011). Temporal associations between weather and headache: analysis by empirical mode decomposition. PloS One 6 (1), e14612. https://doi.org/10.1371/journal.pone.0014612.
Zivadinov, R./Willheim, K./Sepic-Grahovac, D./Jurjevic, A./Bucuk, M./Brnabic-Razmilic, O./Relja, G./Zorzon, M. (2003). Migraine and tension-type headache in Croatia: a population-based survey of precipitating factors. Cephalalgia 23 (5), 336–343. https://doi.org/10.1046/j.1468-2982.2003.00544.x.
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