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MIGRAINES MOST LIKELY TO STRIKE ADOLESCENTS ON MONDAYS
MONTREAL -- Adolescents prone to migraine are most likely to get the excruciating headaches on Mondays and least likely on Saturdays, according to a large multi-center study being presented in a special session here at the 42nd Annual Scientific Meeting of the American Headache Society (AHS).
"We suspect it may have to do with the anxiety of getting ready to go school, or perhaps the changing sleep patterns," said Paul Winner, D.O., co-director of the Palm Beach Headache Center, and an investigator in the multi- center study. "About half of people with migraines get them before the age of 20, and unless they get pain relief, it can set them up for a lifetime of not achieving, first in school, then at work. It's crucial to identify the kids and get them appropriate treatment."
In related research from the Cleveland Clinic Foundation being presented in the special session, of children 7 years old and younger who sought evaluation for their headaches, more than three-quarters had migraines. However, the number who suffer from tension headaches between ages 13 and 17 is about the same as those who have migraines.
"It's not that there are fewer kids getting migraines. Research shows the frequency of all types of headaches is going up in teens and young adults," said A. David Rothner, M.D., director of the Pediatric Headache Center, Cleveland Clinic Foundation. "A common theory is that it's stress and environment, with all of the divorce, and pressure at school, and from peers and society in general.
"Doctors treating children with headaches should keep in mind the child's age when determining what type of headache he or she is suffering from," said Dr. Rothner.
Headache is a common ailment among children. At age 7, up to 3 percent of children suffer from migraines, and between ages 7 and 15, from 4 to 11 percent suffer from them. Overall, as many as half of 7-year-old children get occasional headaches, while as many as four of five 7- to 15-year-olds get headaches from time to time.
Children and teens suffering from headaches, whether tension or migraine, can and should be treated. Dr. Rothner suggests the child with severe tension or migraine headaches see a psychologist who knows about headaches, and then consider once-weekly biofeedback or relaxation sessions, in combination with medication prescribed by their physicians.
"Some of these kids are already taking medications, such as ibuprofen, but they may take them too often and suffer from rebound headaches," said Dr. Rothner. "They shouldn't take acute pain medications more than two or three times a week. Kids who get a lot of headaches need to see a physician, who can put them on preventive medicines."
Adolescents Most Likely to Get Migraines on Mondays
In the multi-center study conducted at 35 clinics, 1,858 adolescents, ages 12 to 17 years old, were surveyed regarding the times when their headaches occurred: 373 (20 percent) got them on Mondays, making it the most common day for migraines; and 172 (9 percent) got them on Saturday, the least common day. Incidence of headache for the rest of the week was as follows: Sunday, 13 percent; Tuesday, 16 percent; Wednesday, 16 percent; Thursday, 13 percent; and Friday, 13 percent. In 1,363 patients (73 percent), the attacks began between 6 a.m. and 6 p.m., with no consistent starting time.
"It has always been believed that kids got their headaches early in the day, but according to our data, there is no special time," said Dr. Winner, who is co-director of the Premiere Research Institute at Palm Beach Neurology.
The children who were surveyed had partaken in studies on various triptan drug treatments.
"The treatment studies were positive, showing us that these triptans work as well for kids as adults," said Dr. Winner.
Migraine Most Common Headache Among Younger Children
In the Cleveland Clinic study, 309 children ages 3 to 17 who sought evaluation for their headaches were studied. Of 53 children 7 years old or younger, 77 percent were determined to be suffering from migraines, 15 percent from tension headaches, and 8 percent had tension and migraine headaches. Of 127 children ages 7 to 13, 67 percent had migraine headaches, 20 percent had tension headaches and 13 percent had both. Between ages 13 and 17, 41 percent had migraine headaches, 40 percent had tension headaches and 19 percent had both.
"About 10 percent of all kids suffering from headaches missed more than 20 days of school in a semester," said Dr. Rothner.
Co-authors of the multi-center study being presented by Dr. Winner are: A. David Rothner, M.D.; G. Putnam; J. Saires, Ph.D.; S. O'Quinn, Ph.D.; and M. Asgharnejad, Ph.D.
Co-authors of the Cleveland Clinic study being presented by Dr. Rothner are: Paul Winner, M.D.; Donald Lewis, M.D.; Robert Nett, M.D.; M. Asgharnejad, Ph.D.; Antonio Laurenza, M.D.; Randall Austin, M.D.; and Margaret Peykamian.
The American Headache Society (AHS), founded in 1959 as the American Association for the Study of Headache, is based in Mt. Royal, N.J. AHS is a professional organization for those interested in the study and management of headache and face pain. AHS has approximately 1,500 members. For more information, visit the AHS Web site at http://www.ahsnet.org. To fill the need for patient education, AHS established the American Council for Headache Education (ACHE), a non-profit patient-physician organization for the advancement of the treatment and management of headache and the encouragement of more constructive social attitudes towards the disease. Individuals who would like more information about headache, who would like a referral to a specialist who treats headache, or who would like information on support groups can call (800) 255-ACHE, write to ACHE at 19 Mantua Road, Mt. Royal, N.J. 08061, or visit the ACHE Web site at http://www.achenet.org.
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