Sleeping in (a Bit) May Help Teens With Migraine Headaches

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Fewer headaches reported when school begins later on, UCSF-led research study programs.

Research shows that beginning school later on in the early morning yields health and scholastic advantages for high schoolers, whose natural body clock tends towards late-to-bed, late-to-rise routines. While moms and dads raise issues about sleepy driving, inflammation and impaired school efficiency, a brand-new research study led by scientists at UC San Francisco recommends another factor to press back the start time.

The scientists discovered that teenagers with migraines whose high schools began prior to 8: 30 a.m. experienced a typical 7.7 headache days monthly. This was close to 3 more headache days than those with later school start times, the scientists reported in their research study, which releases in Headache: The Journal of Head and Face Pain on November 25, 2020.

“Evidence suggests that there is a relationship between sleep and migraine,” stated very first author Amy Gelfand, MD, a neurologist at the Pediatric Headache Program at UCSF Benioff Children’s Hospitals, keeping in mind that 8-12 percent of teenagers experience the illness. “Getting adequate sleep and maintaining a regular sleep schedule may reduce the frequency of migraines.”

The American Academy of Sleep Medicine recommends that teenagers obtain from 8 to 10 hours of sleep a night. In acknowledgment of teenagers’ postponed circadian clock, the American Academy of Pediatrics suggests that middle and high schools begin no earlier than 8: 30 a.m. However, simply 18 percent of public middle and high schools follow this suggestion, according to the Centers for Disease Control and Prevention.

To measure what effect, if any, school start times have on migraine frequency, the scientists connected to high schoolers through social networks, providing a $10 present card to finish a short study. Approximately 1,000 9th-12th graders whose headaches fit the requirements for migraine reacted to the study. They made up 509 trainees who began school prior to 8: 30 a.m. and 503 who began school after 8: 30 a.m.

Both groups had an average 24-minute commute to school, with the earlier-start group getting up at 6: 25 a.m. and starting school at 7: 56 a.m., and the later-start group getting up at 7: 11 a.m. and starting school at 8: 43 a.m. Of note, the later-start group went to sleep previously on school nights – usually at 10: 19 p.m., versus 10: 58 p.m. in the earlier-start group.

While the typical variety of headache days monthly balanced 7.7 days for the earlier-start group and 4.8 days for the later-start group, the distinction narrowed to 7.1 and 5.8 days when the scientists changed for danger elements such as insufficient sleep and avoiding breakfast, in addition to for gender, grade, research volume and migraine medication usage. Nevertheless, the 1.3 days distinction in between the 2 groups stayed substantial, stated Gelfand, who is associated with the UCSF Weill Institute for Neurosciences.

“The magnitude of the effect size in this study is similar to that seen in studies of migraine prevention drugs,” she stated. “For example, in a trial of topiramate (Topamax) versus placebo in 12- to 17-year-olds with episodic migraine, those receiving the drug had an average of two migraine days in the last month, compared with 3.5 migraine days for those on placebo – a difference of 1.5 days.”

Similarly, in 2 research studies of grownups getting onabotulinum contaminant A (Botox) injections to avoid persistent migraines, the distinction in between the variety of headache days in between the 2 treatment groups and each placebo group was 1.4 days and 2.3 days.

“If our findings are confirmed in future research, shifting to a later high school start time is a modifiable, society-level intervention that could translate to thousands of fewer migraine days and fewer missed days of school for teenagers,” stated Gelfand, who will be the brand-new editor-in-chief of Headache in January.

In 2019, California ended up being the very first state to enact laws that high schools start no earlier than 8: 30 a.m., a modification that will be executed in the 2022-23 scholastic year. “The COVID-19 pandemic has actually resulted in widescale modifications in how trainees participate in schools,” stated Gelfand. “As we rethink what a typical school day looks like, the time may be ripe for changing school start time as well.”

Reference: 25 November 2020,  Headache: The Journal of Head and Face Pain.

Co-Authors: Senior author is Isabel Elaine Allen, PhD, of the UCSF Department of Epidemiology and Biostatistics. Co-authors are Sara Pavitt, MD, Alexandra Ross, PhD, Samantha Irwin, MD, Barbara Grimes, PhD, and Remi Frazier of UCSF; Katie Stone, PhD, from UCSF and California Pacific Medical Center; Christina Szperka, MD, from Children’s Hospital of Philadelphia; and Suzanne Bertisch, MD, from Brigham and Women’s Hospital.

Funding: UCSF Research Allocation Program

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