Frequent Headaches in Children: These Are the Lifestyle Risk Factors

Frequent recurring headaches in children and youth are associated with modifiable risk factors, such as meal irregularity and increased screen time, according to study findings published in Neurology.

Some lifestyle behaviors have a suggested link to frequent headaches among children and the youth, including prolonged screen time, meal irregularity, and lower levels of activity. These modifiable risk factors have the potential to lead to a decreased quality of life in this population. 

Researchers conducted a cross-sectional observational study to evaluate the association between lifestyle factors and headache frequency among children and youth. Data was collected from the Canadian Health Survey on Children and Youth (CHSCY) conducted in 2019, which included participants aged 1 to 17. 

Surveys were distributed electronically to the youth or to the person who was most knowledgeable about the participant in the same household. Participants with missing information were excluded from the study. 

The primary outcome was headache frequency over the past 6 months. Responses were organized into headaches that occur approximately once a week or less or into frequent recurrent headaches, defined as headaches occurring more than once a week. 

The researchers collected information regarding physical activity, screen exposure, sleep chronotype, household smoking, and substance use. 

The estimated weighted total sample size included 4,978,370 (average age, 10.93; 48.80% female) children and youth.

Over half of the participants rarely or never experienced headaches within the past few months (61.2%; 95% CI, 60.5-61.9), while 6.1% (95% CI, 5.8-6.5) had frequent recurrent headaches.

The simple logistic regression models revealed that frequent recurrent headaches were associated with patients of older age (odds ratio [OR], 1.31; 95% CI, 1.28-1.34; P <.001) and female sex (OR, 2.39; 95% CI, 2.08-2.75; P <.001). 

When adjusting for age and sex, meal regularity was associated with decreased headache frequency (adjusted OR [aOR], 0.90; 95% CI, 0.89-0.92; P <.001). However, the risk for frequent headaches was increased with excess screen exposure (aOR, 2.97; 95% CI, 1.53-5.77; P =.001) and later sleep chronotype (aOR, 1.10; 95% CI, 1.05-1.15; P <.001). Patients with mood (aOR, 3.05; 95% CI, 2.53-3.68; P <.001) and anxiety disorders (aOR, 3.89; 95% CI, 3.01-5.03; P <.001) also had a greater risk for frequent recurrent headaches.

The researchers did not observe a significant association between physical activity and headache frequency (aOR, 0.95; 95% CI, 0.67-1.34; P =.77). 

Participants living in households where they were exposed to indoor smoking had an increased risk for frequent recurrent headaches (aOR, 2.00; 95% CI, 1.23-3.27; P =.005).

Study limitations included the potential overadjustment of models and that all data was retrospectively collected. 

“Although we were unable to establish causality in a cross-sectional design, this work suggests that future studies should assess whether interventions targeted at addressing the associated lifestyle factors would be effective in reducing headache frequency because there may be important clinical and public health implications to this type of work,” the researchers concluded.