Pediatric Headache Experience During the COVID-19 Pandemic

Abstract

Objective Headache disorders are exceedingly common in children and adolescents. The association between headaches, emotional stress, and disruptions in daily routines are well established. The goal of this study is to compare the experiences of patients with a preexisting diagnosis of a primary headache disorder in terms of headache frequency and severity, lifestyle techniques for headache prevention, screen use, and mood from before and after the onset of the COVID-19 pandemic. Methods Patients evaluated by the Headache Clinic at Children’s National Hospital between Summer 2020 and Winter 2021 were enrolled in a patient registry. Patients completed a questionnaire examining changes in headache characteristics and lifestyle factors since the onset of the COVID-19 pandemic. Results A total of 107 patients completed the survey. Since the pandemic’s onset, patients reported decreased physical activity (n = 59, 55%), increased frequency of chronic headaches from 40% (N = 42) to 50% (N = 54), and increased constant daily headaches from 22% (n = 24) to 36% (n = 38). Patients reported worsened anxiety (n = 58, 54%), mood (n = 50, 47%), and workload (n = 49, 46%). Sixty-one percent (n = 65) of patients reported using screens for school for more than 6 hours per day. The majority (n = 67, 63%) of patients indicated that they would prefer attending in-person school, with 14% (n = 15) responding that they preferred online school. Conclusion Since the COVID-19 pandemic’s onset, pediatric headache patients have experienced increasing headache frequency, worsening anxiety and mood, decreased physical activity, and increased screen usage. Although this study is limited by sample size and observational design, future population-based studies will further elucidate the impact of this pandemic on pediatric headache.

Screen time and pediatric headache: A scoping review of the literature

“…with >80% of their sample of Trinidad and Tobago school children spending >4 h daily on digital devices with headache the most common symptom in 75%. Likewise, daily screen use >6 h/day over COVID‐19 with worsening seen in both chronic headache frequency and increased daily persistent headache was reported in a United States Headache Clinic sample 24 . In fact, Rashid et al 48 .…”

“…Of the included studies, 10 (21%) demonstrated changes in screen use and headache patterns during and following the COVID‐19 pandemic 8,14,23–25,36,42,44,48,54 . For example, in their study of 407 Saudi Arabian children aged 6–18 years during COVID‐19, Abuallut et al 8 .…”

“…Of the included studies, 10 (21%) demonstrated changes in screen use and headache patterns during and following the COVID-19 pandemic. 8,14,[23][24][25]36,42,44,48,54 For example, in their study of 407 Moreover, an Italian study (n = 240) exploring the association between problematic internet use, somatic symptoms, and emotional behavioral functioning in teenagers reported excessive internet use in 64%, with 21.8% identified as problematic/addicted users. In this population, headache was reported in 16.5%.…”

Virtual issue: Recent advances in pediatric headache: Bridging the data gap

“…According to the National Center for Education Statistics, 98% of United States public schools offered full‐time in‐person instruction in June of 2022, while 33% offered full‐time remote instruction, and 10% offered combination (i.e., hybrid) instruction. Recent research has shown that while the majority of youth with headache disorders prefer in‐person instruction, a non‐negligible proportion would rather attend school virtually 1 . As highlighted in this issue, each of these educational options carries a unique risk–benefit profile for youth with headache disorders 2 .…”

“…Recent research has shown that while the majority of youth with headache disorders prefer in-person instruction, a non-negligible proportion would rather attend school virtually. 1 As highlighted in this issue, each of these educational options carries a unique risk-benefit profile for youth with headache disorders. 2 Moving forward, clinicians must be keenly aware of how the delivery of education (i.e., virtual vs. in person) could affect patients' ability to adhere to healthy habit recommendations, take preventive and acute medications, and engage in nonpharmacologic preventive strategies.…”