The Influence of Migraine on Driving: Current Understanding, Future Directions, and Potential Implications of Findings

Abstract

Objective.-To review the published findings relevant to migraine and driving performance, with an intent to encourage discussion on research which may broaden understanding in this area and help educate healthcare providers and their patients. Background.-Motor vehicle crashes result in more than 35,000 deaths and more than 2 million injuries annually in the United States. Migraine is one of the most prevalent diseases in the world, and many symptoms associated with migraine attacks have the potential to negatively influence driving ability. Methods.-We reviewed the published findings related to migraine and driving performance. Study findings relevant to symptoms of migraine and their potential effect on driving were also reviewed. This required a more expansive exploration of the literature beyond migraine, for example, review of the literature relating to the effect of pain, sleepiness, visual disturbances, or vertigo on driving. Finally, the potential effects of treatment for migraine on driving were reviewed. Results.-Literature on the effect of migraine on driving performance is sparse and, in general published studies on the topic have a number of limitations. Based on review of the literature pertaining to other disorders, it seems feasible that some symptoms occurring as part of the migraine attack could impact driving performance, although formal study in this area is lacking. Many of the approved treatments for migraine have the potential to impact driving, yet this has not been specifically studied, and the extent to which these risks are communicated to patients is not clear. Conclusion.-The impact of migraine on driving performance has been largely neglected, with few studies specifically designed to address the topic, and relevant studies were generally small with limited control of confounders. This area requires more focus, given a potential for impact on road safety.

Seasickness among Icelandic seamen

“…Our findings also show an association between migraine/tension headache and increased likelihood of accidents, although no comparable studies have been found that indicate such an association. Migraine alone has also been associated with fatigue and drowsiness, and driving performance [28]. The incidence of migraine among seamen in the study was rather high (18.4%), but due to a lack of reports on seamen and their physical health, a comparison is difficult.…”

“…Studies from Iceland and other countries indicate that seamen often feel that they are tired [24], and their sleep is often disrupted, due to both noise and the movements of the vessel [26]. Inadequate sleep increases the likelihood of headache and can also be a cause of headache [27,28]. Various environmental factors at sea are believed to have a negative impact on seamen´s health.…”

Medical Cannabis for Headache Pain: a Primer for Clinicians

“…Malone et al [88] CB1 receptor activation in the vIPAG attenuated trigernirucervical complex activity. This effect was inhibited by the addition of the CB1 receptor antagonist or the 5HT1B/1D receptor antagonist.…”

Migraine headaches are associated with motor vehicle crashes and driving habits among older drivers: Prospective cohort study

“…4 Migraine symptoms have the potential to adversely affect driving safety. 5 Prospective studies in New Zealand and Canada reported significantly increased risks of motor vehicle crash (MVC) injuries in people with prevalent (i.e., ever diagnosed or treated) migraine, while a smaller retrospective study in male military drivers found migraine diagnosis associated with police-reported MVCs. [6][7][8] Migraines could also reduce crash risk if symptoms lead to reductions in driving.…”

“…9 Medications to prevent or treat migraine, including triptans, opioids, barbiturates and antiemetics for acute attacks, or β-blockers, antidepressants, or antiepileptics used as preventive treatments, may reduce driving safety. 5 However, by decreasing migraine symptoms, such medications might also reduce impaired driving and promote safety. Vingilis et al (2012) simultaneously examined migraines and pain medications (not necessarily prescribed specifically for migraine) and found that the increased odds of MVC…”