The Natural History of Headache: Predictors of Onset and Recovery

Abstract

The objective of this study was to determine predictors of onset of new headache episodes and recovery from headache over one year. A population-based cohort study was conducted, comprising a baseline postal survey to a random sample of adults aged>or=18 years, with follow-up survey after 1 year. Risk factor data at baseline were compared with headache status at follow-up in two groups: (i) those free of recent headache at baseline and (ii) those with a recent headache at baseline. In respondents free of recent headache at baseline, previous headache [risk ratio (RR) 4.15], the presence of other pain at baseline (RR 1.43), severe sleep problems (RR 1.67) and drinking caffeine (RR 1.99) increased the risk of a new headache episode during the follow-up year. In respondents with recent headache at baseline, less severe headaches at baseline predicted recovery during the follow-up year, as did the absence of anxiety [recovery ratio (ReR) 2.84] and of sleep problems (ReR 2.77). Risks for increased headache-related disability reflected those for onset of a new episode and these risks increased in strength for large increases in disability. Sleep problems and caffeine consumption increase the risk of developing headache and thus provide targets for prevention. Low levels of anxiety, sleep problems and the absence of other pain improve the likelihood of recovering and remaining free from headache.

Paranasal sinus opacification in headache sufferers: A population-based imaging study (the HUNT study-MRI)

“…However, in another HUNT study (25), good agreement was found for the diagnosis of migraine and the status of being a headache sufferer despite the fact that the questionnaire was filled in 5-9 months prior to interview. Boardman et al (26) found that the prevalence of headache was quite stable over time, but that some headache characteristics changed. Thus, it is likely that most participants with headache would have continued to report headache at the time of the MRI, but could have been classified to other headache groups.…”

Sleep and pain sensitivity in adults

“…19,32,44 Although the direction of causality is not entirely clear, and is most likely bidirectional, several lines of evidence point to sleep problems as the primary antecedent factor. This includes evidence that insomnia exacerbates existing pain and predicts new-onset pain 5,25,35,46 as well as studies demonstrating that sleep quality predicts pain severity the next day.…”

The effect of sleep restriction on laser evoked potentials, thermal sensory and pain thresholds and suprathreshold pain in healthy subjects

“…Furthermore, as epidemiological studies indicate that there is a causal relationship between insomnia and several painful disorders (Boardman et al, 2006;Canivet et al, 2008;Gupta et al, 2007;Hoogendoorn et al, 2001;Kaila-Kangas et al, 2006;Lyngberg et al, 2005;Odegard et al, 2011;Siivola et al, 2004), it would be interesting to find out whether these two observations are related or not. Specifically, if lack of sleep in healthy individuals result in LEP-habituation abnormalities, it might indicate that sleep loss could be the explanatory mechanism for the observed decreased LEP-habituation in migraine and fibromyalgia.…”