Yom Kippur headache

Abstract

Fasting is frequently mentioned by patients and in textbooks as a trigger for headache. In this study, we attempted to define the role of fasting as a possible precipitator of headache. Headache history was documented in 370 hospital employees (60% female) before and immediately after a 25-hour fast for the 1993 Day of Atonement (Yom Kippur). The population included 211 who fasted; 39% of fasters developed headache, compared with only 7% of nonfasters (p < 0.000001). Headache was usually of a nonpulsating quality, mild to moderate in intensity, and bilateral and frontal in location. Subjects with a history of headache were more likely to develop fasting-induced headache than were those without such history (66% versus 29%, p < 0.000002). The number of headache sufferers increased in direct relation to the duration of the fast. Caffeine and nicotine withdrawal and oversleeping did not appear to have an influence on headache development. We conclude that fasting is a strong headache precipitator, especially among chronic headache sufferers. It is usually nonpulsating and nonlateralized.

Effects on health of fluid restriction during fasting in Ramadan

“…Headaches were rated as being mild to moderate in intensity and individuals who were prone to headaches were more likely to develop fasting-induced headaches (66% and 29%, respectively). The investigators in this study considered that caffeine and nicotine withdrawal and oversleeping did not have an influence on headache development in their subjects, but fasting per se was the main contributor to inducing the headaches (Mosek & Korczyn, 1995) but they did not appear to consider the possibility of acute dehydration as a factor.…”

“…Irritable-related stress was et al (1990) considered to be the main factor leading to tension headaches, while Ramadan fasting appeared as the prime precipitating factor for migraines (Shah & Nafee, 1999). In the study of Awada and al Jumah (1999) (Mosek & Korczyn, 1995). The number of headache sufferers increased in direct relation to the duration of the fast.…”

The role of diet and lifestyle in adolescents with headache: a review

“…The fasting appears to be an important precipitating factor for headache attacks and individuals who fast may more easily develop fasting headache [27]. Thus, subjects who already suffer from headache, especially TTH, may develop headache more frequently during prolonged fasting, as during Ramadan, Yom Kippur [28][29][30] or preoperative fasting [31]. These data may suggest that diet and eating behaviors can play an important role in modifying frequency and evolution of headache.…”

Caffeine and headaches

“…However, two studies suggest that caffeine-withdrawal headaches are actually rare. An Israeli study of prolonged fasting during the Jewish holiday of Yom Kippur found no signifi cant difference in the incidence of induced headaches among caffeine consumers versus nonconsumers [ 27 ]. This study suggests that other factors (eg, abstinence from water or foods, genetic background, or cultural factors) may contribute more strongly to fasting-induced headaches but does not fully exclude caffeine as a factor.…”