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High School Start Time and Migraine Frequency in High School Students
Author(s) -
Gelfand Amy A.,
Pavitt Sara,
Greene Kaitlin,
Szperka Christina L.,
Irwin Samantha,
Grimes Barbara,
Allen Isabel E.
Publication year - 2019
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/head.13535
Subject(s) - migraine , medicine , pediatrics , observational study , physical therapy , anesthesia
Objective To investigate whether later high school start time is associated with lower migraine frequency in high school students with migraine. Background Adequate sleep is thought to be important in managing adolescent migraine. The American Academy of Sleep Medicine recommends teenagers sleep ≥8 hours/night. Adolescents have a physiologically delayed sleep phase, going to bed, and waking later than children and adults. The American Academy of Pediatrics (AAP) accordingly recommends high schools start no earlier than 8:30 AM. Methods Cross‐sectional observational study of U.S. high schoolers with migraine. Participants were recruited nationally using social media. Respondents attending high schools starting at 8:30 AM or later were compared to those attending earlier start time schools. The primary outcome was headache days/month. Results Two hundred and fifty‐six subjects constituted the analysis set: 115 later group vs 141 earlier group. Age and sex did not differ. Mean (SD) self‐reported headache days/month were 7 (5) vs 8 (7), respectively, ( P = .985); mean difference (95% CI for the difference) was −0.8 (−2.3‐0.7) days. Median (IQR) self‐reported total hours of sleep/school night were: 5.6 (5.0‐6.6) vs 5.6 (4.5‐6.4), P = .058. Students attending later start time schools woke later (median [IQR] 6:38 AM [55 minutes] vs 6:09 AM [59 minutes], P < .0001) and left home later (median [IQR] 7:28 AM [28 minutes] vs 7:02 AM [60 minutes], P < .0001). Average commute time was also longer: 41 (21) minutes vs 28 (16), P < .0001. The vast majority in both groups reported missing breakfast at least once/week: 103/114 (90.4%) vs 128/141 (90.8%), P = .907. Hours of sleep did not correlate with headache days per month. Conclusion High school start time does not have a large effect on headache frequency in high schoolers with migraine. Given the high variance in headache days/month observed in this study, a larger study would be needed to determine whether there might still be a small effect of starting high school at/after 8:30 AM. More research is needed to establish evidence‐based recommendations about lifestyle factors in adolescent migraine management.