Lifestyle behaviors, including meal irregularity, late chronotype, prolonged screen exposure, and frequent substance use/exposure are associated with frequent headaches in children and adolescents, according to a study published online Feb. 28 in Neurology.

Christelle Nilles, M.D., from the University of Calgary in Alberta, Canada, and colleagues enrolled children and adolescents aged 5 to 17 years in a large cross-sectional Canadian population-based health survey to examine the association between lifestyle factors and frequent recurrent headaches. The population included an estimated 4,978,370 participants (mean age, 10.9 years).

Overall, 6.1 percent of participants had frequent headaches. The researchers observed associations for frequent headache with older age and female sex (odds ratios, 1.31 and 2.39, respectively). The odds of frequent headaches decreased with meal regularity in models adjusted for age/sex (adjusted odds ratio, 0.90) and increased with later chronotype (adjusted odds ratio, 1.10) and excess screen exposure (adjusted odds ratio, 2.97 for ≥21 hours versus none in past week); no significant association was seen with physical activity. Frequent headaches were associated with frequent alcohol use, binge drinking, smoking cigarettes, using electronic cigarettes, and cannabis use in 12- to 17-year-olds. Daily exposure to smoking inside the home was associated with frequent headache in the entire sample (adjusted odds ratio, 2.00).

“This work suggests that future studies should assess whether interventions targeted at addressing the associated lifestyle factors would be effective in reducing headache frequency because there may be important clinical and public health implications to this type of work,” the authors write.

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