Factors associated with decreased migraine attack risk

In two-thirds of individuals with migraine, at least one factor associated with decreased risk of a migraine attack could be identified using prospective daily data. Most common protectors included feeling refreshed after waking, happiness, and good sleep quality. Although highly individualised, these behavioural factors are relevant in diminishing migraine attack risk.

For the management of migraine, potential protective factors may be equally important as trigger factors, but have been widely ignored. A study set up by Prof. Christian Wöber (Medical University of Vienna, Austria) and colleagues aimed to identify factors associated with decreased migraine attack risk in patients with migraine [1].

A total of 866 individuals with migraine registered to use N1-Headache^®, a mobile app that connects patients to their clinicians and is specifically designed to identify migraine risk factors. Median age of participants was 43 years; 88% were women. In total, 88.7% had a diagnosis of migraine by a physician; 83% had episodic migraine; median number of migraine days was 8.8 per months; and 55.1% of women recorded at least one menstrual cycle. For 90 days, participants entered daily data about potential attack risk factors (e.g. diet, mood), migraine symptoms, and headache characteristics. A factor was defined as a potential protector if it was significantly associated with a decreased risk of migraine attack (unadjusted HR <1.0; P<0.05).

In 31.4% of patients no protectors were found, 65.9% had between 1 and 8 protectors, and 2.7% had 9 or more. The most common protectors were feeling refreshed after waking (32%), happiness (23%), good sleep quality (16%), being relaxed (13%), activity (9.0%), and coffee/caffeine (8.5%). Prof. Wöber stated that, similar to migraine triggers, migraine protectors are highly individual, and that behavioural factors are the most relevant protectors. Knowledge on these migraine ‘protectors’ may help patients adopt behavioural changes that may ultimately decrease migraine attack risk.

1. Wöber C, et al. Potential migraine “protectors”: factors associated with decreased attack risk in individuals. OPR-069, EAN 2021 Virtual Congress, 19–22 June.

 

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Posted on 18 August 202118 August 2021