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Later school start time linked to fewer migraines in adolescents


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Journal
Headache: The Journal of Head and Face Pain
Reuters Health - 07/12/2020 - Adolescents whose high schools start after 8:30 a.m. may have fewer migraines than their counterparts who have to get to school earlier, a U.S. study suggests.

Researchers examined survey data from 1,012 adolescents with migraine. Half of them started school at 8:30 a.m. or later, and the other half started earlier in the morning.

In adjusted analysis, after accounting for total hours of sleep, sex, migraine medication, breakfast habits, grade level, and homework time, teens with a late start had fewer migraine days (mean 5.8) per month than those with earlier starts (mean 7.1).

"I think that part of the association is likely due to greater total sleep duration, however, the association remained even after adjusting for total sleep duration," said lead study author Dr. Amy Gelfand, an associate professor of neurology at the University of California San Francisco and director of Child and Adolescent Headache at UCSF Benioff Children's Hospitals.

"Letting teenagers sleep-in allows them to have a more physiologic, developmentally appropriate sleep schedule, which is healthier for their brains," Dr. Gelfand said by email.

The American Academy of Sleep Medicine recommends 8 to 10 hours of sleep a night for adolescents, the researchers note in Headache: The Journal of Head and Face Pain.

Due to adolescents' delayed circadian clock, the American Academy of Pediatrics recommends that middle schools and high schools start no earlier than 8:30 a.m. to help teens get the minimum amount of sleep they need for optimal development.

For the study, researchers recruited high school students via social media, giving them $10 gift card to complete an online survey.

The study found, overall, that teens with migraines whose schools started before 8:30 a.m. experienced an average 7.7 self-reported headache days per month, as compared with a mean of 4.8 per month among teens with later start times.

Teens in the study had a mean commute time of 24 minutes to get to school.

The earlier-start group had a mean wake-up time of 6:25 a.m. and a mean school start time of 7:56 a.m., compared with a mean wake-up time of 7:11 a.m. and mean start time of 8:43 a.m. in the group with later school start times.

Teens with later school start times also went to bed earlier, with a mean bedtime of 10:19 p.m. compared with 10:58 p.m. for those with early school start times.

Several authors of the study reported receiving consulting fees, grant funding, or other financial support from drug companies that make treatments for migraines.

One limitation of the study, the authors acknowledge, is that all data was self-reported. Migraine diagnosis wasn't verified by medical records or exams, and sleep patterns were not verified by actigraphs or other objective measures.

"The mechanism by which sleep deficiency increases headache frequency remains unknown, and this study did not collect data on sleep quality," said Matthew Weaver, an epidemiologist at Brigham and Women's Hospital Harvard Medical School in Boston who wasn't involved in the study.

"It's likely that these factors are both meaningful, and interact in their influence on health and well-being," Weaver said by email.

SOURCE: https://bit.ly/37FAZDi Headache: The Journal of Head and Face Pain, online November 25, 2020.

By Lisa Rapaport



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