Primary headache disorders susceptibility is associated with fasting-related headache: evidence from a multinational study across 14 countries.
Fasting-related headache has traditionally been attributed to dehydration, caffeine withdrawal, and sleep disruption, but pre-existing primary headache disorders may also play an important role in determining susceptibility.
To determine the prevalence, clinical characteristics, and predictors of headache during Ramadan fasting and to explore the relative contribution of pre-existing primary headache disorders and the lifestyle-related factors assessed in this study to headache occurrence during fasting.
In this multinational cross-sectional survey across 14 countries, adults (18-65 years) observing Ramadan fasting completed a 17-item questionnaire. Headache during Ramadan was the primary outcome. Classification and regression tree (CRT) modelling were used to identify predictors and characterize fasting related headache.
Headache attacks occurred mainly in the afternoon/pre-iftar period and improved after iftar in 54.6% of cases. Pre-existing primary headache disorders, particularly migraine, were more strongly associated with headache occurrence within the exploratory CRT model than the lifestyle variables assessed in this study.
Fasting-related headache is highly prevalent and is influenced by both lifestyle-related factors and underlying headache susceptibility. A history of primary headache disorders was strongly associated with headache occurrence during Ramadan fasting, highlighting the importance of considering individual headache history alongside fasting- related exposures when assessing vulnerability.
To determine the prevalence, clinical characteristics, and predictors of headache during Ramadan fasting and to explore the relative contribution of pre-existing primary headache disorders and the lifestyle-related factors assessed in this study to headache occurrence during fasting.
In this multinational cross-sectional survey across 14 countries, adults (18-65 years) observing Ramadan fasting completed a 17-item questionnaire. Headache during Ramadan was the primary outcome. Classification and regression tree (CRT) modelling were used to identify predictors and characterize fasting related headache.
Headache attacks occurred mainly in the afternoon/pre-iftar period and improved after iftar in 54.6% of cases. Pre-existing primary headache disorders, particularly migraine, were more strongly associated with headache occurrence within the exploratory CRT model than the lifestyle variables assessed in this study.
Fasting-related headache is highly prevalent and is influenced by both lifestyle-related factors and underlying headache susceptibility. A history of primary headache disorders was strongly associated with headache occurrence during Ramadan fasting, highlighting the importance of considering individual headache history alongside fasting- related exposures when assessing vulnerability.
Authors
Ceren Akgor Ceren Akgor, Saghır Saghır, Can Can, Sahbaz Sahbaz, Özcelik Özcelik, Atalar Atalar, Ergin Ergin, Orun Orun, Madani Madani, Ibrahim Ibrahim, Togha Togha, Amirguliyev Amirguliyev, Alabwah Alabwah, Hashel Hashel, Dardar Dardar, Sahli Sahli, Sassi Sassi, Nada Nada, Shalaby Shalaby, Dehal Dehal, Naji Naji, Amine Amine, Alfred Alfred, Karacı Karacı, Yanık Yanık, Gürsoy Gürsoy, Celik Celik, Tasdelen Tasdelen, Ekizoğlu Ekizoğlu, Orhan Orhan, Agırcan Agırcan, Genc Genc, Gesoglu Demir Gesoglu Demir, Domac Domac, Köse Köse, Tepe Tepe, Öztürk Öztürk, Cengiz Cengiz, Erdogan Erdogan, Yıldırım Yıldırım, Hasırcı Bayır Hasırcı Bayır, Demirel Demirel, Ghouri Ghouri, Tasdelen Tasdelen, Bolay Bolay, Ozge Ozge, Kissani Kissani
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