A Large Proportion of Medical Students Experience Migraines, Choose to Self-Manage Symptoms

A high proportion of medical students may suffer from headaches, and more than half may have migraines, according to a new study published in PubMed Central. Though these migraine headaches were associated with significant functional disability among medical students in Malaysia, few students sought medical consultation, instead choosing to self-manage their headaches.

Medical students are viewed as being susceptible to stress due to their learning environment.

“As part of their training, their hectic schedules may result in a lifestyle that predisposes them to migraine headaches, such as excessive caffeine intake, missing meals, lack of sleep, and high psychological stress,” the authors wrote. “This environment results in significant disability and affects their academic performance and clinical training as future healthcare professionals.”

Researchers aimed to determine the frequency of migraines among medical students, the association between migraines, stress level, and functional disability among these students, and describe their self-management practices.

They conducted a cross-sectional study among medical students in a private medical school in Penang state, Malaysia, from June 2013 to November 2014.

All medical students in the study site were screened for the presence of headache symptoms and the diagnosis of migraine using a self-administered questionnaire comprising International Headache Society (IHS) criteria. They also assessed perceived stress level and functional disability using the Perceived Stress Scale ad the Headache Impact Test-6 (HIT-6). A descriptive survey was used to determine self-management practices.

Of the 374 medical students who participated in the study, 157 (42%) reported experiencing headaches.

More than half of those with headaches, 61.8%, fulfilled the IHS criteria for migraines. The frequency of migraines among all medical students who were screened was 27.5%, comparable to previous studies.

Migraines were found to be significantly associated with functional disability compared with non-migraine headaches (P < .001). However, no significant difference in stress levels were reported between the groups. This finding indicates that students suffering from migraines and non-migraine headaches were exposed to similar levels of stress, according to the study authors.

The most common self-management practices during migraine attacks were sleep (60.33%) and self-medication (69.14%). Lack of sleep was reported as the most common trigger for migraine among medical students. Other strategies included controlling the noise in the environment, turning off electronic devices, and resting in a dark room.

Though both students experiencing migraine and non-migraine headaches preferred sleep as the method of self-management, significantly fewer students with non-migraine headaches chose to take painkillers. Researchers determined that only 11.46% of the 157 students with headaches consulted a physician.

These findings suggest that a high proportion of medical students suffer from headaches and migraines, experiencing significant functional disability that previous research indicates can impact quality of life, performance, and absenteeism.

The researchers recommend further study of the severity of migraines including confirmed diagnosis from a clinician to better understand the magnitude of this problem among medical students. They also suggest conducting a similar study among medical doctors and studies identifying different subgroups of migraines and primary causes.

They acknowledge some limitations of their study. The cross-sectional design does not determine causality. Additionally, the population was limited to students at Penang state, meaning the results may not be generalizable to other medical students.

They did not assess the severity of migraines. Due to limited resources, the study did not explore the self-management practices that would influence the impact of migraines on the students, such as sleep quality, sleep pattern, and types of medication. They encourage future studies to explore these impacts.

Reference

Thiagarajan A, Aziz N A, Tan CE, Muhammad N A. The profile of headaches and migraine amongst medical students and its association to stress level, disability and self-management practices. Malays Fam Physician. 2022;17(2):81–88. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9357411/. Published July 24, 2022. Accessed August 16, 2022.