While approximately 42% of medical students in the study experience headaches, many of which cause significant functional disability, most choose to manage the symptoms themselves with sleep and medication.
A large proportion of medical students may suffer from headaches, and more than half may have migraines, according to a new study published in PubMed Central. Although this migraine headache was associated with significant functional disability among medical students in Malaysia, few students sought medical advice, choosing instead to manage their headaches themselves.
Medical students are seen as sensitive to stress because of their learning environment.
“As part of their training, their hectic schedules can result in lifestyles that predispose 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 disabilities and affects their academic performance and clinical training as future healthcare professionals.”
Researchers wanted to determine the frequency of migraines among medical students, the association between migraines, stress level and functional impairment in these students, and describe their self-management practices.
They conducted a cross-sectional survey of medical students in a private medical school in Penang State, Malaysia from June 2013 to November 2014.
All medical students at the study site were screened for the presence of headache symptoms and diagnosis of migraine using a self-administered questionnaire with criteria from the International Headache Society (IHS). They also assessed perceived stress level and functional disability using the Perceived Stress Scale and the Headache Impact Test-6 (HIT-6). A descriptive survey was used to establish 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%, met the IHS criteria for migraines. The frequency of migraines among all medical students screened was 27.5%, comparable to previous studies.
Migraine was found to be significantly associated with functional impairment compared to non-migraine headache (p < .001). However, no significant differences in stress levels between the groups were reported. This finding indicates that students who suffered 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 migraine trigger among medical students. Other strategies included controlling the noise in the environment, turning off electronic devices, and resting in a darkroom.
Although both students with migraine and non-migraine headaches preferred sleep as the method of self-management, significantly fewer students with non-migraine headaches chose to take pain medications. Researchers found that only 11.46% of 157 college students with headaches consulted a doctor.
These findings suggest that a high proportion of medical students suffer from headaches and migraines and experience significant functional disability that previous research indicates may affect quality of life, performance and absenteeism.
The researchers recommend further research into the severity of migraines, including a confirmed diagnosis by a clinician, to better understand the magnitude of this problem among medical students. They also propose to conduct a similar survey among physicians and studies identifying different migraine subgroups and primary causes.
They acknowledge some limitations of their study. The cross-sectional design does not determine causality. In addition, the population was limited to students in Penang state, meaning the results may not be generalizable to other medical students.
They did not assess the severity of migraines. Due to resource constraints, the study did not examine the self-management practices that would affect the impact of migraines on students, such as sleep quality, sleep patterns, and types of medication. They encourage future studies to investigate these effects.
Thiagarajan A, Aziz NA, Tan CE, Muhammad NA. The profile of headaches and migraines among medical students and its association with stress levels, disabilities and self-management practices. Malay Family Arts. 2022;17(2):81–88. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9357411/. Published July 24, 2022. Accessed August 16, 2022.