Drinking 3 or More Caffeinated Beverages Linked to Higher Odds of Migraine, Study Says

There is widespread anecdotal belief that caffeine can cause migraines or ease them once they’ve begun, although there is little scientific evidence to back that up. A new study released Thursday says that it’s the quantity that matters—having 3 or more caffeinated drinks a day is linked to a headache that day or the next.

The study was published in The American Journal of Medicine. The authors said the results were consistent, even when including daily changes in alcohol intake, stress, sleep, physical activity, and menstruation, although the use of oral contraception did appear to create some variation.

In this prospective cohort study, 101 adults with episodic migraine completed electronic diaries twice a day (morning and evening). Ninety-eight participants (86 women, 12 men) completed at least 6 weeks of diaries in March 2016-October 2017. Participants reported daily caffeinated beverage intake, other lifestyle factors, and the timing and characteristics of each migraine headache. Researchers compared the incidence of migraines on days with caffeinated beverage intake with the incidence of migraines in the same individual on days with no intake, accounting for day of the week.

Particpants’ mean age was 35.1 years and most were white; on average, they began having headaches when they were about 16 years of age. A little more than a quarter (26.5%) reported that they use migraine prophylaxis medications. At baseline, 20% of the participants reported that they typically do not drink caffeinated beverages, 66% reported drinking 1 to 2 servings per day, and 12% reported having 3 to 4 servings per day. They reported consuming a mean (SD) of 7.9 (5.6) servings per week on a mean (SD) of 4.5 (2.1) days per week. In total, the participants reported 825 migraines during 4467 days of observation.

There was a statistically significant nonlinear association between the number of caffeinated beverages and the odds of migraine headache occurrence on that day (P-quadratic trend = .024), although estimates for each level of intake were not statistically significant. The associations varied according to habitual intake and oral contraceptive use.

This study is unique from previous ones looking at caffeine and migraine because most previous studies used animal models or the analyses were based on caffeine intake reported after the migraine occurred. In addition, the researchers said, studies that did prospectively collect information on caffeine data did not account for potential confounders, such as physical activity or hormonal changes.

There was some information that the researchers could not assess. They did not see if the association varied by type of caffeinated beverage. They did not look at skipping meals or amount of time looking at device screens; they also did not count other forms of caffeine, such as chocolate.

Additional research should examine the potential effect of caffeine on subsequent symptom onset in the subsequent hours and the intersection of sleep, caffeine, anxiety, environmental factors, and migraine, the researchers said.

Reference

Mostofsky E, Mittleman MA, Buettner C, et al. Prospective cohort study of caffeinated beverage intake as a potential trigger of headaches among migraineurs. Am J Med. 2019:132(8). doi: 10.1016/j.amjmed.2019.02.015.