Study Finds Low Exercise Rates Among Migraineurs Despite Associated Benefits

More than two-thirds of individuals suffering from migraine do not get enough exercise, according to preliminary study findings. However, migraineurs who complete a minimum 2.5 hours of moderate to vigorous exercise a week exhibited reduced rates of migraine triggers including stress, depression, and sleep problems.

The abstract will be presented at the American Academy of Neurology’s 73rd Annual Meeting, being held virtually between April 17-22, 2021.

Previous research has shown exercise is associated with a decreased number of migraine days and that it may constitute an effective prophylaxis in some patients.

Researchers conducted a questionnaire-based study in order to quantify the number of patients referred to an individual headache clinic who achieved the minimum recommended amount of exercise per week, evaluate if low levels of exercise were associated with an increased risk of chronification, and assess exercise in migraineurs as it relates to other common comorbidities.

Each patient who presented to the large tertiary headache center at the University of Washington completed the questionnaire, which included questions regarding amount of exercise per week, headache characteristics, sleep, depression, anxiety, and stress.

A total of 4897 individuals were diagnosed with migraine based on International Classification of Headache Disorders (ICHD-3) criteria. Approximately 75% (n = 3644) presented with chronic migraine while 25.3% (n = 1235) had episodic migraine. Of those diagnosed, 95% (n = 4647) of patients completed the exercise-related questions.

Participants were divided into 5 groups based on their level of moderate to vigorous exercise (defined as jogging, very brisk walking, playing a sport, heavy cleaning, and bicycling): 0 to 30 minutes per week, 1 to 30 minutes, 31 to 90 minutes, 91 to 150 minutes, and more than 150 minutes.

Analyses revealed:

• 27% (n = 1270) of those who exercised reported achieving 150+ minutes of moderate to vigorous exercise weekly, the minimum level recommended by the World Health Organization (WHO)
• Depression was reported by 47% of people in the group that did not exercise (377 of 806), compared with 25% of people in the group that exercised the most (318 of 1270)
• Anxiety was reported by 39% of those in the no exercise group compared with 28% of those in the high exercise group
• Sleep problems were reported by 77% of people in the no exercise group compared with 61% in the high exercise group
• Of those in the no exercise group, 5% had low headache frequency (defined as 0 to 4 headache days per month) and 48% had high headache frequency (defined as having 25 or more headache days per month)
• Of the migraineurs in the high exercise group, 10% had low headache frequency and 28% had high headache frequency

Overall, migraineurs who exercised below the recommended WHO level per week exhibited increased rates of depression, anxiety, and sleep problems.

“Migraine is a disabling condition that affects millions of people in the United States, and yet regular exercise may be an effective way to reduce the frequency and intensity of some migraines," said study author Mason Dyess, DO. "Exercise releases natural pain killers called endorphins, helps people sleep better and reduces stress. But if people with migraine are not exercising, they may not be reaping these benefits."

Participants’ own recording of weekly exercise minutes, as opposed to activity being monitored by a device, marks a limitation to the study, while the investigation’s nature precludes any cause-and-effect conclusions from being drawn.

“We recommend raising awareness that exercise can have a significant impact on the headache itself, and on associated migraine comorbidities. Counseling patients with migraine on recommended exercise levels should be considered by any medical provider,” authors concluded.

Reference

Dyess M, Cuneo A, Narula A, et al. Exercised brain in pain: quantification of exercise in migraine patients seen at a large tertiary headache center. Abstract presented at American Academy of Neurology 73rd Annual Meeting; April 17-22, 2021; Virtual. Accessed February 23, 2021.