From the Guidelines
Headache risk factors include headache frequency, migraine diagnosis, medication use, history of anxiety or depression, physical inactivity, sick leave, self-reported whiplash, and smoking, as identified by the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline for the management of headache 1.
Key Risk Factors
The following are key risk factors for headaches:
- Headache frequency (≥7 d/mo)
- Migraine diagnosis
- Medication use: frequent use of anxiolytics, analgesics, or sedative hypnotics
- History of anxiety or depression, especially in combination with musculoskeletal or gastrointestinal symptoms
- Physical inactivity
- Sick leave of >2 wk in the past year
- Self-reported whiplash
- Smoking (tobacco use) These risk factors are supported by the guideline's recommendations, which suggest that providers assess for and consider these high-risk factors for medication overuse headache in patients with headache 1.
Additional Considerations
Other factors that may contribute to headaches include:
- Genetic predisposition, especially for migraines
- Medical conditions such as high blood pressure, infections, and head trauma
- Environmental factors like strong smells, bright lights, and loud noises
- Certain medications, including some blood pressure drugs and oral contraceptives
- Lifestyle factors like stress, lack of sleep, dehydration, alcohol consumption, and caffeine withdrawal Identifying personal triggers through a headache diary and making lifestyle modifications like regular sleep schedules, stress management techniques, proper hydration, and regular meals can help manage headaches effectively 1.
From the Research
Risk Factors for Headaches
- Sleep-related variables have been identified as risk factors for frequent and severe headache conditions 2
- Medication overuse is a common risk factor for frequent headaches, which can induce central sensitization and transformation to chronic headaches 3
- Other risk factors include stress, obesity, psychiatric disorders, and certain dietary factors 2, 4
Modifiable Risk Factors
- Sleep disorders, such as sleep-disordered breathing, insomnia, and circadian rhythm disorders, can be modified to prevent headache progression or chronification 2
- Identifying and managing environmental, dietary, and behavioral triggers can help prevent migraines 5, 4
- Addressing common comorbid conditions, such as depression, anxiety, substance abuse, and chronic musculoskeletal pain syndromes, can also improve treatment effectiveness 3