Reduction in perceived stress as a migrain

Richard B. Lipton, Dawn C. Buse, Charles B. Hall, Howard Tennen, Tiffani A. DeFreitas, Thomas M. Borkowski, Brian M. Grosberg, Sheryl R. Haut

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Objective: To test whether level of perceived stress and reductions in levels of perceived stress (i.e., "let-down") are associated with the onset of migraine attacks in persons with migraine. Methods: Patients with migraine from a tertiary headache center were invited to participate in a 3-month electronic diary study. Participants entered data daily regarding migraine attack experience, subjective stress ratings, and other data. Stress was assessed using 2 measures: the Perceived Stress Scale and the Self-Reported Stress Scale. Logit-normal, random-effects models were used to estimate the odds ratio for migraine occurrence as a function of level of stress over several time frames. Results: Of 22 enrolled participants, 17 (median age 43.8 years) completed >30 days of diaries, yielding 2,011 diary entries including 110 eligible migraine attacks (median = attacks per person). Level of stress was not generally associated with migraine occurrence. However, decline in stress from one evening diary to the next was associated with increased migraine onset over the subsequent 6, 12, and 18 hours, with odds ratios ranging from 1.5 to 1.9 (all p values < 0.05) for the Perceived Stress Scale. Decline in stress was associated with migraine onset after controlling for level of stress for all time points. Findings were similar using the Self-Reported Stress Scale. Conclusions: Reduction in stress from one day to the next is associated with migraine onset the next day. Decline in stress may be a marker for an impending migraine attack and may create opportunities for preemptive pharmacologic or behavioral interventions.

Original languageEnglish (US)
Pages (from-to)1395-1401
Number of pages7
JournalNeurology
Volume82
Issue number16
DOIs
StatePublished - Apr 22 2014

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Migraine Disorders
Odds Ratio
Headache

ASJC Scopus subject areas

  • Clinical Neurology
  • Arts and Humanities (miscellaneous)

Cite this

Lipton, R. B., Buse, D. C., Hall, C. B., Tennen, H., DeFreitas, T. A., Borkowski, T. M., ... Haut, S. R. (2014). Reduction in perceived stress as a migrain. Neurology, 82(16), 1395-1401. https://doi.org/10.1212/WNL.0000000000000332

Reduction in perceived stress as a migrain. / Lipton, Richard B.; Buse, Dawn C.; Hall, Charles B.; Tennen, Howard; DeFreitas, Tiffani A.; Borkowski, Thomas M.; Grosberg, Brian M.; Haut, Sheryl R.

In: Neurology, Vol. 82, No. 16, 22.04.2014, p. 1395-1401.

Research output: Contribution to journalArticle

Lipton, RB, Buse, DC, Hall, CB, Tennen, H, DeFreitas, TA, Borkowski, TM, Grosberg, BM & Haut, SR 2014, 'Reduction in perceived stress as a migrain', Neurology, vol. 82, no. 16, pp. 1395-1401. https://doi.org/10.1212/WNL.0000000000000332
Lipton RB, Buse DC, Hall CB, Tennen H, DeFreitas TA, Borkowski TM et al. Reduction in perceived stress as a migrain. Neurology. 2014 Apr 22;82(16):1395-1401. https://doi.org/10.1212/WNL.0000000000000332
Lipton, Richard B. ; Buse, Dawn C. ; Hall, Charles B. ; Tennen, Howard ; DeFreitas, Tiffani A. ; Borkowski, Thomas M. ; Grosberg, Brian M. ; Haut, Sheryl R. / Reduction in perceived stress as a migrain. In: Neurology. 2014 ; Vol. 82, No. 16. pp. 1395-1401.
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