Background

Fasting is known as a trigger for migraines. Muslims fast 1 month every luminal year. We aimed to study the impact of The Holy month of Ramadan on migraine headaches.

Methods

This retrospective study included patients diagnosed with migraines according to The International Classification of Headache Disorders, 3rd edition (ICDH-3). Both genders, aged between 18 and 65 years were included. The impact of Ramadan fasting and changing habits during the month of Ramadan was studied. The frequency and the severity of migraine attacks, and the number of analgesic days during Ramadan were compared to those during Shaban, the immediately preceding month to Ramadan. The number of breaking fasting due to migraines was reported.

Results

This study identified 293 with migraine with mean age and mean disease duration 37.09 ± 9.36, 12.34 ± 9.27 years respectively. Most of them were females (89.1%). Most of our cohort had changed sleep and food habits during Ramadan (93.2%). The majority of them were dehydrated (89.8%). Most of the patients completed fasting the whole month of Ramadan. A minority (1.7) could not tolerate fasting the whole Ramadan due to intolerable migraine headaches and 36.5% broke their fasting for some days during Ramadan. Most of our cohort (82.3%) continue on the same management plan for migraines during Ramadan. During the month of Ramadan, the patients had a significant increase in migraine days of 10.42 ± 7.98 compared with 6.90 ± 6.55 migraine days during the previous month (p < 0.001). Also, days of analgesic use (11.32 ± 10.46 versus 6.11 ± 6.69; P < 0.001) and migraine severity (7.46 ± 2.39 versus 6.84 ± 2.25; P < 0.001) were significantly increased during Ramadan compared with Shaban. In multivariate analysis, change in sleep and feeding habits together with non-modification of the treatment plan before Ramadan significantly predict breaking fasting due to worsening of migraine headache (p value = 0.041, p value = 0.025; respectively). The majority of our cohort (75.4%) reported that migraines interfered with their daily activities due to fasting during Ramadan.

Conclusion

Change in sleep and food habits along with dehydration make Migraine frequency and severity worse during Ramadan fasting. Physicians should educate migraine patients who fast to manage their headaches and habits before starting fasting.

中文翻译：

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斋月禁食会使偏头痛恶化

背景

禁食被称为偏头痛的诱因。穆斯林每光年斋戒 1 个月。我们旨在研究斋月对偏头痛的影响。

方法

这项回顾性研究包括根据国际头痛疾病分类第 3 版 (ICDH-3) 诊断为偏头痛的患者。包括年龄在 18 至 65 岁之间的男女。研究了斋月期间斋月禁食和改变习惯的影响。将偏头痛发作的频率和严重程度以及斋月期间的镇痛天数与斋月前一个月的沙班期间进行了比较。报告了因偏头痛而断食的次数。

结果

这项研究确定了 293 名偏头痛患者，平均年龄和平均病程分别为 37.09 ± 9.36、12.34 ± 9.27 年。其中大多数是女性（89.1%）。我们的大多数队列在斋月期间改变了睡眠和饮食习惯（93.2%）。他们中的大多数脱水（89.8%）。大多数患者完成了整个斋月的禁食。少数人（1.7）由于无法忍受的偏头痛而无法忍受整个斋月的禁食，36.5% 的人在斋月期间断食了几天。我们的大多数队列（82.3%）在斋月期间继续采用相同的偏头痛管理计划。在斋月期间，患者的偏头痛天数显着增加，为 10.42 ± 7.98，而前一个月为 6.90 ± 6.55 (p < 0.001)。此外，镇痛药使用天数（11.32 ± 10.46 vs 6.11 ± 6.69；P < 0.001）和偏头痛严重程度（7.46 ± 2.39 对 6.84 ± 2.25；P < 0.001）在斋月期间与沙班相比显着增加。在多变量分析中，睡眠和饮食习惯的改变以及斋月前治疗计划的未修改可显着预测由于偏头痛恶化而导致的断食（p 值 = 0.041，p 值 = 0.025；分别）。我们队列中的大多数人（75.4%）报告说，由于斋月期间的禁食，偏头痛干扰了他们的日常活动。睡眠和饮食习惯的改变以及斋月前治疗计划的未修改显着预测由于偏头痛恶化而导致的断食（p 值 = 0.041，p 值 = 0.025；分别）。我们队列中的大多数人（75.4%）报告说，由于斋月期间的禁食，偏头痛干扰了他们的日常活动。睡眠和饮食习惯的改变以及斋月前治疗计划的未修改显着预测由于偏头痛恶化而导致的断食（p 值 = 0.041，p 值 = 0.025；分别）。我们队列中的大多数人（75.4%）报告说，由于斋月期间的禁食，偏头痛干扰了他们的日常活动。

结论

睡眠和饮食习惯的改变以及脱水使偏头痛的频率和严重程度在斋月禁食期间变得更糟。在开始禁食之前，医生应该教育禁食的偏头痛患者控制他们的头痛和习惯。