Migraines More Debilitating with Allergies

A new study finds that headache symptoms may be worse in patients with migraines who also suffer from allergies and hay fever. Researchers found the likelihood of experiencing more frequent headaches was 33% greater in patients with rhinitis (including allergies and hay fever) and migraine, compared to those with migraines only.

“People with both migraine and rhinitis had more impairment in all areas of their lives, including work, school, social activities, and family responsibilities,” says study co-author Dawn C. Buse, PhD, Associate Professor at Albert Einstein College of Medicine and Director of Behavioral Medicine at the Montefiore Headache Center in Bronx, NY.

“An attack of either of these conditions can be debilitating on its own—combined, they are even more impairing.” Buse and colleagues analyzed data from the American Migraine Prevalence and Prevention (AMPP) Study. Nearly 6,000 participants from across the country who have experienced migraines filled out the 2008 questionnaire. Rhinitis occurred in 2 out of 3 respondents with migraine. “We found that migraine and rhinitis were highly comorbid,” Buse says.

“In addition, people with migraine who also had rhinitis were more likely to have more frequent migraine attacks, including chronic migraine (or headache on 15 or more days per month) and more headache-related disability.”

The researchers also found that this pattern was more pronounced in a specific subset of participants with rhinitis who experienced both allergic and non-allergic triggers. This group was 45% more likely to experience more frequent headaches and 60% more likely to endure headaches more disabling than those without rhinitis.

In light of these results, treating rhinitis may play a key role in relieving headache in patients with both rhinitis and migraine.

“A health care professional should design an optimal treatment plan for each individual, depending upon the individual condition, symptoms, preferences, and prior experience,” Buse says. “This may include acute and preventive medications as well as behavioral interventions, such as relaxation exercises and trigger avoidance.”

The researchers are studying many comorbid conditions in patients with migraine, including cardiovascular, psychiatric, respiratory, and pain conditions.

They are currently examining rates of asthma and the effects among people with migraine, among other research questions. For more information about the AMPP Study, visit www.achenet.org/resources/ampp_study.

Common Headache or Chronic Migraine?
(Dawn C. Buse provides some great tips for migraine screening below)

If a patient reports frequent or debilitating headaches, it’s wise to screen for migraines to determine if there’s a bigger issue at hand. The three-item ID-Migraine Screener is a sensitive and quick screening approach, according to Buse.

Simply ask: During the last 3 months, did you have any of the following with your headaches?

• You felt nauseated or sick to your stomach when you had a headache.

• Light bothered you (a lot more than when you don’t have headaches).

• Your headaches limited your ability to work, study, or do what you needed to do for at least 1 day.

“An affirmative response on 2 of 3 questions yields a sensitivity of 81% and specificity of 75,”Buse says.

—Colleen Mullarkey

Reference

Martin VT, Fanning KM, Serrano D, Buse DC, Reed ML, Bernstein JA, Lipton RB. Chronic rhinitis and its association with headache frequency and disability in persons with migraine: Results of the American Migraine Prevalence and Prevention (AMPP) Study. Cephalalgia. 25 November 2013. [Online ahead of print]