Screen time and pediatric headache: A scoping review of the literature

Abstract Objective The aim of this study was to summarize the evidence regarding screen use as a contributing factor in pediatric headache and migraine. Background Screen exposure is often reported as a headache trigger, though there is no current consensus in terms of how screen type, duration, or frequency influences pediatric headache and the associated burden of disease. Methods A systematic search in PubMed, Scopus, Cochrane Library, ProQuest Health and Medical Database, and Google Scholar was performed through November 2022 in accordance with Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement. All English‐language articles of pediatric patients aged ≤18 years evaluating screen use in relation to headache were included. Results A total of 48 studies were included. Nearly all studies were cross‐sectional and represented international samples. The strongest association between screen use and headache found was for duration of use, and computer use emerged as the most common device type related to headache. While there were mixed findings related to screen use and specific headache diagnosis, migraine appeared to confer a higher risk. Across studies, there were insufficient data to assess the impact of screen use on headache frequency or headache‐related disability. Several studies demonstrated changes in screen use and headache patterns related to the COVID‐19 pandemic and computer vision syndrome was commonly reported. Conclusions While there is preliminary evidence supporting possible associations between screen use and pediatric headache, there are several limitations in the present review including a lack of prospective and randomized controlled trials to better demonstrate causal relationships as well as methodological limitations with significant variability in how both headache and screen use are defined and measured. Future studies including real‐time screen use and device monitoring are needed to better understand the influence of screen use behaviors on pediatric headache and to help further define best‐use guidelines around these technologies.