Triggers of migraine and tension‐type headache in China: a clinic‐based survey

Background and purpose Identification of the trigger factors of headache could be an important aspect of preventive management, but the characteristics of primary headache triggers in C hina are unknown. This study was performed to estimate the frequencies of the putative headache triggers, which are endorsed by patients with migraine and tension‐type headache (TTH). Methods From J uly 2011 to D ecember 2011, a cross‐sectional survey was conducted in the neurological clinic of a tertiary care hospital in C hongqing. All consecutive patients with the chief complaint of headache were interviewed by a board‐certified headache specialist. The diagnoses were made according to International C lassification of H eadache D isorders – 2nd edition. Patients with migraine and TTH were recruited. Results The number of investigated patients was 1219, of whom 394 were migraine and 344 were TTH ; and 80.2% migraineurs and 67.4% TTH patients reported trigger factors. The most common triggers for both migraine and TTH were sleep disturbance, negative affect and sunlight. Menstrual cycle ( OR 3.6, 95% CI 1.2, 11.2), change of the weather ( OR 3.1, 95% CI 1.9, 4.8), noise ( OR 2.2, 95% CI 1.1, 4.4) and alcohol ( OR 1.8, 95% CI 0.7, 1.8) were more associated with migraineurs. Negative affect was more associated with TTH ( OR 2.0, 95% CI 1.3, 2.9). Conclusions Trigger factors were frequent among both migraine and TTH patients. Avoidance of all headache triggers is impractical. Learning to cope with triggers is important to headache prevention.