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Prospective Cohort Study of Caffeinated Beverage Intake as a Potential Trigger of Headaches among Migraineurs

  • Elizabeth Mostofsky
    Correspondence
    Reprint Address: Elizabeth Mostofsky, ScD, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Kresge Building, Room 505-B, 677 Huntington Ave., Boston, MA 02115.
    Affiliations
    Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, Mass

    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass
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  • Murray A. Mittleman
    Affiliations
    Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, Mass

    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass

    Harvard Medical School, Boston, Mass
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  • Catherine Buettner
    Affiliations
    Harvard Medical School, Boston, Mass

    Department of Medicine, Mount Auburn Hospital, Cambridge, Mass
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  • Wenyuan Li
    Affiliations
    Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, Mass

    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass
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  • Suzanne M. Bertisch
    Affiliations
    Harvard Medical School, Boston, Mass

    Department of Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, Mass

    Sleep Medicine Epidemiology Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Mass
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      Abstract

      Purpose

      We aimed to evaluate the role of caffeinated beverage intake as a potential trigger of migraine headaches on that day or on the following day.

      Methods

      In this prospective cohort study, 101 adults with episodic migraine completed electronic diaries every morning and evening. Ninety-eight participants completed at least 6 weeks of diaries in March 2016-October 2017. Every day, participants reported caffeinated beverage intake, other lifestyle factors, and the timing and characteristics of each migraine headache. We compared a participant's incidence of migraines on days with caffeinated beverage intake to the incidence of migraines among the same individual on days with no intake, accounting for day of week. We used conditional logistic regression to estimate odds ratios (OR) and 95% confidence intervals.

      Results

      Among 98 participants (86 women, 12 men) with mean age 35.1 years, 83% white, and 10% Hispanic or Latino, the average age when headaches started was 16.3 years. In total, the participants reported 825 migraines during 4467 days of observation. There was a statistically significant nonlinear association between the number of caffeinated beverages and the odds of migraine headache occurrence on that day (P-quadratic trend = .024), though estimates for each level of intake were not statistically significant. The associations varied according to habitual intake and oral contraceptive use.

      Conclusions

      There was a nonlinear association between caffeinated beverage intake and the odds of migraine headache occurrence on that day. This suggests that high levels of caffeinated beverage intake may be a trigger of migraine headaches on that day.

      Keywords

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