Perceived Stress Linked to Higher Frequency of Migraine, Study Says

According to the study, the perceived stress level of people with a greater number of migraines was higher than those with fewer migraines per month.

Higher perceived stress was associated with higher migraine frequency, but not chronic migraine, a new study found.

Migraines effect more than 1 billion people worldwide. According to the World Health Organization, headache disorders are in the top 10 most common disabling conditions in both sexes and in the top 5 for women. Headaches affect 60% of children and adolescents worldwide. This can affect school, physical activities, and relationships. Migraine frequency may be triggered by hormone variance, changes in weather, meals, caffeine intake, medication, sleep and stressful events, among others.

The study was conducted by analyzing 557 outpatients at a hospital in Taiwan. The sample was made up of men and women both with and without auras. Out of the 557, 100 experienced chronic migraines (more than 15 per month), 97 had between 9 to 14 per month (high), 93 had between 5 to 8 per month (medium), and 174 had 1 to 4 per month (low).

Additionally, 93 volunteers without migraines and no family history of migraines volunteered. Each participant completed a screening questionnaire and were interviewed by a board-certified neurologist and headache specialist in order to confirm the migraine diagnosis and rule out emotional headaches.

Perceived stress was significantly higher in high frequency migraineurs (mean ± standard deviation (SD), 23.3 ± 8.7) than in low frequency migraineurs (mean ± SD, 21.9 ± 9.2; P < .05). By sex, the result was observed in men, but was insignificant in women. In addition, migraines with or without auras had no effect on the association between migraine frequency and perceived stress.

“The biological response to stress is associated with activity of the hypothalamic-pituitary-adrenal (HPA) axis, which is regulated by the release of hypothalamic corticotropin releasing factor (CRF),” investigators write. “Dysregulation of CRF, which is regarded as a stress neuropeptide, is thought to contribute to the pathophysiology of stress related disorders.”

Investigators write that there have been several other studies that document the relationship between sex and stress response. Women report having a higher stress sensitivity than men. Furthermore, women are also at an increased risk of depression and anxiety disorders. Generally, women have a higher frequency of migraine in every category than men besides for high frequency. Investigators also believe their research that women have a poor response to stress and more psychiatric and psychosomatic problems. This may have increased the association between migraine and perceived stress in women.

“Adaptation to migraine and psychiatric comorbidities may contribute to the association between migraine frequency and perceived stress level,” study authors wrote.


An YC, Liang CS, Lee JT, et al. Effect of sex and adaptation on migraine frequency and perceived stress: A cross-sectional case-control study [published online June 5, 2019]. Front. Neurol. doi: 10.3389/fneur.2019.00598.