Evidence map›Paper›PMID 31016722›Full record

Observational studyHeadache2019

High School Start Time and Migraine Frequency in High School Students.

Amy A Gelfand, Sara Pavitt, Kaitlin Greene, Christina L Szperka, Samantha Irwin, Barbara Grimes, Isabel E Allen

Open access · greenAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Headache, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.8field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 14 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Review
  6. Pediatric Migraine and Academics.Current pain and headache reports · 2020
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Amy A GelfandDepartment of Neurology, University of California, San Francisco, San Francisco, CA, USA.
Sara PavittDepartment of Neurology, Stanford University Hospital and Clinics, Palo Alto, CA, USA.ORCID 0000-0002-6822-3118
Kaitlin GreeneDepartment of Neurology, University of California, San Francisco, San Francisco, CA, USA.
Christina L SzperkaDivision of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Samantha IrwinDepartment of Neurology, University of California, San Francisco, San Francisco, CA, USA.ORCID 0000-0002-6564-7986
Barbara GrimesDepartment of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
Isabel E AllenDepartment of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
University of California, San Francisco · USChildren's Hospital of Philadelphia · USStanford Health Care · US

Funding

Occipital Nerve Blocks for Acute Treatment of Pediatric MigraineK23NS102521 · NINDS · CHILDREN'S HOSP OF PHILADELPHIA · PI SZPERKA, CHRISTINA LYNCH · 2018 to 2022
$940k
Global Healthy Living FoundationNIH HHS K23NS102521NINDS NIH HHS K23 NS102521
6 · The paper itself

Abstract

objectiveTo investigate whether later high school start time is associated with lower migraine frequency in high school students with migraine.

backgroundAdequate sleep is thought to be important in managing adolescent migraine. The American Academy of Sleep Medicine recommends teenagers sleep ≥8 hours/night. Adolescents have a physiologically delayed sleep phase, going to bed, and waking later than children and adults. The American Academy of Pediatrics (AAP) accordingly recommends high schools start no earlier than 8:30 AM.

methodsCross-sectional observational study of U.S. high schoolers with migraine. Participants were recruited nationally using social media. Respondents attending high schools starting at 8:30 AM or later were compared to those attending earlier start time schools. The primary outcome was headache days/month.

resultsTwo hundred and fifty-six subjects constituted the analysis set: 115 later group vs 141 earlier group. Age and sex did not differ. Mean (SD) self-reported headache days/month were 7 (5) vs 8 (7), respectively, (P = .985); mean difference (95% CI for the difference) was -0.8 (-2.3-0.7) days. Median (IQR) self-reported total hours of sleep/school night were: 5.6 (5.0-6.6) vs 5.6 (4.5-6.4), P = .058. Students attending later start time schools woke later (median [IQR] 6:38 AM [55 minutes] vs 6:09 AM [59 minutes], P < .0001) and left home later (median [IQR] 7:28 AM [28 minutes] vs 7:02 AM [60 minutes], P < .0001). Average commute time was also longer: 41 (21) minutes vs 28 (16), P < .0001. The vast majority in both groups reported missing breakfast at least once/week: 103/114 (90.4%) vs 128/141 (90.8%), P = .907. Hours of sleep did not correlate with headache days per month.

conclusionHigh school start time does not have a large effect on headache frequency in high schoolers with migraine. Given the high variance in headache days/month observed in this study, a larger study would be needed to determine whether there might still be a small effect of starting high school at/after 8:30 AM. More research is needed to establish evidence-based recommendations about lifestyle factors in adolescent migraine management.

Indexed as

SchoolsStudentsAdolescentCross-Sectional StudiesFemaleHumansMaleMigraine DisordersSleepTime FactorsUnited StatesWakefulnessadolescentmigrainesleep

Identifiers

PMID31016722
PMCPMC6625845
OpenAlexW2941343584

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.