Evidence map›Paper›PMID 33237581›Full record

ArticleHeadache2021

Later high school start time is associated with lower migraine frequency in adolescents.

Amy A Gelfand, Sara Pavitt, Alexandra C Ross, Christina L Szperka, Samantha L Irwin, Suzanne Bertisch, Katie L Stone, Remi Frazier, Barbara Grimes, I Elaine Allen

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PubMed Full text at PMC Publisher
In one paragraph

Article in Headache, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Headache in Children and Adolescents.Continuum (Minneapolis, Minn.) · 2021
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Amy A GelfandChild & Adolescent Headache Program, University of California, San Francisco, San Francisco, CA, USA.
Sara PavittChild & Adolescent Headache Program, University of California, San Francisco, San Francisco, CA, USA.ORCID 0000-0002-6822-3118
Alexandra C RossChild & Adolescent Headache Program, University of California, San Francisco, San Francisco, CA, USA.
Christina L SzperkaDivision of Neurology, Children's Hospital of Philadelphia & Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Samantha L IrwinChild & Adolescent Headache Program, University of California, San Francisco, San Francisco, CA, USA.ORCID 0000-0002-6564-7986
Suzanne BertischDivision of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Katie L StoneDepartment of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
Remi FrazierAcademic Research Systems, University of California, San Francisco, San Francisco, CA, USA.
Barbara GrimesDepartment of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
I Elaine AllenDepartment of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA.

Funding

Occipital Nerve Blocks for Acute Treatment of Pediatric MigraineK23NS102521 · NINDS · CHILDREN'S HOSP OF PHILADELPHIA · PI SZPERKA, CHRISTINA LYNCH · 2018 to 2022
$940k
NINDS NIH HHS K23 NS102521UCSF Resource Allocation Program
6 · The paper itself

Abstract

objectiveTo determine whether high school start time is associated with headache frequency in adolescents with migraine.

backgroundAdolescence is marked by a physiologic delayed circadian phase, characterized by later bedtimes and wake times. The American Academy of Pediatrics (AAP) recommends that high schools start no earlier than 8:30 a.m., but most high schools in the United States start earlier. The study hypothesis was that adolescents with migraine whose high schools start at 8:30 a.m. or later (late group) would have lower headache frequency than those whose schools start earlier than 8:30 a.m. (early group).

methodsThis was a cross-sectional Internet survey study of US high schoolers with migraine recruited online through social media. Comparisons were made between the late group and the early group. The primary outcome measure was self-reported headache days/month.

resultsIn total, 1012 respondents constituted the analytic set: n = 503 in the late group versus n = 509 in the early group. Mean (SD) self-reported headache days/month was 4.8 (4.6) versus 7.7 (6.1) in the late and early groups, respectively (p < 0.001); mean difference -2.9 (95% CI -2.2 to -3.6). Mean (SD) self-reported hours of sleep on a school night was 7.9 (0.9) versus 6.9 (1.3), p < 0.001. Adjusting for total hours of sleep, sex, taking a migraine preventive, days of acute medication use, hours of homework, grade level, and missing breakfast, mean (SD) self-reported headache days/month remained lower in the late group than in the early group: 5.8 (95% CI 5.3-6.2) versus 7.1 (95% CI 6.7-7.4), (p < 0.001); mean difference -1.3 (95% CI -1.9 to -0.7).

conclusionAdolescents with migraine who attend high schools that follow AAP recommendations for start times have lower self-reported headache frequency than those whose high schools start before 8:30 a.m. If prospective studies confirm this finding, shifting to a later high school start time may be an effective strategy for migraine prevention in adolescents.

Indexed as

AdolescentAdultCross-Sectional StudiesFemaleHealth SurveysHumansMaleMigraine DisordersSchoolsSelf ReportStudentsTime FactorsUnited StatesYoung Adultadolescentmigrainesleep

Identifiers

PMID33237581
PMCPMC8074009

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.