Evidence map›Paper›PMID 40874381›Full record

ArticleHeadache2026

Waning light, waxing pain: The lunar cycle's association with migraine headache occurrence.

Alexander Yoo, Brendan Keenan, Angeliki Vgontzas, Murray A Mittleman, Suzanne M Bertisch, Ron Anafi

Abstract read
In one paragraph

Article in Headache, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Alexander YooDepartment of Medicine, Division of Sleep Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Brendan KeenanDepartment of Medicine, Division of Sleep Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Angeliki VgontzasDepartment of Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA.ORCID 0000-0002-5191-1475
Murray A MittlemanHarvard Medical School, Boston, Massachusetts, USA.
Suzanne M BertischHarvard Medical School, Boston, Massachusetts, USA.
Ron AnafiDepartment of Medicine, Division of Sleep Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.

Funding

The Harvard Clinical and Translational Science CenterUL1TR002541 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2018 to 2022
$93.0M
Training in Sleep & Sleep DisordersT32HL007953 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI David Menassah Raizen, AMY M SAWYER · 2000 to 2026
$10.6M
Circadian Organization and Disorder in Alzheimer's DiseaseR01AG068577 · NIA · UNIVERSITY OF PENNSYLVANIA · PI ANAFI, RON C. · 2020 to 2024
$2.0M
American Sleep Medicine FoundationHarvard CatalystHarvard UniversityNational Center for Advancing Translational Sciences, NIH UL 1TR002541National Institute of Neurologic Disorders and Stroke R21-NS091627NIA NIH HHS R01 AG068577NIH HHS T32HL007953The Harvard Clinical and Translational Science Center
6 · The paper itself

Abstract

objectiveTo examine circalunar rhythms in migraine headache occurrence in a prospective cohort of 98 adults with episodic migraine.

backgroundMigraine is a prevalent neurological disorder characterized by paroxysmal attacks. While time-of-day and seasonal rhythmicity in migraine occurrence have been described, little is known about circalunar patterns. Understanding these rhythms may inform headache prediction and guide personalized preventive medication timing.

methodsWe performed a secondary, post-hoc analysis using data from a prospective cohort study (March 2016-October 2017). Participants completed twice-daily electronic diaries, recording various characteristics including headache, and, when applicable, menstrual cycle timing. Participants wore wrist actigraphs for 6 weeks. We tested for a 30-day circalunar rhythm in headache risk at the population-level. We then examined for lunar synchronized rhythms in individuals, adjusting our analysis for participant-specific factors and differences in baseline headache risk. Sleep characteristics and menstrual timing were assessed as potential mediators of the relationship between lunar phase and headache occurrence.

resultsNinety-eight participants were followed for a median length of 43 days (interquartile range [IQR]: 42-45 days) with an average of 24.2% (standard deviation [SD] 13.2) of those days being headache days. Population-level analysis showed a significant relationship between lunar phase and headache risk (trough-to-peak odds ratio: 1.2 [95% confidence interval {CI}: 1.04, 1.49]). Individual-level analysis, adjusted for age, sex/menopausal status, and preventative medication use, showed 1.34 (95% CI: 1.1, 1.72) times higher headache odds at lunar cycle peak versus trough. Risk peaked 1-2 days before new moon. Neither sleep characteristics nor menstrual timing appeared to mediate the lunar phase-headache relationship.

conclusionsHeadache risk varied with the lunar cycle, with 34% higher odds shortly before new moon compared to before full moon. Sleep and menstrual cycle timing did not appear to explain this relationship, suggesting underlying chronobiological mechanisms. Additional studies are needed to confirm these findings and characterize individual variability in rhythmicity. PLAIN LANGUAGE SUMMARY:

Indexed as

Circadian RhythmMenstrual CycleMigraine DisordersMoonAdultFemaleHumansMaleMiddle AgedProspective Studiesbiological rhythmschronobiologycircalunar rhythmslunar rhythmsmigrainesleep

Identifiers

PMID40874381
PMCPMC12951705

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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.