ArticleThe journal of headache and pain2026
Epidemiology of primary headache and lifestyle factors among children and adolescents: a regional school-based study in China.
Article in The journal of headache and pain, 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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Abstract
backgroundLimited epidemiological data exist on pediatric headache disorders and their association with lifestyle factors in China. This study estimated the prevalence of primary headaches and examined lifestyle patterns including screen time (ST), physical activity (PA), and sleep duration that are associated with headache presence among children and adolescents in a Chinese city.
methodsA cross-sectional survey was conducted using stratified multistage cluster sampling across four educational stages (primary, junior high, senior high, and vocational high school) in a city within the Anhui Western Region, China. Self-completed structured questionnaires were administered within classes to assess headache characteristics, ST, PA, and sleep duration. Univariate and multivariable logistic regression were used to identify risk factors.
resultsAmong 1200 potential participants, 1,128 responded (94%); exclusions left 1,025 for analysis. The 1-year headache prevalence was 47.3%, increasing from 31.4% in primary to 67.2% in senior high school. The prevalences of migraine, tension-type headache (TTH), undifferentiated headache (UdH), and probable medication-overuse headache were 8.7%, 14.6%, 21.9%, and 0.3%, respectively. Only 8.0% sought medical consultation. Past-week measures showed 51.2% reported ST ≥2 h/day, the median day of moderate-to-vigorous intensity physical activity (MVPA) and vigorous intensity physical activity (VPA) was 1 h (Interquartile Range [IQR] 0, 3), the median school-night sleep was 8 h (IQR 7, 9), and weekend sleep was 9 h (IQR 8, 10). ST ≥2 h/day increased overall headache risk by 42% (Odds Ratio [OR] = 1.422) and migraine risk by 102% (OR = 2.017). Each additional day of MVPA reduced headache risk by 14% (OR = 0.864). Longer weekend sleep duration decreased headache (OR = 0.842) and migraine (OR = 0.787) risks, while longer school-night sleep reduced TTH risk (OR = 0.802). Female and senior high school attendance were also significant risk factors for headache.
conclusionsHeadache disorders are highly prevalent yet underdiagnosed in this sample, particularly among senior high school students. Affected individuals show higher ST, lower PA, and shorter sleep duration than headache-free peers. These findings provide region-specific epidemiological data that warrant confirmation in national studies. Future research should employ longitudinal designs to establish causality and evaluate interventions.
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