Trigger of a migraine headache among Thai adolescents smartphone users: a time series study

Abstract

Trigger of a migraine headache among Thai adolescents smartphone users: a time series study Wanna Chongchitpaisan, Phongtape Wiwatanadate, Surat Tanprawate, Assawin Narkpongphan, Nipapon Siripon. Trigger of a migraine headache among Thai adolescents smartphone users: a time series study. Environ Anal Health Toxicol. 2021 Mar;36(1):e2021006-0. doi: 10.5620/eaht.2021006. Abstract The study aims to investigate the effect of modern technology in the trigger of migraine headaches in high school students by using generalized estimating equation analysis. The prospective time series study was conducted in one hundred and forty-five smartphones using high school students in Chiang Mai Province who each completed a headache diary giving a total of 12,969 data entries. The smartphone output power was measured and recorded by a smartphone application. Smartphone use, sleep quality, anxiety, and depression also were assessed. Results revealed that the prevalence of repeated headache be 13.4% and migraine 16.9%. The migraine had the strongest association with handfree device use and internet use, followed by age and anxiety. Furthermore, the strongest effect of smartphone output power in triggering a migraine was found at ≤ 1.79×10-5 and 1.80-1.99×10-5 mW ranges. Meanwhile, Lag_6 of daily smartphone output power exposure produced the migraine effect in a reverse dose-response manner. The smartphone electromagnetic radiation was a primary migraine trigger. The study results led to the recommendation to avoid triggers by use of smartphone talking with hand-free devices to prevent a recurrent migraine. Conclusions SOP, which is smartphone electromagnetic radiation, has a non-linear correlation with migraine headaches which has been called a window effect response. The result has also found migraine response to a delayed effect of SOP in the form of reverse dose-response. The delayed effect response on repeated exposure can recover and re-balance itself after exposure to electromagnetic radiation. Additionally, smartphone electromagnetic radiation has effects that fit the criteria for triggers that induce migraines. Finally, younger student, internet use and talking without hand-free devices were risk factors of migraines. It is recommended that limited time for smartphone talking with hand-free device and older age starting using smartphone be suggested in order to prevent migraine attack. Open access paper: ncbi.nlm.nih.gov

AI evidence extraction

Main findings

In a prospective time series of 145 high school smartphone users with headache diaries (12,969 entries), migraine prevalence was reported as 16.9% and repeated headache prevalence as 13.4%. Migraine was most strongly associated with hand-free device use and internet use, and smartphone output power exposure showed a non-linear association with migraine, including reported strongest effects at specific output power ranges and a lagged (Lag_6) reverse dose-response pattern.

Outcomes measured

• Migraine headaches
• Repeated headache prevalence
• Associations with smartphone use factors (hand-free device use, internet use)
• Association with smartphone output power exposure (including lagged exposure)

Limitations

• Frequency band and SAR were not reported in the abstract.
• Exposure metric was smartphone output power measured via a smartphone application; details on validation/calibration are not provided in the abstract.
• Study conducted in a single province and specific age group; generalizability is not described in the abstract.
• Observational design (prospective time series with GEE) limits causal inference; residual confounding cannot be assessed from the abstract.

Suggested hubs

• mobile-phones (0.95)
  Study evaluates smartphone output power (electromagnetic radiation) and migraine triggers among adolescent smartphone users.

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    },
    "population": "High school students (Thai adolescents) in Chiang Mai Province, Thailand",
    "sample_size": 145,
    "outcomes": [
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        "Repeated headache prevalence",
        "Associations with smartphone use factors (hand-free device use, internet use)",
        "Association with smartphone output power exposure (including lagged exposure)"
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    "main_findings": "In a prospective time series of 145 high school smartphone users with headache diaries (12,969 entries), migraine prevalence was reported as 16.9% and repeated headache prevalence as 13.4%. Migraine was most strongly associated with hand-free device use and internet use, and smartphone output power exposure showed a non-linear association with migraine, including reported strongest effects at specific output power ranges and a lagged (Lag_6) reverse dose-response pattern.",
    "effect_direction": "harm",
    "limitations": [
        "Frequency band and SAR were not reported in the abstract.",
        "Exposure metric was smartphone output power measured via a smartphone application; details on validation/calibration are not provided in the abstract.",
        "Study conducted in a single province and specific age group; generalizability is not described in the abstract.",
        "Observational design (prospective time series with GEE) limits causal inference; residual confounding cannot be assessed from the abstract."
    ],
    "evidence_strength": "low",
    "confidence": 0.7399999999999999911182158029987476766109466552734375,
    "peer_reviewed_likely": "yes",
    "keywords": [
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        "smartphone",
        "smartphone output power",
        "electromagnetic radiation",
        "time series",
        "generalized estimating equation",
        "hand-free device",
        "internet use",
        "lagged exposure",
        "window effect"
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