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ASSESSMENT OF THE PREVALENCE OF MIGRAINE HEADACHES AND THEIR IMPACT ON ACADEMIC PERFORMANCE OF STUDENTS AT ACHIEVERS’ UNIVERSITY, OWO.
CHAPTER ONE
INTRODUCTION
1.0 Background to the study
Headache disorders, characterized by recurrent headaches, are among the most common disorders of the nervous system. A headache is a painful and disabling feature of primary headache disorders, namely migraine, tension-type headache and cluster headache (WHO, 2024).
A migraine is a type of headache marked by intense throbbing pain or a pulsating feeling, typically felt on just one side of the head (Mayo Clinic, 2023). Although, up to one-third of patients do not have throbbing pain. Modern imaging has demonstrated that vascular changes are not linked to pain and diameter changes are not linked with treatment (American Headache Society, 2019). Headache disorders were found to be the third highest cause of disability-adjusted life years (DALYs) worldwide, after stroke and dementia (Steinmetz et al., 2024).
Migraine is a prevalent form of primary headache disorder often occurring intermittently and lasting from 4 to 72 hours. It is commonly accompanied by nausea, vomiting, and sensitivity to light and sound. It is occasionally signalled by a brief, reversible aura featuring unilateral visual, sensory, or other manifestations (WHO, 2024). In 2021, a study revealed that about 4.3% of adults aged 18 and above in the United States had encountered either a migraine attack or a severe headache within the preceding 3 months. This study further indicated that migraine impacts approximately 7.4% of females compared to 2.5% of males. While these episodes typically occur among individuals aged 18 to 44, they can manifest at any age, including childhood (CDC, 2023). Migraine is a very common condition that affects 12% of the population, up to 17% of women and 6% of men annually. It is more common in girls than in boys. The adjusted prevalence of migraine is highest in North America, followed by South America, Central America, Europe, Asia, and Africa. It is the second leading cause of disability globally. Migraine usually runs in families. The risk of 40% increases if one parent has a history of migraine, and it rises to 75% if both parents have a history of migraine. It is consistently the fourth or fifth most common reason for emergency room visits, accounting for 3% of all emergency room visits. The prevalence of migraine increases with puberty but keeps increasing until 35 to 39 years of age, decreasing later in life especially after menopause (Ruschel & De Jesus, 2023).
It is observed that certain factors can exacerbate a migraine, including stress, lack of sleep, and regular physical activity. Conversely, being in a dimly lit, peaceful environment lessens the intensity of a migraine attack (Rustom et al., 2022). Migraine headaches pose a prevalent health concern among university students, attributed to their widespread occurrence and the resulting complications such as disability and academic underperformance (Rustom et al., 2022).
Various factors, including stress, sun exposure, insomnia, dietary habits, weather changes, temperature fluctuations, frequent travel, specific foods, oral contraceptives, and physical exertion can trigger migraine headaches. Among these triggers, the most prevalent are sleep deprivation, fatigue, and smoking (Birkie et al., 2021). Migraine headaches have impacts on psychological well-being, including conditions such as depression, obsessive-compulsive disorder, bipolar disorder, and anxiety disorders (Birkie et al., 2021). Migraines can progress through four stages: prodrome, aura, attack, and post-drome. Prodrome involves subtle changes that warn of an upcoming migraine, while auras are reversible symptoms of the nervous system. Attacks can last from 4 to 72 hours if untreated, and post-drome can cause confusion, and elatedness (Migraine – Symptoms and Causes – Mayo Clinic, 2023).
Meningeal vasodilation and inflammation are triggered by the activation of vascular networks, resulting in headaches. The pathophysiology of migraines involves regulating pain that originates from disrupted neural networks in the head (Khan et al., 2021). Research indicates that the brain stem and diencephalic nuclei control the trigeminovascular system, which consists of efferent neurons supplying vascular networks and afferent neurons transmitting information to the trigeminal nucleus caudalis (Khan et al., 2021). The sensation of head pain is linked to meningeal inflammation and vasodilation due to the activation of these neural networks. Neurotransmitters, particularly serotonin, play crucial roles in both the pathophysiology and treatment of migraines. Serotonin triggers a cascade of intracellular events that influence inhibitory or excitatory neurotransmission (Khan et al., 2021). Serotonin receptors are distributed throughout the brain, including those involved in pain signalling pathways and cranial blood vessels. Therapeutic approaches for managing migraines focus on modulating serotonin receptors to enhance the serotonin signal, which leads to pain relief through vasoconstriction of blood vessels and the inhibition of peptides like substance P and calcitonin gene-related peptide (CGRP) (Khan et al., 2021).
Unfortunately, migraine headaches are often overlooked and inadequately treated among undergraduate students, resulting in compromised academic performance. A comprehensive study is warranted to assess the prevalence of migraine headaches among students and understand how these headaches may affect their academic performance. Migraine headaches are known to cause disruptions in daily activities, including concentration difficulties, absenteeism, and decreased productivity, all of which can have a profound impact on a student’s ability to excel academically. This study aims to shed light on the extent of the issue within the student population at Achievers’ University, Owo, and identify potential strategies to support students suffering from migraines.
1.1 Statement of the Problem
The prevalence of migraine headaches among undergraduate students is a notable public health issue, with research indicating a significant effect on their academic performance. Consistent findings demonstrate that migraines are more common among young adults, particularly university students, compared to other age groups. For example, a systematic review and meta-analysis in the European Journal of Pain reported that the pooled prevalence of migraines among university students was 19% (95% CI, 16%-22%) (Flynn et al., 2022). This rate is notably higher than the general population’s prevalence, estimated at around 10% (Birkie et al., 2021). Additionally, a study in the Egyptian Journal of Neurology, Psychiatry and Neurosurgery found a 26.3% prevalence among university students, with over half of those affected unaware they had migraines (Rustom et al., 2022). This underscores the need to raise awareness about migraines among young adults.
Despite the significance of this issue, comprehensive research on the prevalence and effects of migraine headaches on undergraduate students is lacking. This study aims to evaluate the prevalence of migraine headaches and their impact on the academic performance of students at Achievers University, Owo, Ondo state.
1.2 Significance of Study
This study is significant as it addresses a critical gap in research by focusing on the prevalence and impact of migraine headaches among undergraduate students at Achievers University, Owo, Ondo state. Understanding the prevalence and impact of migraines among undergraduate students is crucial for several reasons. First, it can inform the development of targeted interventions and support services within university health systems, potentially reducing the academic disruptions caused by migraines. Second, raising awareness about this issue can empower students to seek timely medical care and adopt effective management strategies, improving their overall quality of life and academic success.
By providing localized insights, the research aims to inform targeted interventions and support systems that can improve student health outcomes and academic success in this population.
1.3 General Objectives
The general objective of this study is to assess the prevalence of migraine headaches and their impact on the academic performance of students at Achievers University, Owo, Ondo state.
1.3.1 Specific objectives
- To Determine the Prevalence of Migraine Headaches Among Students at Achievers University.
- To Investigate the Impact of Migraine Headaches on Academic Performance Among Students at Achievers University.
- To Identify Factors Associated with Migraine Headaches Among Students at Achievers University.
- To Develop and Implement Effective Strategies for Managing Migraine Headaches and Enhancing Academic Performance Among Students at Achievers University.