Frontiers in neurology · 2026
Primary headache disorders susceptibility is associated with fasting-related headache: evidence from a multinational study across 14 countries.
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Ceren Akgor M, Saghır K, Can A I, Sahbaz F G, Özcelik E U, Atalar A C, Ergin N, Orun M O, Madani A A, Ibrahim E A A, Togha M, Amirguliyev S, Alabwah Y, Hashel J A, Dardar I M, Sahli R E, Sassi S B, Nada M, Shalaby N, Dehal Y, Naji Y, Amine M, Alfred K, Karacı R, Yanık E, Gürsoy G, Celik H T, Tasdelen S, Ekizoğlu E, Orhan E K, Agırcan D, Genc H, Gesoglu Demir T, Domac F M, Köse N, Tepe N, Öztürk S, Cengiz E K, Erdogan K, Yıldırım I, Hasırcı Bayır B R, Demirel E A, Ghouri R, Tasdelen B, Bolay H, Ozge A, Kissani N
Аннотация
BACKGROUND: Fasting-related headache has traditionally been attributed to dehydration, caffeine withdrawal, and sleep disruption, but pre-existing primary headache disorders may also play an important role in determining susceptibility.
OBJECTIVES: To determine the prevalence, clinical characteristics, and predictors of headache during Ramadan fasting and to explore the relative contribution of pre-existing primary headache disorders and the lifestyle-related factors assessed in this study to headache occurrence during fasting.
METHODS: In this multinational cross-sectional survey across 14 countries, adults (18-65 years) observing Ramadan fasting completed a 17-item questionnaire. Headache during Ramadan was the primary outcome. Classification and regression tree (CRT) modelling were used to identify predictors and characterize fasting related headache.
RESULTS: Headache attacks occurred mainly in the afternoon/pre-iftar period and improved after iftar in 54.6% of cases. Pre-existing primary headache disorders, particularly migraine, were more strongly associated with headache occurrence within the exploratory CRT model than the lifestyle variables assessed in this study.
CONCLUSION: Fasting-related headache is highly prevalent and is influenced by both lifestyle-related factors and underlying headache susceptibility. A history of primary headache disorders was strongly associated with headache occurrence during Ramadan fasting, highlighting the importance of considering individual headache history alongside fasting- related exposures when assessing vulnerability.
OBJECTIVES: To determine the prevalence, clinical characteristics, and predictors of headache during Ramadan fasting and to explore the relative contribution of pre-existing primary headache disorders and the lifestyle-related factors assessed in this study to headache occurrence during fasting.
METHODS: In this multinational cross-sectional survey across 14 countries, adults (18-65 years) observing Ramadan fasting completed a 17-item questionnaire. Headache during Ramadan was the primary outcome. Classification and regression tree (CRT) modelling were used to identify predictors and characterize fasting related headache.
RESULTS: Headache attacks occurred mainly in the afternoon/pre-iftar period and improved after iftar in 54.6% of cases. Pre-existing primary headache disorders, particularly migraine, were more strongly associated with headache occurrence within the exploratory CRT model than the lifestyle variables assessed in this study.
CONCLUSION: Fasting-related headache is highly prevalent and is influenced by both lifestyle-related factors and underlying headache susceptibility. A history of primary headache disorders was strongly associated with headache occurrence during Ramadan fasting, highlighting the importance of considering individual headache history alongside fasting- related exposures when assessing vulnerability.