Primary headache patients who used smartphones were more likely to take analgesics and found less headache relief than those who didn't use smartphones, a cross-sectional study in India suggested.
A higher proportion of headache patients who were smartphone users treated their headache acutely with drugs (95.6%) than patients who used voice-only phones or no cell phones (80.9%; P<0.001), reported Deepti Vibha, DM, of All India Institute of Medical Sciences in New Delhi, and co-authors.
Smartphone headache patients also had lower rates of relief with treatment (84.3%) than non-users (94.3%; P<0.001), they wrote in .
"While these results need to be confirmed with larger and more rigorous studies, the findings are concerning, as smartphone use is growing rapidly and has been linked to a number of symptoms, with headache being the most common," Vibha said in a statement.
Several causative mechanisms have been suggested, including , eye strain, , decreased sleep, and mental strain. A meta-analysis showed that , but there's little known about smartphones and primary headache, Vibha and colleagues noted.
To study this, they evaluated 206 smartphone users and 194 non-smartphone users with primary headache who were 14 or older in North India from June 2017 to December 2018. They used the Headache Impact Test 6 () to assess disability and a questionnaire to evaluate mobile phone experiences and habits. The questionnaire classified 130 patients who used smartphones as higher users and 76 patients as low users.
Smartphone users had higher education and a socioeconomic status than non-smartphone users. The most common headache type in both groups was migraine, followed by chronic migraine/chronic tension-type headache. Smartphone users had a higher occurrence of aura (17.5%) than non-users (7.7%).
The proportion of patients taking migraine prevention drugs and the median duration of preventive treatment were similar in both groups. There was no difference between groups in how often headaches occurred, how long they lasted, or how severe they were.
Overall, smartphone users took an average of eight pills a month for acute treatment and non-users took five. High-use smartphone users took 10.
"These results are consistent with the sparse data that we have regarding the link between smartphone use and headaches," observed Heidi Moawad, MD, of Case Western Reserve University in Cleveland, Ohio, and Elaine Jones, MD, of SOC Telemed in Reston, Virginia, in .
"The key finding is that patients who are already prone to headaches may require acute medication more often and at the same time respond less well to that medication. This effect increases with heavier smartphone use," they wrote.
But the root of the problem isn't clear: "Is it a user's neck position? Or the phone's lighting? Or eye strain? Or the stress of being connected at all times? Or is there another characteristic that could lead to high cell phone use and have this same effect of more acute dosing and less effective medication?" Moawad and Jones asked.
Answers are likely to emerge in upcoming years and can guide ways to better use devices, they added.
The study has several limitations, the researchers noted. Its cross-sectional design means no correlations can be drawn. Headache severity, frequency of smartphone use, and acute and preventive medication use were based on patient recall and subject to bias. In addition, smartphone users and non-users were not matched for characteristics like education level and socioeconomic status, Vibha said.
Disclosures
No targeted funding was reported.
The researchers and the editorialists reported no disclosures.
Primary Source
Neurology Clinical Practice
Uttarwar P, et al "Smartphone use and primary headache: A cross-sectional hospital-based study" Neurology Clinical Practice 2020; DOI:10.1212/CPJ.0000000000000816.
Secondary Source
Neurology Clinical Practice
Moawad H, Jones E "Smartphone use and headaches: Are we ready to accept a link?" Neurology Clinical Practice 2020; DOI:10.1212/CPJ.0000000000000822.