Headaches are a pain, especially when they are frequent or interfere with our daily activities. Getting a headache is more common during Ramadan, usually due to dehydration, caffeine withdrawal and low blood sugar.
The side effects of fasting aside, headaches can often be attributed to a trigger — such as stress, a type of food or dehydration — but sometimes it takes some detective work to find out the cause and best course of management.
Dr Taoufik Al Saadi, chief medical officer and chairman of the neurology department at the American Center for Psychiatry and Neurology, answers our questions about headaches and migraines.
What are some common causes of headaches?
Headaches can be caused by a number of things. Generally, there are two distinctive types of headaches, which are brought on by primary or secondary causes. Primary causes are mainly related to stress, and a tension headache is the most common outcome. A migraine is another form of a primary headache.
Secondary causes of headaches are the result of structural or metabolic disturbances in the brain. In theses cases, there is possibly underlying pathology that could account for the headaches, such as a brain tumour or cerebral haemorrhage.
Why do people get headaches when they’re fasting during Ramadan?
There are several reasons why people suffer from headaches during Ramadan, which are most commonly caused by dehydration, hypoglycaemia [low blood sugar levels], caffeine withdrawal, a shift in the sleep cycle, and sleep deprivation.
There are two strategies for the prevention of headaches, which include preparing for Ramadan and the lifestyle changes that occur during the month. Heavy users of caffeine can start by reducing their intake beforehand. During the month, however, they can drink a strong cup of coffee or tea at the time of suhoor, or alternatively, they can take a painkiller, as suggested by their neurologist.
Secondly, during Ramadan, patients should try to get sufficient hours of sleep as well as make sure that they hydrate well at the time of breaking the fast.
What is the best way to treat a headache?
First we need to understand whether the headache is due to a primary or secondary cause. In the case of secondary causes, the patient would need to see a specialised neurologist, who can offer several treatments depending on the severity, frequency and any external factors causing the symptoms. If the headache is primary and there is no brain abnormality, then treatment can be offered depending on the underlying cause — tension versus migraine versus other types.
How does a migraine differ from a headache?
Migraine is a brain disorder characterised by headaches. The characteristics of this condition, which distinguish it from other headaches, are the quality, intensity, duration of symptoms and specific triggers. For example, migraines tend to last longer and are more severe than other primary types of headaches, interfering with the patient’s ability to function during that time. Patients with migraines cannot operate normally at the time of the headache, especially when it’s severe. In addition, they may have other symptoms such as nausea and vomiting.
What are some common causes or triggers of migraines?
There are several triggers for migraines, including sleep deprivation, a shift in sleep cycles, dehydration, certain types of foods and drinks and hypoglycaemia. The most common cause, however, is stress. Other known triggers include an excessive and extended use of computers and smartphones, direct and prolonged exposure to sunlight and, in the case of some women, the menstrual cycle.
How can migraines be managed more effectively?
There are various ways to manage migraines and avoid the triggers mentioned above. Primarily, patients should maintain regular sleeping hours and stay hydrated.
The treatment employed for migraines depends on the use of certain medication that sufferers are advised to take as soon as possible to reduce severity.
In most cases, these medicines, when used appropriately, can relieve headaches about 80 per cent of the time. However, if the migraine is quite critical or stressful, and is affecting the patient’s productivity, we would advise preventive treatments that patients can follow on a daily basis for six months to a year.
More and more data is being collected on using new molecules for both migraine prevention and acute treatment to improve the effectiveness of these drugs.
When should someone worry about their headache / migraine?
Any time you see a change in the characteristics of your headaches, or a worsening of your migraine symptoms that last longer and do not respond to the painkillers you normally take, you should see a neurologist as soon as possible. These can be warning signs that necessitate a thorough and careful evaluation by a medical expert.
Dr Taoufik Al Saadi, left, is the chief medical officer and chairman of the neurology department at the American Center for Psychiatry and Neurology, Abu Dhabi.