Recurrent headache in indian adolescents.

Objective. To analyze the epidemiology and characteristics of primary recurrent headaches in Indian adolescents. Methods. This cross sectional study was conducted in three urban public schools. Adolescents of 9th to 12th grades were included and they were given a questionnaire in their classrooms in the presence of at least one of the authors, who assisted them in filling it. They were asked to provide responses based on most severe recurrent headache they had experienced rather than the more frequent one. Diagnosis was based upon the information contained in questionnaire, however, where it was inadequate, those subjects were approached telephonically. Statistical analysis was done with the help of SPSS v. 11.0. Descriptive analysis, Chi-Square test, Fisher’s Exact test, and independent sample‘t’ test were run. Results. We studied 2235 adolescents (boys: girls 1.6:1). 57.5% adolescents reported recurrent headaches in past one year. Migraine was the most prevalent (17.2%) headache followed by unspecified (14.9%) and tension type headache (11%). Family history of headache was more common in adolescents with headache (p < 0.001) compared to those without headache. Average age of headache onset was 11.33 yr (10.72 yr in girls vs. 11.75 years in boys; p < 0.001). 37.1% adolescents complained of progression of headache since its onset. A significantly higher proportion of girls suffered headache (p=0.018), particularly migraine, than boys. However, other characteristics of headache were not dependent upon gender. Headache was more prevalent in higher grades. Conclusion. Primary recurrent headaches are prevalent in Indian adolescents and migraine is comparatively the most prevalent type of headache. Female gender and increasing age is associated with higher chances to have headache, particularly migraine. It progresses in approximately one third of sufferers and aura increases the chances of worsening of headache.

Sleep patterns of urban school-going adolescents.

OBJECTIVE: To analyze the variance in sleep habits of adolescents of different high school Grades in urban India. DESIGN: Cross-sectional questionnaire-based study. SETTING: Community based school survey in an urban setting. SUBJECTS: School going adolescents from 9th to 12th Grades. METHODS: A total of 1,920 adolescents aged 12-18 years were included. The questionnaire contained questions related to sleep habits. Each question was explained to the participants and their responses were noted. Outcome parameters were total sleep time in a day, time to go to bed and wake up-time, sleep latency, nocturnal awakenings (duration, frequency per night and nights per week), wake-time after sleep onset, wake time after sleep offset, sleep efficiency, quality of sleep, daytime napping (duration and frequency), and sleepiness during the day. RESULTS: Mean age of the adolescents included in this study was 15.1 years and mean total sleep time was 7.8 hr/day. Adolescents of higher Grades had lesser total sleep time (9th=8 hours; 10th=7.7 hours; 11th=7.9 hours; 12th=7.6 hours; P=0.001), and more frequent nocturnal awakenings (9th=35.9%; 10th=44.7%; 11th=40.3%; 12th=28.3%; P=0.001). Daytime leg pain ( 9th=14.4%; 10th=18.4%; 11th=6.1%; 12th= 21.8%; P=0.01), daytime napping (9th=47.6%; 10th=50.4%; 11th=61.8%; 12th=69.8%; P=0.001), and daytime sleepiness (9th=37.2%; 10th=39.1%; 11th=39.7%; 12th=54.2%; P=0.001) increased progressively among higher Grades. Adolescents in higher Grades were more prone to not follow their weekly schedule on week-ends (P= 0.001). Sleep debt of approximately one hour per day was seen in all adolescents, and progressed with higher Grades. CONCLUSION: Adolescents of higher Grades had lesser sleep time, and frequent awakenings; suffered daytime leg pain, and felt sleepy during the day. These factors suggest increasing sleep deprivation among higher Graders.