Migraine interferes with driving ability, reduces driving frequency
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Functional impairments and symptoms related to migraine caused patients to avoid driving, which negatively affected work productivity, according to findings presented at the Annual Meeting of the American Neurological Association.
“People with migraine have reported concerns with driving during an attack, and several epidemiological studies have shown an association between migraine and risk of motor vehicle accidents and driver injury,” Richard B. Lipton, MD, Edwin S. Lowe Chair in Neurology at Albert Einstein College of Medicine and director of the Montefiore Headache Center, and colleagues wrote. “Despite these reports, the overall magnitude of the impact of migraine and its symptoms on driving remains uncertain.”
To evaluate how migraine symptoms affected driving behaviors, Lipton and colleagues used the Impact of Migraine on Driving (i-MOD) questionnaire. They assessed migraine-related disability with the Migraine Disability Assessment (MIDAS).
The total study population, which was composed of patients from the OVERCOME study, included 5,928 patients. The mean age was 48.9 years and the majority of patients (75.1%) were women. Most patients (n = 5,378) had a valid driver’s license, according to Lipton and colleagues.
MIDAS grade distribution varied among patients with and without a driver’s license (grade I: 2,847 vs. 248; grade II: 759 vs. 69; grade III: 717 vs. 74; grade IV: 1,055 vs. 159), as did migraine-related functional impairment (ability to work normally: n = 992; work with some degree of impairment: n = 2,373; work with severe impairment: n = 1,117; bed rest required: 1,274). MIDAS driving-related responses among individuals with a valid driver’s license demonstrated that patients reported a mean of 2.5 days (standard deviation, 8.1) not driving in the previous 90 days because of migraine or severe headache, according to Lipton and colleagues. This correlated with other negative outcomes in the previous 90 days, including missed work or school (mean, 1.1 days); decreased work or school productivity by half or more (mean, 2.5 days); not doing housework or chores (mean, 4.5 days); productivity related to housework or chores reduced by half or more (mean, 4.3 days); missed social or leisure activities (mean, 1.9 days).
Patients most frequently reported that light sensitivity (29.1%), head pain (21.1%), motion sensitivity (20.4%), visual changes (20.2%), mental fogginess (20%), sound sensitivity (18.8%) and nausea (16.5%) affected their ability to drive. Compared with patients who reported mild or moderate pain, patients who reported severe pain associated with migraine said that they never or rarely drove, Lipton and colleagues found.
The researchers also demonstrated that driving frequency decreased as the migraine’s impact on driving increased in duration. For example, patients who reported that a migraine affected driving ability for more than 24 hours drove a mean of 4.2 days per week and a mean of 77.7 miles per week compared with patients who reported the impact of a migraine for less than 2 hours. Those patients drove an average of 5.4 days per week and a mean of 133 miles per week, Lipton and colleagues demonstrated.
“This is the first study to examine the impact of migraine frequency, migraine-associated symptoms and disability on driving behaviors,” the researchers wrote. “The positive association between migraine and impact on driving merits additional attention and clinical assessment.”