Effect of Fasting during Ramadan on Migraine Sufferers

Abstract

Background: Fasting during Ramadan in Muslim communities is distinct from regular voluntary or experimental fasting. Its consequent caffeine withdrawal, stress and low blood glucose level (hypoglycemia) may trigger headache in patients with migraine. Objectives: The main aim of this study was to evaluate the effect of the Ramadan fasting on the frequency of migraine attacks among observant Muslim migraine sufferers. Material and Methods: This research study was based on fasting Muslims; both genders were aged between 18 and 65 years. Fifty migraineurs were selected, participated and gave consent at Internal Medicine and Neurology Clinics in Riyadh National Hospital, KSA. Those patients were recruited over three consecutive months of Ragab, Shaban and Ramadan during the period of 2010 and 2013. The effect of fasting and special eating pattern during the month of Ramadan compared with the preceding two months (Ragab and Shaban) was studied. The primary parameters used for comparisons were migraine attack count, duration of migraine attacks in days, attack duration and severity of the attacks. Results: Only forty three migraine sufferers completed the current study to the end, 4 patients of them were males (9.3%) and 39 were females (90.7%). They were aged between 18 and 44 years (Mean ± SD, 30.9 ± 6.9 years). Most of the fasting migraineurs during Ramadan were caffeine drinkers (n = 36, 83.7%), cigarette smokers (n = 2, 4.6%), overweight or obese (with BMI ＞ 25) n = 27, 62.8%), under stress (n = 29, 67.4%) and with low to moderate physical activities (No exercise) (n = 31, 72%). The worst time for the fasting individuals was afternoon between 2:00 PM to 4:30 PM because majority of them had headache during these hours. This study showed a significant reduction in migraine attack count, number of headache days, number of attacks with acute medication and total medication intake among migraineurs during the month of Ramadan compared with the two pre-Ramadan months. However, attack severity and attack duration did not change significantly between all three months. Conclusion: In conclusion, the present study did not find any negative effects of fasting during Ramadan on the migraine sufferers.