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Give yourself a break

Give yourself a break – on university stress and headaches


Give yourself a break – time off from university stress helps prevent headaches

ZIES gGmbH, the non-profit that launched Headache Hurts, conducted a comprehensive study on headache burden from 2016 to 2019 under the scientific direction of Professor Hartmut Göbel (Pain Clinic Kiel), a medical doctor and trained psychologist. The study was carried out at Dresden University of Technology, Kiel University of Applied Sciences and Humboldt University Berlin as part of a pilot project on headache and migraine prevention at universities (‘KopfHoch – Kopfschmerz und Migräne an der Hochschule kompetent vorbeugen‘). The evidence collected in the study is robust and revealing: 74.8% of female students and 56.8% of male students report regular headaches with the features of migraine, tension-type headache, or medication overuse headache. (Of the 367 types of headache known to medical science, migraine, tension-type headache, and medication-overuse headache are by far the most common. Over 92% of people living with headache have at least one of these three types.)

Headaches significantly interfere with student quality of life

The 'KopfHoch' study shows that headache disorders take a heavy toll on student productivity and performance. Nearly one in three sufferers reported 'severe disability' (the highest severity level) using the MIDAS score, an international scale for migraine disability assessment. Adding moderate disability to the numbers gives an extrapolated figure of approximately 900,000 students in Germany whose everyday lives are significantly impaired by headache. Sufferers miss an average of 2.4 workdays at university every month because of their headaches. For students with migraine, the figure goes up to 2.7 working days.


Stress is a major headache trigger for students

Numerous studies suggest a link between stress and headache. Current research indicates that stress may arise from minor life events or situations (daily hassles) as well as being caused by acute, major life-changing events. Those daily hassles include the overwhelming demands you face as a student, pressure to meet submission deadlines, frustration, conflict with fellow students and in personal relationships.


University stress: the extra pressures of intellectual work <

Studying is hard mental labor, and the brain uses up as much as 20% of the total energy available to the body. Logically, energy deficits in the brain (key migraine triggers, see here) and pain regulation system overload (key tension headache triggers, see here) are more likely during intense intellectual activity – unless you take action to offset the high energy consumption associated with energy-draining brainwork (regular meals, breaks for recreation).


Bad posture = headache risk

As a student, you spend large chunks of your day studying, i.e. with your head stuck in a book and/or hunched over a computer. Digital screen time drains your energy balance by making extra demands on the energy-intensive optic nerve. Another factor: students tend to sit for hours in an unnatural posture, straining the shoulders and neck and putting pressure on the cervical spine. You may not even notice the musculoskeletal stress building up. If you are concentrating hard and need to keep going, it’s easy to miss neck tension and other important warning signals from your body. But remaining in your unnatural posture increases your risk of a headache, tension headaches in particular.


So much fun stuff to do, so little time...

Here’s something else the 'KopfHoch' survey shows. Cramming too much into your calendar can give you a headache, even if it’s all fun stuff. The research around 'KopfHoch' showed that students who get headaches spend about the same amount of time on leisure activities as their non-headachy peers – but are more likely to report never or only sometimes having unstructured time (i.e., when you have NOTHING planned). The statistical correlations between total hours invested in leisure activities and MIDAS stress score support the theory that a lack of unstructured time increases your risk of migraine attacks.


The pandemic is hitting students hard

The exceptional times we are living in are making things worse. The global Covid-19 pandemic has dragged on for almost two years now, with all the unique challenges it presents for students. A lot of classes are still online-only. That, plus limited access to libraries as spaces to study, means you probably do a lot of your research and studying in front of a screen. University workstations have been unavailable or access-restricted for a long time. You study at home all on your own, can't chat to fellow students in the corridor during breaks or interact with your professors in person, and the motivating atmosphere of face-to-face lectures is missing too. Younger students have not had a single 'normal' semester ever, and it’s unclear when the restrictions may end. Uncertainty, frustration, anxiety about the future, loneliness: all these emotions pile up the stress.


The challenge of studying in a pandemic

Unhealthy habits creep up on you. In the absence of regular dining hall meals, you may fall into unhealthy eating habits. Your sleep suffers because your days all merge into one boring grind. You’re probably getting less exercise because you don’t have to head out to university every day and the gyms are closed – yet again. Plus, you’re exposed to more digital stress during online semesters, and it shows. According to a 2018 study by the Hans Böckler Foundation, even if there doesn’t happen to be a pandemic, digital stress affects 25- to 35-year-olds the most. 55 percent of the digitally stressed have regular headaches, the study says – that’s 25 percentage points higher than in subjects reporting less digital stress. The proportion of subjects struggling with poor sleep is 25 percentage points higher too. (Find more about digital stress here) hier.)


Breaks are fundamental , research shows

A number of studies (Finland 2010, Denmark 2011, Germany 2020) on the impact of breaks on the headache burden of desk-bound office workers conclude that interrupting your desk work makes a real difference to your headache burden. The researchers say that you get the most out of your breaks if you move about to offset the effects of prolonged sitting and do a couple of exercises to strengthen and stretch your stiff muscles. Practicing special relaxation techniques on a regular basis is a great way to beat stress in general, and it has proven benefits for headache sufferers.


Practical tips on taking breaks and managing stress in university life

Regular breaks, exercise and relaxation techniques are extremely effective ways to reduce stress and can help against headaches. The right mix of concentration and relaxation helps maintain the balance of the nervous system and counteract stress hormones. Here are a few tips to get the balance right.


Tip 1: Make a plan and stick to it

Schedule realistic but regular breaks in your study routine. Stick to your plan. Try to schedule breaks of at least half an hour several times a day and give yourself a short breather (at least five minutes) every now and then. Let your phone remind you: set up work break reminders and follow the prompts. The Headache Hurts app has a break reminder feature that you can use. Spend the actual breaks off-screen, though. Put your phone down and take your eyes off the screen.


Tip 2: Active breaks

Use the breaks to interrupt your sitting posture. Stand up, move around, pandiculate (yawn and stretch like a cat!) Jump up, shake out your arms and legs. Open a window, close your eyes and breathe deeply in and out. Make the most of working from home: How about a handstand against your bookshelf? A nice big loud yawn can work wonders too!


Tip 3: Drink breaks

Take a few sips of water or other unsweetened beverage (you might prefer tea, for instance) at each break. Your brain cannot work without water. Drink breaks help you clock up your recommended 2-3 liters of fluids per day.


Tip 4: Meal breaks

Plan proper breaks to eat. Devouring a sandwich with your eyes glued to the screen is bad for your stress levels and for your digestion. Focus on your food and take time to eat. Chew slowly. Relish every bite.


Tip 5: Relaxation exercises

Certain relaxation techniques are proven to be very effective in reducing stress and preventing headaches. Relaxation exercises can calm your mind even when you’re dealing with worries, pressures and deadlines. Schedule periodic relaxation exercises into your day. Jacobson's progressive muscle relaxation gets great results. Find it here on the website and in the app (this article has more about the effectiveness of relaxation exercises)..


Tip 6: Move

Exercise helps reduce stress. Try to get regular exercise that you like. Regular walks are another good way to meet your move goals. (More about the connection between exercise and headaches is here.).)


Tip 7: Get busy doing nothing

The pressure to have fun can stress you out. Having lots of fun stuff in your calendar is hardly a bad thing, but it’s important to have some unstructured time when you have nothing going on at all. Enjoy that feeling of not having to rush for what’s up next – no matter how nice it might be.


Tip 8: Sleep is a game changer

It’s no secret that regular, good-quality sleep is good for preventing headaches (we’ve devoted two articles to the topic, one on the function of sleep and one on sleep duration). Find out what you need for a restful night's sleep. Wind down for half an hour before going to bed. Switch off your phone. Don't go straight from your desk to bed. Allow your body and mind to wind down – even if it means going to bed half an hour later. Consider establishing an evening ritual that prepares you for bed. How many hours of sleep do you need to feel refreshed in the morning? 7 hours is a good rule of thumb.


A 2018 Swiss-Dutch study revealed something that might interest students more than anybody else. Sleep is not only good for preventing headaches – it also helps you to retain facts better and learn more effectively. It does so by improving the active consolidation of declarative memories, which is another way of saying that you recall things better after a good night’s sleep. Good sleep: a game changer!

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    Epidemiologische Untersuchung im Rahmen von „KopfHoch – Kopfschmerz & Migräne an der Hochschule kompetent vorbeugen“, ZIES gGmbH, Frankfurt am Main, 2019

    Gimpel H, Lanzl J, Manner-Romberg T, Nüske N. Digitaler Stress in Deutschland. Eine Befragung von Erwerbstätigen zu Belastung und Beanspruchung durch Arbeit mit digitalen Technologien. Hans-Böckler-Stiftung, Working Paper Forschungsförderung 101, Düsseldorf, 2018.

    Hubbard K. et al. (2016): Improving Academic Performance and Working Memory in Health Science Graduate Students Using Progressive Muscle Relaxation Training; American Journal of Occupational Therapy, 70 (6), 7006230010. http://dx.doi.org/10.5014/ajot.2016.020644.

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    Reiss N. et al. (2018): Effects of cognitive-behavioral therapy with relaxation vs. imagery rescripting on psychophysiological stress responses of students with test anxiety in a randomized controlled trial, Psychotherapy Research, https://doi.org/10.1080/10503307.2018.1475767.

    Schreiner T, Rasch B. To gain or not to gain – The complex role of sleep for memory: Comment on Dumay (2016). Cortex. 2018 Apr;101:282–287. doi: 10.1016/j.cortex.2016.06.011. Epub 2016 Jun 24. PMID: 27423210.

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    Simić S, Rabi-Žikić T, Villar JR, Calvo-Rolle JL, Simić D, Simić SD. Impact of Individual Headache Types on the Work and Work Efficiency of Headache Sufferers. Int J Environ Res Public Health. 2020 Sep 22;17(18):6918. doi: 10.3390/ijerph17186918.

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