Headaches among nursing and care staff: a growing problem

Headaches among nursing and care staff: a growing problem 

It has been clear for some time that nursing staff face challenges in every part of their working lives. Staff shortages, heavy workloads, long hours, stress and fatigue are all part of a day’s work for many people in the nursing profession. All in all, these are ideal conditions for tension-type headaches and migraine attacks. The toll that headache disorders take on nursing staff is now firmly in the spotlight of research. In this article, we will take a closer look at what the latest research tells us, what it means for nursing staff, and what can be done to prevent headaches.

A demanding job with a lot at stake

Whether in a hospital, nursing home or other care setting, people working in nursing and care face a wide range of physical and emotional challenges – so it’s hardly surprising that headache disorders are also a common problem among nursing staff. When they are constantly at breaking point while trying to do their job, recurring tension-type headaches and migraine attacks become yet another burden to cope with.

What does the research tell us?

Research has long highlighted the considerable pressures faced by many people working in nursing and care. One finding stands out: nursing staff are significantly more likely to experience the three most common types of headache – migraine, tension-type headache and medication-overuse headache – and their symptoms may be more severe. One explanation put forward for the high rate of medication-overuse headache is the widespread preventive use of painkillers. Medication-overuse headache (MOH for short) is a particular problem in nursing. One reason is that health workers may find themselves under enormous pressure to turn up for work and remain fit for duty no matter what (we have looked at this phenomenon, known as “presenteeism”, in a separate article). This kind of pressure may result in people taking painkillers ‘just in case’, hoping to stop a headache or migraine attack before it starts. What they may not realise is that overuse of these medicines can itself cause headaches (read more about MOH here).

Shift work is another important reason why headaches are so common in nursing. In fact, a growing body of research suggests that working shifts can actually trigger headache attacks. We will take a closer look at some of those studies below.

Shift work in the spotlight

One research study from Zaragoza, Spain looked at 24-hour on-call shifts, which are common in the health sector. This study found that employees with a confirmed diagnosis of migraine reported worsening symptoms just six months after they first started working these shifts. The researchers assessed this using the MIDAS questionnaire, a well-established tool for measuring the degree to which migraine affects a person's everyday life. MIDAS scores were significantly higher in these migraine patients, indicating a clear link between migraines and shift work.

The same study also found higher rates of depression and anxiety. Similar results have emerged from many other studies, including research involving nursing staff in Danish intensive care units. This study from Denmark produced another interesting finding. During periods of shift work, participants reported paying less attention to eating regularly and maintaining a healthy diet. This is particularly concerning for people with migraine, as getting enough energy at regular intervals is essential for preventing attacks. The study also shows how the various pressures associated with shift work can interact and make each other worse. The most common complaints were mood changes, headaches and difficulty falling asleep – all factors that can influence one another and, in turn, make headaches worse.

shifts and sleep problems are particularly relevant

Sleep may be one of the most important pieces of the headache puzzle. The Danish study we referred to above found that night shifts had a particularly heavy impact – and an Italian study involving 1,000 female hospital employees found that night shifts made symptoms significantly worse.

More recently, researchers in Kyoto, Japan, reported significant sleep problems among hospital employees with migraine as well as among those who frequently experienced tension-type headaches. The authors argue that the way work is organised needs to be part of the solution. Changes to working arrangements could help reduce excessive stress and its effects, they say.

Several studies from China have identified frequent sleep problems as a possible reason why shift work can lead to headaches. The researchers link this phenomenon to the body’s circadian rhythm – the natural cycle governing when we wake up, when we feel tired, and when we sleep. Shift work can disrupt our circadian rhythm, moving our usual sleep and waking times away from the pattern our bodies are used to.

This is particularly important for people with migraine, who benefit from going to bed and getting up at roughly the same time every day. Shift work disrupts this regularity, making headaches and migraine attacks more likely. You can find out more about sleep and headaches in this article.

Does the impact increase the longer you work in nursing?

Two of the studies referred to earlier came up with another interesting finding: the people most affected by headaches were often those who had already spent many years working in nursing. The Italian study, for example, found that female employees over 40 who had worked in nursing for more than 15 years were particularly badly affected. The Chinese research teams reached a similarly clear conclusion, identifying more than five years of experience in nursing as being a risk factor for migraine. Taken together, these findings suggest that the burden of headaches increases the longer you work in nursing.

Possible solutions and ways to prevent headaches

So, what can be done? What could change, both in the nursing profession as a whole and for individual nursing staff, to tackle what appears to be a widespread problem with headaches? The authors of the Italian study focus particularly on workplace stress. They recommend looking closely at all the factors that contribute to stress and finding ways to reduce them. Their overall message is that both efforts on an organisational level and measures tailored to individual employees are needed if workplace stress is to be reduced in the long term.

For many nursing staff, avoiding shift work altogether simply isn't an option. Nevertheless, there are things that can help to make shift work easier on the body and help prevent headaches. For example, researchers recommend favouring forward-rotating shifts – early, then late, then night – because this pattern puts less strain on the body's circadian rhythm.

For people prone to migraines, lighting can make a difference. Bright lights should be avoided where possible, and several smaller light sources should be used instead. When working outdoors, sunglasses or a peaked cap can also provide useful protection from bright sunlight. Regular breaks are essential too, as they can help prevent sensory overload, which can be particularly problematic for people with migraine. During these breaks, it can help to rest or close your eyes and step away to a quiet place. Relaxation techniques can also be useful. Jacobson's progressive muscle relaxation, for example, can be an effective way of preventing stress from becoming overwhelming. For more recommendations for coping with shift work, try this article.

We offer a wide range of resources to help prevent headaches, which we also recommend for people working in nursing and care. Our websites and medically certified apps provide reliable information about headaches and practical advice on prevention. You will also find a selection of strategies to help keep you headache-free at work, at home, and elsewhere.

Published: August 2026