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Current Research

Noise: an underestimated risk factor in headache and migraine

Everyone has a different noise tolerance level. One person’s “barely noticeable” is another’s “unbearable”. Many people find it especially hard to be around those everyday sounds we hear all the time. For many, traffic noise tops the “most annoying” list. The incessant drone of a nearby highway or a roadway soundscape featuring every kind of vehicle from whining mopeds to small cars and heavy trucks can stretch your nerves to breaking point.

Not all noise pollution has a nearby source. Residential neighborhoods near airports know all about it. They have to contend with a byproduct of a society in perpetual motion, be it for work, play or study: aircraft noise.

Throw in a collection of roadworks next door, and the noise literally causes pain to many people. The roaring, rattling, booming and droning from all directions is a full-blown aural assault capable of triggering a migraine attack or tension-type headache.

The proof is in the science

The message that took decades to be heard: noise is a health hazard with massive impacts in many areas. Patients who linked their symptoms – such as chronic headaches – to the noise around them used to be brushed off as oversensitive or dismissed as cranks.  

Luckily, attitudes have changed since then. Scientific research has provided ample evidence that environmental noise can trigger, maintain, or exacerbate headache events. Some of those studies and research outcomes are presented here.

A Norwegian study found that many migraineurs list noise as a trigger, both for migraine with aura (69%) and without (36%). The same patients were found to be more sensitive to noise during migraine-free periods as well.

An Australian research group led by Paul Martin studied the effects of noise on 18- to 30-year-old subjects. When asked to solve difficult tasks while exposed to noise – a situation students deal with on a daily basis – 79 percent of the participants got a headache. With these odds, no wonder noise has such a detrimental effect on learning ability and academic success.

Noise is harmful even in small doses

It doesn’t always have to be a jackhammer. Exposure to white noise (a type of random unstructured noise) provoked a headache in over half of the subjects in one particular study. Interestingly, subjects in the study who said they often had headaches in real life had a lower discomfort threshold than healthy participants. However, noise was a clear headache trigger in both groups.

A study by Alan Main et al, Guildford, UK, indicates a possible physiological basis for noise as a putative headache trigger. Although migraine and healthy control subjects had equally good hearing, the migraineurs had a significantly lower hearing discomfort threshold. In other words, the point where noise felt painful came sooner for people with migraine. This might be the physiological correlate that explains why many migraineurs can – so to speak – sense an approaching attack.

The young are not spared

You might think noise would not have much of a headache-inducing effect in young people, a population for whom exposure to high decibels is considered a normal part of a fun night out. We’ve all been to clubs where you need to shout over the music to have a halfway intelligible conversation.

But a University of Lille study in 7- to 17-year-old migraineurs says otherwise. When asked which environmental factors triggered their migraine attacks, more than half of the subjects reported noise, ranking it among the four main triggers.

Harmful to your whole health

A WHO study into the overall health effects of everyday noise (road traffic, neighborhood, airplanes, city) showed that noise does great harm. Adverse health impacts included high blood pressure, allergies and respiratory diseases in addition to a higher than usual incidence of migraine attacks. Migraine is the second most common adverse health outcome in the younger population, the authors found. Migraine ranks just behind allergies and on a par with respiratory diseases like asthma and bronchitis. The experts attribute this to the fact that noise exposure beginning early in life and continuing throughout childhood and adolescent development is a major risk factor for chronic diseases in general. The well-known cardiovascular impacts of constant noise are more apparent in adults.

What can you do?

Noise is everywhere and it may seem like there’s little you can do to escape its harmful effects. But effective prevention is possible even here. Hearing protection equipment (earplugs) helps to cancel everyday noise. At a club or concert, keep your distance from the speakers. Better still: play it safe by wearing special earplugs.

If you use headphones to listen to music, exercise a level of caution. If the music from your headphones is loud enough to drown out the sounds of a noisy environment, the volume is too high and you risk harming your health.

While compliance with noise limits at work and elsewhere is important, regular breaks for rest and recuperation are just as vital. Special relaxation exercises are extremely effective too. They help by releasing tension throughout your body and getting your sensory organs back to baseline dis/comfort thresholds. Try out the exercise on this website. It is highly recommended.

The surest way to counteract the harmful effects of noise is open to everyone: be mindful and stop noise at the source wherever possible. When everybody plays along and does their bit, we all win.

  • 1. Chakravarty A, Mukherjee A, Roy D. Trigger factors in childhood migraine: a clinic-based study from eastern India. J Headache Pain. 2009 Oct;10(5):375-80. doi: 10.1007/s10194-009-0147-x. Epub 2009 Aug 25.

    2. Friedman DI, De ver Dye T. Migraine and the environment. Headache. 2009 Jun;49(6):941-52. doi: 10.1111/j.1526-4610.2009.01443.x. Review.

    3. Main A, Dowson A, Gross M. Photophobia and phonophobia in migraineurs between attacks. Headache. 1997 Sep;37(8):492-5.

    4. Martin PR, Reece J, Forsyth M. Noise as a trigger for headaches: relationship between exposure and sensitivity. Headache. 2006 Jun;46(6):962-72.

    5. Martin PR, Todd J, Reece J. Effects of noise and a stressor on head pain. Headache. 2005 Nov-Dec;45(10):1353-64.

    6. Martin PR. Triggers of Primary Headaches: Issues and Pathways Forward [published online ahead of print, 2020 Jul 10]. Headache. 2020;10.1111/head.13901. doi:10.1111/head.13901

    7. Neut D, Fily A, Cuvellier JC, Vallée L. The prevalence of triggers in paediatric migraine: a questionnaire study in 102 children and adolescents. J Headache Pain. 2012 Jan;13(1):61-5. doi: 10.1007/s10194-011-0397-2. Epub 2011 Nov 1.

    8. Niemann H, Bonnefoy X, Braubach M, Hecht K, Maschke C, Rodrigues C, Röbbel N. Noise-induced annoyance and morbidity results from the pan-European LARES study. Noise Health. 2006 Apr-Jun;8(31):63-79.

    9. Park JW, Chu MK, Kim JM, Park SG, Cho SJ. Analysis of Trigger Factors in Episodic Migraineurs Using a Smartphone Headache Diary Applications. PLoS One. 2016 Feb 22;11(2):e0149577. doi: 10.1371/journal.pone.0149577. eCollection 2016.

    10. Solotareff L, Cuvellier JC, Duhamel A, Vallée L, Tich SNT. Trigger Factors in Childhood Migraine: A Prospective Clinic-Based Study From North of France. J Child Neurol. 2017 Jul;32(8):754-758. doi: 10.1177/0883073817705251. Epub 2017 Apr 24.

    11. Spierings EL, Ranke AH, Honkoop PC. Precipitating and aggravating factors of migraine versus tension-type headache. Headache. 2001 Jun;41(6):554-8.

    12. Vingen JV, Pareja JA, Støren O, White LR, Stovner LJ. Phonophobia in migraine. Cephalalgia. 1998 Jun;18(5):243-9.







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