Perceived headache associations in Singapore: results of a randomized national survey

We attempted to discern commonly perceived associations between headache symptomatology and various clinical and social parameters based on the results of a nationwide randomized survey involving 2096 respondents. A questionnaire incorporating demographic data, headache characteristics, and management as well as basic health screening was administered by trained interviewers to those aged 12 years and older. A digital semiautomated blood pressure monitor, a Snellen chart, and urinalysis sticks were used to gather clinical information. Elevated blood pressure, poor visual acuity, and fewer hours of nightly sleep did not positively correlate with headaches of increased frequency, intensity, or duration. On the contrary, an age-dependent negative trend was observed with regard to blood pressure and visual acuity. Individuals who performed shift work had more frequent, although not more intense or long-lasting, headaches. Income had no effect on headache prevalence or severity. Our findings are at variance with common perceptions of headache in the region. They highlight the need for informed counseling of patients presenting to medical attention with headaches and suggest that serious intracranial disease should be excluded in atypical headaches even if perceived associations are present.