Frequency and burden of headache-related nausea: results from the American Migraine Prevalence and Prevention (AMPP) study

While nausea is a defining feature of migraine, the association of nausea with other headache features and its influence on the burden of migraine have not been quantified. Population-based data were used to elucidate the relative frequency and burden of migraine-associated nausea in persons with migraine.

Participants with episodic migraine who completed the 2009 American Migraine Prevalence and Prevention survey rated their headache-related nausea as occurring none of the time, rarely,

Among the 6488 respondents with episodic migraine, approximately half (49.5%) reported high-frequency nausea (ie, ≥half the time) with headache. High-frequency nausea was more common in females than males (adjusted odds ratio 1.35, 95% confidence interval 1.26-1.44). Persons with high-frequency nausea, compared with the no/rare or less than half the time nausea groups, reported significantly more headache symptoms and more headache-related impact as measured by the Headache Impact Test-6. High-frequency nausea was also associated with being occupationally disabled or on medical leave, and more self-reported financial burden of headache medications, worry about running out of headache medication(s), and that headache medications interfered with work or school work, household work, and family/leisure activities. Regression-based correlational analyses indicated that nausea contributes significantly and independently to headache-related impact.

High-frequency migraine-associated nausea is common and is a marker for severe, debilitating migraine. Nausea makes an independent contribution to migraine-associated disability and impact. Management strategies that take nausea into account could reduce the burden of migraine. Nausea is an important target for monitoring and treatment.