title: Headache triggers in the US military.
abstract: BACKGROUND
  Headaches can be triggered by a variety of factors. Military service members have a high prevalence of headache but the factors triggering headaches in military troops have not been identified.
  
  
  OBJECTIVE
  The objective of this study is to determine headache triggers in soldiers and military beneficiaries seeking specialty care for headaches.
  
  
  METHODS
  A total of 172 consecutive US Army soldiers and military dependents (civilians) evaluated at the headache clinics of 2 US Army Medical Centers completed a standardized questionnaire about their headache triggers.
  
  
  RESULTS
  A total of 150 (87%) patients were active-duty military members and 22 (13%) patients were civilians. In total, 77% of subjects had migraine; 89% of patients reported at least one headache trigger with a mean of 8.3 triggers per patient. A wide variety of headache triggers was seen with the most common categories being environmental factors (74%), stress (67%), consumption-related factors (60%), and fatigue-related factors (57%). The types of headache triggers identified in active-duty service members were similar to those seen in civilians. Stress-related triggers were significantly more common in soldiers. There were no significant differences in trigger types between soldiers with and without a history of head trauma.
  
  
  CONCLUSIONS
  Headaches in military service members are triggered mostly by the same factors as in civilians with stress being the most common trigger. Knowledge of headache triggers may be useful for developing strategies that reduce headache occurrence in the military.
authors.affiliation: Department of Medicine/Neurology Service, William Beaumont Army Medical Center, Medical Corps, United States Army, El Paso, TX 79920, USA.
authors.forename: Brett J
authors.initials: BJ
authors.lastname: Theeler
authors.forename: Kimbra
authors.initials: K
authors.lastname: Kenney
authors.forename: Olga A
authors.initials: OA
authors.lastname: Prokhorenko
authors.forename: Ulgen S
authors.initials: US
authors.lastname: Fideli
authors.forename: William
authors.initials: W
authors.lastname: Campbell
authors.forename: Jay C
authors.initials: JC
authors.lastname: Erickson
mesh_terms: D000328:Adult; D015331:Cohort Studies; D015897:Comorbidity; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006261:Headache / Q000145:classification / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000523:psychology; D016273:Occupational Exposure / Q000009:adverse effects*; D013315:Stress, Psychological / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult