www.cheo.on.caForm # P6153E juin 2017

Headache hygiene

Many things can trigger headaches or make them worse. This fact sheet will outline some things you can do so that headaches don’t happen as often.

We help children and families be their healthiest

Sleep

Diet

PhysicalActivity

Water

Substances

Go to bed and wake up at the same time every day (including weekends!).Don’t sleep more on the weekend to make up for too little sleep during the week.

Most children need approximately 8-12 hours of sleep every night.

Blood sugar can have a big impact on headaches. Low blood sugar is a headache trigger. Headaches can also be triggered by eating too much sugar. This can cause a sudden rise in blood sugar, followed by a rapid drop in blood sugar. It can help to:• Eat 3 regular meals every day, with 1 to 3 snacks in between.• Try to include protein, carbohydrates and vegetables or fruit at each meal.• Have a high protein breakfast within an hour after waking up. This helps to prevent sudden drops in blood sugar. Greek yogurt, cheese, or milk are good options.

• Children and youth need at least 60 minutes of moderate-vigorous physical activity every day. • Moderate-vigorous exercise for 60 minutesdailywillhelpreducestress,keepyouphysicallyfit

and improve your migraines.• Too much exercise or erratic exercise patterns may trigger headaches. Regular physical activity

is key.

Dehydration(notenoughfluidsinthebody)maycauseheadaches.Makesureto:• Drink plenty of water throughout the day• Avoid highly coloured drinks that contain food dye (for example Kool-Aid® or sports drinks).

These dyes may trigger headaches.

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Stress

• Limit caffeine, alcohol and other drugs. • Caffeine is a stimulant. Caffeine withdrawal may cause headaches when blood levels of caffeine begin to drop.

• Stress may lead to an increase in headache.• Learning to manage stress in a positive way may help to reduce headaches (for example, relaxation

exercises, yoga or mindfulness practice). See the last page for resources.

Patient: ___________________________________________

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Headache diaryKeeping a headache diary is one way to help your doctors manage your headaches. It can help keeptrack of triggers and how the treatment plan is working. Please remember to bring your headache diaryon your next clinic visit. You can use a regular calendar or notebook, or check out the apps listed on the next page.

Research studies have shown that some nutritional supplements can help to reduce the frequency of migraines.

These supplements: • Occur naturally in our bodies; • May take 2-4 months to work;• Must be taken every day;• Do not work as pain medications for migraines;• Do not interfere with other migraine medications.

Nutritional supplements for headaches

Magnesium Oxide The amount you give will depend on your child’s weight.Swiss Naturals brand offers magnesium oxide as a single ingredient tablet. The pharmacist should be able to order Magnesium Oxide tablets for you, if needed.

o For patients less than 30kg: Give ½ a 420 mg tablet daily

o For patients 30-50kg: Give 420mg tablet once daily

o For patients 50kg and over: Give 835mg tablet once daily

Side effects: Can cause diarrhea and stomach upset; should not be taken in patients with kidney disease.

Nutritional supplements are not regulated by Health Canada. So the companies that make them don’t have to follow the same quality control laws that drug companies do. But there have not been reports of any problems with these supplements.

Coenzyme Q10 The amount you give will depend on your child’s weight.

o For patients less than 20kg: Give 50mg capsule once daily

o For patients 20-60kg: Give 100mg capsule once daily

o For patients over 60kg: Give 200mg capsule once daily

Side effects:Nosignificantsideeffects

Vitamin B2 (Riboflavin) The amount you give does not depend on your child’s weight.Give 100mg twice a day. You can gradually increase this to 200mg, twice a day.

Side effects: Can cause an upset stomach, can cause orange discoloration of the urine.

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Managing stress & self calming exercises• MindMasters 2 app (iPad) & web resources (for children 4-9 years) http://www.cyhneo.ca/mindmasters-2-dha2r

• www.Smilingmind.com.au• www.neuronovacentre.com• Relaxation resources www.dawnbuse.com• www.anxietybc.com (mind shift app)• Breathing Zone app• Healing Buddies Comfort Kit app• Take a Chill – Stressed Teens app• Stop, Breathe and Think app

Headache diary apps (print out the diary and bring to your next clinic visit)iPhone users: upload a free Headache diary app through iTunes (eg. MigraineBuddy, ecoHeadache)

Android phone users: upload a free headache diary app through migraine.com

Headaches & migraines • American Migraine Foundation www.americanmigrainefoundation.org• Canadian Headache Society http://www.migrainecanada.org/ • Sick Kids Hospital (Toronto) http://www.aboutkidshealth.ca/En/HealthAZ/ConditionsandDiseases/Symptoms/Pages/Headache.aspx• National Headache Foundation www.headaches.org• Pain Retreat- a fun and interactive website designed to teach children about pain, headache and stomach ache

and relaxation exercises www.painretreat.net

Helpful resources