For many students, this school year brings new challenges
Going back to school with migraine is already tricky, but how can our kids with migraine adapt to school in COVID times? Increased screen time, wearing a mask and changing routines can all increase how often they experience migraine attacks. The good news: Whether your child is participating in remote learning, in-person school or some type of hybrid model , there are ways to help minimize migraine triggers and symptoms.
We asked three doctors to weigh in on the back-to-school topics many parents have on their minds and share their top tips for helping children with migraine have a successful school year.
1. Build in screen breaks and use good posture.
Extended screen use can cause eye discomfort, blurry vision and tired eyes. “Dry eye is likely a major contributor to these symptoms,” says Dr. Carlyn Patterson Gentile, an attending physician in the Division of Neurology at Children’s Hospital of Philadelphia. “We blink less when watching a computer screen, and individuals with migraine may be more prone to experiencing symptoms of dry eye.” Sitting in front of a screen can also cause poor posture, which can lead to neck pain and potentially contribute to migraine for children.
What to do: Because increased screen time can worsen migraine symptoms, or in some cases, trigger a migraine attack, your child may need more frequent breaks as they adjust to e-learning. Connect with your child’s teacher about implementing regular breaks so your child can stretch and rest their eyes throughout the day. If possible, a helpful option may be to complete an assignment on paper. You can also add a sticky note next to your child’s screen as a reminder to blink more frequently and occasionally look at something farther away. Promote good posture by having the screen at eye level for your child. You can adjust the height of the screen with books or adjust the seat height.
2. Remember: Physical activity and sleep are just as important and screen time learning.
Prior to the COVID-19 pandemic, the American Academy of Pediatrics recommended children have a maximum of one hour of screen time a day. But now, screens have become a necessary tool for education and connecting with friends and family. Given how important school and friends are for our children, setting limits on screen time has become extra challenging.
What to do: Be sure to include non-screen time each day and make sure they are getting enough exercise and sleep. Dr. Patterson Gentile recommends one hour of physical activity and 8 to 12 hours of sleep a night, depending on age, with more for younger children. “Screens should be turned off one to two hours before bed to promote falling asleep, and children and teens should not sleep with devices in their bedroom,” she says. For more sleep tips, download the American Migraine Foundation’s guide to healthy sleep here.
3. Consider the room lighting and screen brightness.
“Light sensitivity both during and between headaches is a very common symptom of migraine, and can be worsened by screen use,” says Dr. Patterson Gentile. Using a bright screen in a dimly lit room may contribute to this type of sensitivity.
What to do: Have your child use the screen in a room with uniform brightness levels. This is typically more comfortable for viewing a screen than a sharp contrast between a bright light and a dark room. Try reducing screen brightness, changing the settings to warmer colors or using blue-light blocking glasses. While there isn’t strong evidence on the benefits of these changes, some children with migraine may find them helpful.
4. Stay hydrated, especially when wearing a mask all day.
Wearing a mask is a crucial part of keeping your child and others safe if they’re returning to school or other activities in person. But some adults and children report increased headaches after wearing a mask or face covering for several hours. Some also feel dizzy or lightheaded.
What to do: “Wearing a mask can sometimes make you breathe a little faster,” says Dr. Scott Turner. Some people worry that wearing a mask causes you to breathe back in too much carbon dioxide, perhaps triggering a headache or passing out, but most cloth and surgical masks do not trap air inside. “If you are feeling dizzy or lightheaded, it is more likely that you are getting dehydrated from breathing a little faster,” says Dr. Turner. Encourage your child to drink extra water throughout the day to make up for the water they may lose due to more rapid breathing.
5. Choose a mask that fits comfortably and take breaks when it’s safe to do so.
If your child is heading back to school in person, they will likely spend several hours wearing a mask each school day. “Healthcare workers who got headaches when wearing a mask reported that their headaches were more likely to happen if they wore the mask for more than four hours without a break,” says Dr. Turner. Some masks also fit tightly against the face and strap around the head, putting pressure on areas that are often sensitive in people with migraine.
What to do: Ask your child’s school about “mask breaks” when it’s safe for students to remove their face coverings, like when outside and socially distanced from others. The four-hour point may coincide with lunch or recess time, providing your child with a natural break from wearing a mask. Be sure to choose a mask that fits your child comfortably. While most of the healthcare workers who experienced headaches had been wearing N-95 respirators, children are not likely wearing this type of mask. Using a face covering that doesn’t put pressure on sensitive areas of the face or head or neck is important for children with migraine.
6. Set reminders to help your child stick to routines.
A schedule ensures your child gets enough food, water, movement and sleep each day. These healthy habits are important for managing migraine triggers and symptoms, but with the changes that come with going back to school, it can be tough to stick to a routine.
What to do: Even if the world seems to be constantly changing, try to instill some structure for your child. This could take the form of printing schedules for your child to follow, even if these schedules need to change as you and/or your child’s teacher discover what works best. “[Setting] reminders on phones, especially for things like breaks or snacks, can be a lifesaver,” says Dr. Trevor Gerson. “Keeping reminders or objects (a water bottle, snacks) easily visible means that they won’t be ‘out of sight, out of mind.’” Read more about creating a routine for your child with migraine.
7. Find ways to maintain consistency and balance.
Especially in the case of a hybrid model, which alternates remote learning with in-person instruction, your child’s schedule may look different day-to-day. It can be challenging to find balance and a regular/consistent routine, which are important for children with migraine.
What to do: Work for as much consistency as possible, even when your child’s days look different. On days your child is learning at home, or on weekends, try to mirror the timing of key parts of an in-person school day, such as snack time and recess. “And don’t forget to schedule breaks,” says Dr. Gerson. No matter what type of schedule, planning ahead helps families maintain a consistent routine and prevent extra stress. Set aside time to plan and prep healthy foods, activities that encourage movement, and a bedtime routine.
With a little extra planning and effort, you can help your child navigate this school year, no matter what it looks like.
The American Migraine Foundation is committed to improving the lives of those living with this debilitating disease. For more of the latest news and information on migraine, visit the AMF Resource Library or Pediatric Migraine Content Hub. For help finding a healthcare provider, check out our Find a Doctor tool. Together, we are as relentless as migraine.
Reviewed for accuracy by the American Migraine Foundation’s subject matter experts, headache specialists and medical advisers with deep knowledge and training in headache medicine. Click here to read about our editorial board members.