The prevalence and impact of migraine on US military officer trainees

Objective. - To determine the prevalence and impact of migraine in US Army officer trainees. Background. - The prevalence of migraine in military officer trainees, frequency of diagnosis, pharmacologic management, and the impact of migraine on military training has not been previously determined. We sought to elucidate the above and also to identify trainee characteristics associated with impaired training performance because of the disabling effects of migraine. Methods. - An anonymous voluntary migraine questionnaire was administered to 1389 consecutive US Army Reserve Officer Training Corps cadets upon completion of 5 weeks of military training. Headaches were classified as definite migraine or possible migraine. Migraine frequency, prior diagnosis, number of missed or suboptimal training days attributable to migraine, patterns of analgesic use, and trainee characteristics associated with impaired training performance were identified. Results. - In total, 741 of 1389 (54%) officer trainees completed the migraine questionnaire, including 582 males and 159 females. The prevalence of definite migraine was 18% in all cadets including 14% in males and 31% in females. Migraines had been previously diagnosed in only 10% of trainees meeting criteria for definite or possible migraine. During training, male trainees experienced a mean of 0.70 migraines/month compared with female trainees at 1.4 migraines/month. Only 3% of trainees meeting criteria for definite or possible migriane had ever been prescribed triptans. Eight percent of cadets experienced impaired training performance because of migraine resulting in 63 days of suboptimal or missed training. Characteristics associated with impaired training performance included a prior diagnosis of migraine, screening positive for definite migraine vs possible migraine, and a higher baseline frequency of migraine. Conclusions. - Migraine is common yet underdiagnosed and undertreated in US Army officer trainees and adversely impacts military training. We identified characteristics which place military trainees at risk for impaired training performance. We predict that improved diagnosis and treatment of migraine would result in improved training performance.