Anxiety Sensitivity May Lead to Activity Avoidance in Women With Migraine

Researchers found data that showed avoiding exercise because of anxiety that it is a trigger in migraine can be addressed by gradual exposure to help with desensitization.

Raised levels of anxiety sensitivity in women with probable migraine were significantly associated with avoiding moderate and vigorous physical activities, according to a preliminary study published in Cephalalgia.

The study researchers defined anxiety sensitivity as “the fear of anxiety-related arousal due to harmful physical, cognitive, and socially observable consequences.” They hypothesized that these fears were related to patients’ intentionally avoiding physical activity, which can be problematic because physical activity may help ease the frequency and duration of migraine attacks. 

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Using secondary analyses, researchers reviewed results from 100 women with a mean age of 37.8±9.6 years who completed an online anonymous survey about physical activity avoidance and migraine. The participants had previously screened positive for likely migraine using the IDMigraine self-administered screening tool. They retrospectively reported their 30-day frequency of migraine attacks. The participants also shared details about their fears related to anxiety using the Anxiety Sensitivity Index-3. The researchers reviewed participant answers from the Global Physical Activity Questionnaire to evaluate physical activity levels and avoidance. 

After adjusting the results for participant migraine frequency and body mass index, researchers found that scores from the Anxiety Sensitivity Index-3 were significantly associated with higher odds of avoiding physical activity at moderate- and vigorous-intensity levels. Physical concerns (eg, difficulty breathing) were likely the cause of vigorous-intensity avoidance (odds ratio [OR] 7.56; 95% CI, 1.24-46.04; P =.028) and cognitive concerns (eg, difficulty concentrating) were the likely culprits in participants avoiding moderate-intensity activities (OR 5.22; 95% CI, 1.20-24.80; P =.038). 

Though not explicitly mentioned in the study, some limitations do include retrospective analysis and a reliance on self-reported survey results.

The researchers concluded that physical activity “may be a particularly promising behavior in migraine to target via exposure intervention.” The study researchers also noted that “patients with migraine and elevated [anxiety sensitivity] could benefit from tailored, multiple-component intervention.” The suggested interventions include psychoeducation, feedback, and desensitization. 

Multiple researchers declared affiliations with the pharmaceutical industry. Please refer to the reference for a complete list of disclosures. 

Farris SG, Thomas JG, Abrantes AM, et al. Anxiety sensitivity and intentional avoidance of physical activity in women with probable migraine [published online July 1, 2019]. Cephalalgia. doi: 10.1177/0333102419861712