Epidemiology and risk factors of migraine and TTH in Sudanese health sciences students

Headache disorders, particularly migraine and tension-type headache (TTH), are common among university students and significantly affect academic performance and quality of life. However, data from Sudanese students remains few. A descriptive cross-sectional questionnaire-based study was conducted between November 2023 and February 2024 among undergraduate medical, dental, and pharmacy students across Sudan. Using International Classification of Headache Disorders-III (ICHD-3) criteria, we assessed prevalence, risk factors, headache characteristics, triggers, and management. Of 1789 respondents, 746 students with recurrent headaches were included in the analysis. The overall prevalence of recurrent headaches was 41.7% (41.7%, 746/1789), comprising migraine (23.8%, 426/1789) and TTH (17.9%, 320/1789). Photophobia associated with 63% of migraine cases, and 18% were associated with nausea/vomiting, while 64% of TTH had no associated symptoms. Age and academic level were significantly associated with migraine with aura, with most cases aged (19–23 years) (p = 0.019) and third-year academic level (p = 0.045). Stress (54%) and sleep deprivation (50%) were the most common triggers, with stress strongly associated with TTH (65%) and sleep deprivation with migraine with aura (67%). Most students relied on over-the-counter analgesics (91%), with limited prescription use (6.3%) and low medical consultation rates (21%). Headaches negatively impacted academic performance, with 19% reporting missed classes or exams, and 27% had impacted mental health by migraine with aura. Migraine and TTH are highly prevalent among Sudanese health sciences students, with stress and poor sleep as major modifiable triggers. The high burden of self-medication and low healthcare-seeking behaviors highlight a major care gap. We recommend campus health programs to raise awareness about these common disorders.