The Impact of Fasting on Migraine in Saudi Arabia 2025
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Abstract
Background: Migraine is a common neurological disorder that may be triggered by lifestyle changes, including fasting during Ramadan. Although many patients report worsening symptoms during fasting, evidence from Saudi Arabia remains limited. This study aimed to evaluate the impact of Ramadan fasting on migraine frequency, severity, and contributing factors among adult patients with migraine. Methods: A retrospective cross-sectional study was conducted at King Fahad Medical Complex, Dhahran, Saudi Arabia. Medical records of 277 adult migraine patients were reviewed, and additional information was collected via structured telephone interviews. Data were analyzed using SPSS version 28. Descriptive statistics summarized patient demographics and clinical characteristics, while Chi-square and Exact Probability tests assessed associations between fasting-related migraine and clinical variables. A p-value <0.05 was considered significant. Results: Of 277 participants, 75.1% were female, and 83.4% reported severe migraine (VAS 7–10). During Ramadan, 75.8% (210/277) experienced fasting-related migraines, with 59.0% reporting more than five daily attacks. Most participants managed their attacks by resting (89.5%), while few used medications (5.2%) or broke their fast (4.3%). Factors significantly associated with fasting-related migraine included longer migraine history (p=0.001), higher pain severity (p=0.002), current medication use (p=0.001), prior emergency visits (p=0.017), shorter sleep duration (p=0.016), and poorer sleep quality (p=0.049). Notably, 61.9% reported no change in migraine frequency or severity compared to non-fasting months, while 21.0% experienced worsening and 6.2% noted improvement. Conclusion: Ramadan fasting significantly influences migraine experiences, with many patients reporting increased attack frequency and severity, particularly those with chronic migraine history, severe baseline pain, or poor sleep. Pre-Ramadan counseling on hydration, sleep hygiene, and medication adjustments is recommended to reduce fasting-related migraine burden.
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Copyright (c) 2025 Abdolaziz Al-Ghamdi, Adeeb Alangari, Abdullah Memish, Bader Alrowaished, Ziyad Alshagawi
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons License All articles published in Annals of Medicine and Medical Sciences are licensed under a Creative Commons Attribution 4.0 International License.
Abdolaziz Al-Ghamdi, Department of Adult Neurology, King Fahad Medical Military Hospital, Dhahran, Saudi Arabia.
Department of Adult Neurology, King Fahad Medical Military Hospital, Dhahran, Saudi Arabia.
Adeeb Alangari, Department of Adult Neurology, Epilepsy and Clinical Neurophysiology, King Fahad Medical Military Hospital, Dhahran, Saudi Arabia.
Department of Adult Neurology, Epilepsy and Clinical Neurophysiology, King Fahad Medical Military Hospital, Dhahran, Saudi Arabia.
Abdullah Memish, Department of Adult Neurology, King Fahad Medical Military Hospital, Dhahran, Saudi Arabia.
Department of Adult Neurology, King Fahad Medical Military Hospital, Dhahran, Saudi Arabia.
Bader Alrowaished, Department of Adult Neurology, King Fahad Medical Military Hospital, Dhahran, Saudi Arabia.
Department of Adult Neurology, King Fahad Medical Military Hospital, Dhahran, Saudi Arabia.
Ziyad Alshagawi, Department of Adult Neurology, King Fahad Medical Military Hospital, Dhahran, Saudi Arabia.
Department of Adult Neurology, King Fahad Medical Military Hospital, Dhahran, Saudi Arabia.
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