For Dubai resident Amina H., the most difficult part of Ramadan is the splitting headache she gets when she fasts. “Sometimes, I feel like my head is going to split into two,” she said. “It usually occurs in the first few days of Ramadan but sometimes, it extends for several days.”

Experts say, Amina is not alone in suffering from debilitating headaches during the holy month of Ramadan. In fact, according to Dr. Manio Ritter v. Maravic, Consultant Neurology at German Neuroscience Centre in Dubai, almost half of the fasting population is susceptible to it.

“One study amongst fasting patients reported 41 percent suffered from headaches and headache frequency increased with the duration of fasting,” he said. “The headache is very similar to Tension Type Headache with a diffuse non-pulsating pain of mild or moderate intensity. People suffering from headaches or migraine before Ramadan are at greater risk, but it can happen to anyone.”

There are several hypotheses on what causes these headaches. The one that most seem to concur on is that it was a combination of dietary factors and loss of sleep.

Several factors

Dr. Emad Estemalik, Section Head for Headache and Facial Pain at Cleveland Clinic’s Neurological Institute says that dehydration, poor sleep, and caffeine and nicotine withdrawal are among the factors that can trigger headaches while fasting during Ramadan. According to him, while it is important to consume enough water between fasts, those who are fasting must also pay attention to the amount of caffeine they consume.

“Reducing the amount caffeine, a person normally consumes in the form of coffee, tea or soda can lead to withdrawal symptoms that include headaches. The right amount of caffeine can be protective against migraines too. However, excessive caffeine can actually trigger headaches and migraines,” he explained. “We generally advise people to aim for 100mg of caffeine a day, which is around one mug of coffee, and not to exceed this amount.”

This year in the UAE, fasting hours will range between 13 hours and 43 minutes to 14 and a half hours during the month of Ramadan. According to Dr. Estemalik, this was the perfect time to adopt some positive habits as well.

“Ramadan provides an ideal opportunity to quit smoking completely, or to start reducing the number of cigarettes a person smokes daily,” he said. “In addition to the well-known health benefits of quitting, smoking is also associated with cluster headaches, so smoking cessation could help reduce their headaches in general.”

Dr. Estemalik also suggested that people take a walk or exercise around two hours after iftar. He also advised people to break their fast gradually, rather than with a heavy meal, and also to ensure that they get adequate sleep during Ramadan.

Five tips to reduce headaches

(Courtesy: Dr. Manio Ritter v. Maravic)

After breaking the fast, consume complex carbohydrates (i.e. whole grains) with a low glycemic index as they will help steady blood glucose levels and provide longer lasting energy. By avoiding simple carbohydrates like pure sugar, you avoid a rapid rise in blood sugar levels followed by a fast drop that may trigger a headache.

A cup of strong coffee before starting the fast will reduce the risk of caffeine withdrawal.

Dehydration during the fast should be prevented by sufficient fluid intake during meals.

Keep a steady Ramadan routine, avoid going to bed too late and lack of sleep.

In case you cannot control the headaches with preventative measures, medication may be indicated, and certain types have been shown to be particularly effective e.g., non-steroidal anti-inflammatory drug (NSAID) taken in the morning before starting the fast.

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