Headache prevalence and impact among school-aged children in a Japanese town: the AMI-GRAINES study

Headaches are common in youth and can impact school and daily life. Data on headaches and care-seeking in Japanese schoolchildren are scarce. We investigated prevalence, impact, and consultation patterns. A school-based online survey was conducted between February and March 2025 among 3,766 students in seven elementary and three junior high schools in Ami-town, Ibaraki-prefecture, Japan. Two questionnaire versions were distributed: one for lower-grade students (grades 1-3) and one for upper-grade students (grades 4-9). The survey included items on headache frequency, triggers, associated symptoms, medication use, and consultation experiences. The prevalence of headaches was 29.1% in lower-grade and 37.6% in upper-grade students. The most common age of onset was 10 years. Students with Headaches that meet most of the diagnostic criteria for episodic migraine experienced more headache days and more school absences compared to students with other headache characteristics. Although nearly half of the students had taken medication, fewer than one-third had consulted a physician. Despite experiencing headaches, only a small number of children sought medical care, which may raise concerns about the potential overuse of over-the-counter medications. Therefore, collaboration between educational and medical institutions is essential to improve early recognition and intervention.