Letter to Editor: Exploring the Link Between Headache, Possible Sleep Bruxism, and Self‐Medication in Adolescents

We read with keen interest the study titled “Exploring the Link Between Headache, Possible Sleep Bruxism, and Self-Medication in Adolescents” by Nascimento et al. [1]. The authors deserve commendation for addressing this critical and often overlooked aspect of adolescent health, as the association between sleep-related disorders, headache and self-medication carries significant clinical and public health implications. Their methodical approach to exploring this complex relationship is highly admirable, and the findings contribute valuable insights to the limited existing literature on this topic. Nevertheless, the study presents several limitations that warrant further consideration. Firstly, the use of self-reported questionnaires introduces the potential for recall and reporting biases, particularly in an adolescent population. Such biases may result in underestimation or overestimation of symptom prevalence [2]. Incorporating objective assessments, such as polysomnography for bruxism or validated headache diaries could substantially improve data accuracy and reliability. Secondly, the relatively small sample size drawn from a restricted geographic region of Recife Brazil may limit the generalisability of the results, as cultural, socioeconomic and regional factors can significantly influence both bruxism and self-medication behaviours [3]. Expanding the study to multiple centres with larger, more diverse populations would enhance external validity and applicability. Thirdly, the study did not account for key potential confounders, including stress levels, mental health status, and caffeine consumption; all of which can markedly impact both headache and bruxism in adolescents [4]. Future research that systematically adjusts for these variables would help delineate the independent relationship between bruxism, headache and self-medication behaviours. Additionally, the study did not explore the influence of parental supervision or family health literacy on adolescents' self-medication practices. Evidence suggests that family guidance and awareness significantly shape health behaviours in teenagers, including over-the-counter medication use and coping strategies for headaches [5]. Incorporating these psychosocial factors in future studies could provide a more comprehensive understanding of the determinants of self-medication in adolescents. In conclusion, this study offers important preliminary insights into an important adolescent health issue. Addressing the aforementioned limitations in future investigations will not only strengthen the robustness of the findings but also enhance their clinical relevance, ultimately informing more effective strategies for the prevention and management of headache and bruxism in adolescents. Javeria Ahsan: conceptualization, writing – original draft, resources, data curation. Ahmad Furqan Anjum: writing – review and editing, project administration, supervision. Artificial intelligence (AI) tools, specifically OpenAI's ChatGPT (GPT-4), were used to assist in the drafting and editing of this manuscript. These tools were employed solely to support language refinement, grammar correction, and structural clarity. No AI-generated content was used to replace or simulate original intellectual contributions, data interpretation, critical analysis, or conceptual development. All substantive content reflects the authors' own work and interpretation. The authors have reviewed and verified all AI-assisted text to ensure accuracy and integrity in accordance with the journal's authorship and ethical standards. The authors have nothing to report. Guarantor statement: All authors have read and approved the final version of the manuscript. They took complete responsibility for the data's integrity and the data analysis accuracy. Transparency statement: The Authors affirm that this manuscript is an honest, accurate and transparent account of the study being reported, that no important aspects of the study have been omitted, and that any discrepancies from the study as planned (and if relevant, registered) have been explained. The authors have nothing to report. The authors declare no conflicts of interest. Exploring the Link Between Headache, Possible Sleep Bruxism and Self-Medication in Adolescents, https://doi.org/10.1111/apa.70102. Data sharing does not apply to this article as no datasets were generated during the current study; all data were sourced from published literature.