Experimental relaxation mobile app helps manage migraines

A smartphone-based relaxation app could help migraine sufferers reduce the number of headaches they get each month, a small study suggests. 

Using the app twice a week was associated with an average of four fewer headache days per month, according to the report in Nature Digital Medicine. 

“Migraine is now the second most disabling condition in terms of disability-adjusted years lost,” said lead author Dr Mia Minen of NYU Langone Health in New York City. 

Migraines affect about 1 in 6 adults in the US, with women most at risk. 

“Previous research has shown that the best treatment for preventing migraine is a combination of migraine medication and behavioral therapy,” Minen told Reuters Health by e-mail. However, “patients have significant difficulty accessing these safe, top evidence-based treatments”. 

Minen and colleagues created RELAXaHEAD, an app based on the technique of progressive muscle relaxation, a proven method of migraine prevention, the authors note. The study team analysed whether patients recruited from a neurology clinic would use the app regularly and whether they’d have fewer headache days. 

During the study, 51 patients in their 30s and 40s who typically had 13 or more headache days per month were asked to complete a daily headache diary and to do progressive muscle relaxation with the app for 20 minutes a day for 90 days. Nearly one-third of the participants were considered to have severe migraine disability when they enrolled, meaning they had missed considerable amounts of work, school and family activities due to the headaches. 

On average, participants used the app on 22 days per month, for about 11 minutes per day. Roughly half used it once per week and a third used it two or more times per week. Overall, those who used the app twice per week had four fewer headache days the following month, and those who used it once per week had two fewer headaches days. Use of the app tended to drop over time. 

Patients with higher depression scores were less likely to use the daily headache diary, and those with higher anxiety scores were more likely to use it. 

“The number of mobile health apps available in the iOS and Google Play stores has ballooned, and recent studies show that most people download an app but then rarely use it,” Minen said. “Importantly, we were able to get a considerable number of study participants to use the app.” 

The researchers have received inquiries about the app from patients with migraines outside the NYU Langone system, she noted. Although it was created as a research tool, Minen’s team is exploring ways to expand access to the app or include it in office visits. They’re also studying whether the app can help healthcare providers who do not know where to refer patients with migraines who want behavioural therapy. 

“I would encourage people who live with migraines to consider a behavioural treatment,” said Alice Pressman of Sutter Health in Walnut Creek, California, who wasn’t involved in the study. 

“The great thing about starting a [behavioural therapy] BT is that you don’t have to stop your other treatments if you feel they are effective,” Pressman said by email. “BTs can be used as add-ons with no added side effects.” 

However, an in-person a mindfulness-based stress reduction programme targeting migraines that was offered at her centre was difficult for some patients to attend due to time and location, Pressman said, so an online programme may help. At the same time, patients should know that apps are still new and not fully studied.

“Research here is important to enable therapeutically effective and safe smartphone apps. Lots of apps are offered that are not based on any scientific evidence,” said Thomas Dresler of the University of Tuebingen in Germany, who wasn’t involved in the study.

 “There are a lot of migraine apps out there, but customers need to know that the availability of an app per se does not guarantee effectiveness, safety or the developers’ adherence to specific quality standards,” Dresler said by e-mail.