High school start time and migraine frequency in the US


  • A later high school start time (8:30 am at the earliest) was associated with reduced migraine frequency in adolescents when compared to earlier start times. Shifting high school starting time to 8:30 am or later, in accordance with recommendations from the American Academy of Pediatrics, may help to reduce migraine frequency in adolescents.

Why this matters

  • Between 8 and 12% of adolescents experience migraine headaches, resulting in missed school days and disability. Migraine preventative medications are commonly taken in the adolescent population but have not been clearly or consistently effective in clinical trials.

  • The American Academy of Pediatrics recommends the middle and high schools in the United States (US) start no earlier than 8:30 am to align with the natural sleep physiology of adolescents; however, only 18% of schools are compliant, resulting in adolescents not achieving adequate sleep during the week.

  • It is possible that inadequate sleep exacerbated by early school starting times results in a higher frequency of migraine days for those students at non-compliant schools compared to compliant schools.