An Epidemiological Survey On Primary Headaches In Submarine Personnel In China

Objective: To investigate the prevalence, clinical features, and life quality and relatedfactors of primary headaches in submarine personnel in China.Methods: A total of308submarine personnel from Navy north sea fleet sampled by acluster sampling method were visited by door-to-door calling and surveyed using thestructured questionnaire including socio-demographic data, diagnostic questions onheadache, life quality and sleep quality.Results: Of308participants,73participants (23.79%) reported headache in the pastone year, among whom64participants (20.78%) were diagnosed as primary headaches.The1-year prevalence of migraine was6.2%and that of tension-type headache (TTH)was14.6%. The main features of migraine attacks were unilateral pain (73.7%), pulsatilepain (78.9%) and moderate or severe pain (94.7%). Phonophobia (73.7%) andphotophobia (63.2%) were the most common accompanying symptoms of migraine.Unilateral (51.1%), non-pulsating pain (77.8%) were the obvious characteristics of TTHattacks and phonophobia (53.3%) was the most common accompanying symptom inmost submarine soldiers. Univariate and multivariate Logistic regression analysisrevealed that there was no association of migraine prevalence with the risk factorsincluding age, index of body mass (IBM), education, residence, marital status, length ofservice and identity(P>0.05, for all). Age was a risk factor for TTH (P <0.05).Thirteen of19patients with migraine (68.4%)and16（35.6%）of45patients with TTHhad visited doctors because of headache in the previous year, the difference of rate ofvisiting between them was significant (P <0.05). Of13patients with migraine visitingdoctors,5patients （38.5%）got no definite diagnosis, only2（15.4%）patients gotcorrect diagnosis.16patients with TTH visited doctors, but all of them can not get thecorrect diagnosis, and11（68.8%） patients had not gotten any diagnosis, and the misdiagnosis rate of100%. The World Health Organization quality of life-8(WHOQol-8) questionnaire showed that both migraine and TTH reduced life qualitycompared with the soldiers without headache (P <0.05). Pittsburgh sleep quality index(PSQI) indicated there were significant difference of sleep quality scores between in theparticipants without headache and the participants with migraine or TTH (P <0.001).Conclusions: Migraine and tension-type headache have a high prevalence in submarinepersonnel and exerts serious impact on their work and life quality. Large proportion ofmigraine and TTH don’t seek diagnosis, and most of them visits the primary medicalunits, and misdiagnosis and improper diagnosis was prevalent. Age was influence therisk factor for TTH. The quality of life and sleep quality of soldiers with tension-typeheadache or migraine were significantly reduced.