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Is flying giving you an 'airplane headache'?

By Cari Nierenberg

Body scans, missed connections, fighting for overhead bin space, annoying passengers in flight -- there are many things about flying that can make your head pound. But some researchers are documenting yet another kind of pain from air travel, which they call the "airplane headache."

In a paper published online in the journal Cephalalgia, Italian neurologists report on 75 people who suffer from what they describe as a "peculiar headache." It's peculiar because it tends to occur while on a plane and usually lasts less than 30 minutes. It also seems to mostly affect men, and it typically flares up during the flight's landing.

To gather up information about airplane headache, researchers gave people affected by them a written questionnaire. (They were only able to examine three of the participants in person.) From these completed surveys they found that everyone described the pain as severe. The headache causes a stabbing or jabbing pain that starts suddenly usually on one side of the head. It mainly affects the area of the forehead above the eye. Within minutes of the plane touching the ground, the headache usually goes away. 

As for why airplane headaches occur, scientists think "it's due to an imbalance between the air pressure in the cabin and those in the frontal sinuses," says lead author Dr. Federico Mainardi.

In some people, their sinuses may have difficulty equalizing the increase in barometric pressure that occurs when a plane is landing and this may cause pain, suggests Mainardi, a neurologist at SS Giovanni e Paolo Hospital in Venice, Italy.

The exact cause of airplane headaches remain unclear, but it's likely due to several factors such as the shape of the sinuses, as well as the speed of the aircraft, cabin pressure, and even the maximum altitude reached.

While most of the sufferers in this study had their first airplane headache while they were in their 30s, the attacks don't appear to happen every time people fly.

Airplane headache was first described in the medical literature in 2004, and it was viewed as a rare occurrence. But now experts aren't so sure. "We suppose it's a common condition," says Mainardi, but they've yet to collect the data to back that up.

There can be other reasons for flight-related headaches: Air travelers may get a migraine or tension-type headache from a lack of sleep, stress, or holding their neck in an awkward position during a long flight.

And more than half the participants in this study also appeared to suffer from another type of headache. This raises the possibility that being prone to other kinds of headaches helps activate the pain pathways linked with airplane headache.

Mainardi hopes that airplane headache will become recognized as a new form of headache and included in the International Headache Society Classification, which currently includes more than 200 different types of headaches.

In the meantime, he says that in some cases, taking a non steroidal anti-inflammatory drug, such as ibuprofen or naproxen, along with using a nasal decongestant spray about 30 to 60 minutes before landing, may help relieve or prevent pain.

If you have airplane headaches, Dr. Mainardi is collecting more case studies and would like to hear from you. You can share your symptoms with him at federico.mainardi@ulss12.ve.it

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