Screen time in Egyptian adolescents with headache: impact on headache frequency, severity and school performance

Abstract Background Excessive screen time may contribute to headaches in adolescents, impacting their well-being and academic performance. This study aimed to investigate the relationship between screen time and headache prevalence, frequency, and severity among Egyptian adolescents and its impact on school performance. This cross-sectional study was conducted on adolescents from nine private Egyptian schools between April 2024 and January 2025. Participants were assessed for screen time using the Questionnaire for Screen Time (QueST) and classified by headache type per The International Classification of Headache Disorders, 3rd-edition criteria as migraine, tension-type headache (TTH), or unclassified. Headache severity and impact were evaluated using the Visual Analog Scale (VAS), monthly headache days (MHD), and Pediatric Migraine Disability Assessment Scale (PedMIDAS). Results A total of 742 adolescents were included. Adolescents with headaches (n = 324) had significantly higher screen time than those without headaches (n = 418) ( P < 0.001). Among the headache group, 51.5% had migraine, 31.2% had TTH, while 17.3% had unclassified headaches. There were significant positive correlations between QueST scores and VAS (r = 0.182, P = 0.001), MHD (r = 0.158, P = 0.004), and PedMIDAS (r = 0.262, P < 0.001). Among migraine patients, positive correlations were found between QueST scores and VAS and PedMIDAS ( P = 0.009, < 0.001, respectively), but this correlation was not significant among TTH patients. Conclusion Prolonged screen exposure is associated with increased headache prevalence, severity, and disability in adolescents, particularly in migraine sufferers. These findings highlight the need to regulate screen time and promote healthier digital habits to reduce headache-related consequences.