July 25, 2019

Going back to school can literally be a headache


Surprisingly, school can be a cause of headaches in children. Learn why and find out what you can do about it.

The abrupt change in routine that comes with switching from a lax summer vacation schedule to more stringent school-time demands can trigger headaches in children. What specifically causes these headaches? Changes in sleeping and eating patterns, changes in eyesight and changes in stress levels can play a part.

Stress Headaches

“Stress is a huge trigger for headaches,” said Jane Hearnsberger, CPNP, a member of the Pediatric Neurology Team at Monroe Carell Jr. Children’s Hospital at Vanderbilt. “Kids tend to experience a good amount of stress when returning to school. It’s important to remember that both ‘bad’ stress, like anxiety or academic struggles, and ‘good’ stress, like excitement to see classmates, can set off headaches.”

Hearnsberger and her colleagues, Susan Beaird, CPNP, and Lauren King, CPNP, suggest stress management techniques to help reduce stress headaches in children. Techniques may include relaxation training or counseling or addressing specific stressors such as getting extra help in troubling school subjects.


Kids often stay up late and sleep in during the summer. When school starts, that routine shifts significantly. “This ‘irritates’ the brain and triggers headaches,” Hearnsberger said. “Additionally, the amount of sleep children get tends to dwindle, as kids often continue to stay up late, but have to get up early — so they are not getting as many hours of quality sleep as they should.”

She recommends that children get at least 8.5 hours of sleep per night and that they go to bed within the same two hours every night and wake within the same two hours every morning — even on weekends. They should also avoid after-school naps. (Read the American Academy of Sleep Medicine’s June 2016 age-specific sleep recommendations here).

Food and hydration

“It’s important for children to have regular meals. Skipping meals causes blood sugar to drop, which can trigger a headache,” Hearnsberger said. “And hydration is probably the most important lifestyle factor in headache prevention.”

However, she notes that certain foods can trigger headaches in some individuals. She suggests keeping a headache journal to note when headaches occur and what the child ate in the previous 12 hours. You may see a pattern.

Eyesight and Headaches

Eye strain can trigger headaches in children. A parent who suspects that to be the only cause should take his or her child to see an optometrist or ophthalmologist.

When to see a doctor

Hearnsberger recommends parents seek medical care for their children for the following:

  • A new headache — without any previous headache history;
  • A headache that worsens over time—either becoming more severe or more frequent;
  • When headaches seem to affect the child’s quality of life;
  • When headaches lead to frequent over-the-counter analgesic use;
  • When headaches are worse with positional changes such as lying down or standing up;
  • When headaches occur in the context of an infection;
  • When visual changes are associated with the headaches;
  • When headaches occur in the context of exertion;
  • If the headaches cause the patient or parent anxiety.

If your child has frequent or severe headaches, the Vanderbilt Children’s Neurology team can assess the problem and help your child find relief. For an appointment, call 615-936-5536.

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