The Link Between Migraine-Type Headaches and Sensory Processing Sensitivity: a Cross-Sectional Study

Objective: Migraine-type headaches (MTH) affect over one billion people worldwide each year, particularly the working-age population and women, contributing to 16% of the global neurological disease burden. MTH is characterized by intense, throbbing pain often accompanied by heightened sensitivity to sensory stimuli. This sensitivity is not only a symptom of migraines but also part of a broader personality trait known as Sensory Processing Sensitivity (SPS), which is characterized by deep cognitive processing and strong emotional reactivity. Approximately 15% to 20% of individuals can be defined as highly sensitive persons (HSP) and while SPS can aid in adaptation, it also might play a role in mental and physical disorders. This study investigates the relationship between SPS and the occurrence and severity of migraines.

Participants and Methods: This cross-sectional study was conducted with a sample of 670 Lithuanian employees drawn from 45 randomly selected companies and institutions (mean age = 43.4 years; 69% female; 64% with a university education). Participants completed a paper-and-pencil survey that included the Highly Sensitive Person Scale (HSPS), Migraine Screen Questionnaire (MS-Q), Migraine Disability Assessment (MIDAS), Patient Health Questionnaire-2 (PHQ-2) and general Anxiety Disorder-2 (GAD-2) questionnaires. Binomial logistic regression was employed to predict MTH, and mediation analysis was conducted to assess migraine disability, using HSPS as the independent variable (X) along with potential mediators.

Results: Within the total sample, 15% of participants reported experiencing MTH (95% CI: 11.8-17.1%), and 26% were identified as highly sensitive persons (95% CI: 22.6-29.2%). Individuals with MTH were significantly more likely to be highly sensitive compared to those without MTH (41% vs. 23%; p < 0.001), establishing HSP as a significant predictor of migraine (OR = 2.3; 95% CI: 1.5-3.7). However, the predictive value of HSP diminished when controlling for female gender (OR = 4.6; 95% CI: 2.0-10.2) and anxiety (OR = 2.2; 95% CI: 1.3-3.7). Among migraine sufferers, those with elevated SPS experienced an earlier onset of MTH, increased sensitivity to pain triggers, and more severe and frequent headache episodes, resulting in greater disability (p < 0.05). Moreover, mediation analysis indicated that the relationship between HSPS and migraine disability, as evaluated by the MIDAS score, was fully mediated by the increased number of headache episodes (𝑏 = 0.2907, p = 0.0054), heightened sensitivity to pain triggers (𝑏 = 0.1866, p = 0.0030), and mood disturbances (𝑏 = 0.1527, p = 0.0003), with no significant direct effect observed (p = 0.1287).

Conclusions: This study found that highly sensitive persons were more likely to experience MTH, with earlier onset, increased sensitivity to pain triggers, and more frequent and severe headache episodes, resulting in greater disability. Furthermore, mediation analysis suggested that heightened SPS impacted migraine disability primarily through its effects on mood, pain sensitivity, and the number of pain triggers, rather than directly. These findings highlight the importance of addressing emotional and sensory factors in managing MTH among individuals with high sensory processing sensitivity. As data collection continues, we will update our results to further explore these relationships and their implications for treatment and support.