Risk Factors:

Tension-type headaches are the most common headaches, accounting for nearly half of all headaches. According to one study, nearly 40% of Americans have at least one episode of tension headache during the course of a year. Tension-type headaches are more common among women than men. Some reports estimate that over 85% of women and about 63% of men will have a tension-type headache at some point during a year. Nearly everyone has at least one tension-type headache during their lifetime.

Episodic tension-type headaches are more common than chronic tension-type headaches. Surveys indicate that about 3% of the general population has chronic tension-type headache.

Tension-type headaches are most likely to occur among people in their 40s. The prevalence of tension-type headaches declines as people become older.

Headaches in Children

Headaches are rare before age 4 but increase in prevalence throughout childhood, reaching a peak around age 13. In one large study, about 7% of 7-year olds and 15% of 11-year olds had headaches. Ten percent of these childhood headaches were recurrent. In many of these patients, chronic headaches persist into adulthood. In addition, as adults these patients have a tendency to develop multiple physical or psychiatric complaints, such as back pain, muscle aches, digestive complaints, and depression.

Studies have found that only a minority of chronic childhood headaches are due to physical conditions, such as head injuries or medical problems. Many children with tension-type headache episodes also suffer from some form of emotional disorder.

Psychosocial factors associated with childhood tension-type headaches include:

• Sleep problems. Many children who experience chronic daily headaches suffer from sleep disturbances, especially difficulty falling asleep.
• Moderate or severe depression.
• Emotional rigidity in a child and more repressed anger than their peers.
• Family stress. This includes maternal illness or separation, family bereavement, relationship problems, mental illness in a family member, and other stressful family events.
• Problems at school. According to a National Headache Foundation survey, nearly 30% of children miss school because of headaches. For many children, the start of the school season can be a particularly stressful time.

The National Headache Foundation recommends these tips for parents:

• Keep a diary of childâ ' s headaches noting time of onset, length and intensity of attack, location of pain, and food triggers.
• Make sure child gets plenty of sleep at regular times.
• Avoid changes in childâ ' s eating routing (hunger and eating at irregular times can trigger headaches).
• Discuss any headache concerns with childâ ' s doctor.