Migraine History and Outcomes in Military Pilots and Flight Surgeons

Hesselbrock, Roger; Haynes, Jared T

doi:10.3357/amhp.5980.2022

Cited by 2 publications

(1 citation statement)

References 21 publications

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“…Previous work has not specifically examined sex differences in self-reported symptoms following acute hypoxia. In general, headaches and migraines are more common among women in both military and non-military populations ( Guo et al, 2019 ; Moore et al, 2019 ; Allais et al, 2020 ; Hesselbrock and Haynes, 2022 ). Increased report of headache during hypoxia for females is particularly relevant in an aeromedical context because headache frequency is a major factor influencing suitability for aviation service ( Hesselbrock and Haynes, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Sex comparisons in physiological and cognitive performance during hypoxic challenge

2022

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Within the tactical aviation community, human performance research lags in considering potential psychophysiological differences between male and female aviators due to little inclusion of females during the design and development of aircraft systems. A poor understanding of how male and female aviators differ with respect to human performance results in unknown potential sex differences on aeromedically relevant environmental stressors, perchance leading to suboptimal performance, safety, and health guidelines. For example, previous hypoxia studies have excluded female participants or lacked a sizeable sample to examine sex comparisons. As such, progress toward sensor development and improving hypoxia familiarization training are stunted due to limited knowledge of how individual differences, including sex, may or may not underlie hypoxia symptoms and performance impairment. Investigating sex differences bridges the gap between aerospace medicine and operational health, and addressing hypoxia is one of many facets yet to be studied. In the current study, we retrospectively examined N = 6 hypoxia studies with male-female participant samples (total, N = 189; male, n = 118; female, n = 71). We explored sex as a predictor of physiological response, sensory deficits, the severity of cognitive performance declines, and symptom manifestation via linear and binary logistic regression models. We found that the female sex predicted lower peripheral oxygen saturation and the likelihood of headache reporting in response to hypoxic challenge, yet explained little variance when combined with age and body mass index. The sensory and cognitive performance models did not converge, suggesting high intra-individual variability. Together, sex, age, and body mass index were not the most robust predictors in responses to hypoxic challenge; we cannot infer this for sensory deficits and cognitive performance within an experimentally induced hypoxic environment. The findings have implications for improving hypoxia familiarization training, monitoring sensor development, and emergency response and recovery protocols in case of a hypoxia occurrence suitable for all aircrew. We recommend continuing to elucidate the impact of sex and intrapersonal differences in hypoxia and other aeromedically relevant stressors in tactical aviation.

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Section: Discussionmentioning

confidence: 99%

Sex comparisons in physiological and cognitive performance during hypoxic challenge

2022

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Aeromedical Risk of Migraine

Mainland,

Skinner,

Saary

2024

Aerospace Medicine and Human Performance

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INTRODUCTION: Migraine is a common condition that can carry considerable risk to aeromedical duties. Because randomized controlled trials are not an appropriate method to evaluate flight safety risk for medical conditions that may cause subtle or sudden incapacitation, the determination of fitness-to-fly must be based on risk assessments informed by extrapolated evidence. Therefore, we conducted a review of current literature to provide background information to inform the aeromedical risk assessment of migraine using a risk matrix approach.METHODS: We identified studies on topics pertinent to conducting an aeromedical risk assessment of migraine. We generated an overview of the literature synthesizing the findings of articles retrieved from searches of Scopus, Ovid, PubMed, and the Cochrane Library published in English from all years, in both general and aircrew populations. International headache and neurology guidelines, as well as headache policies from the U.S. Air Force, were also reviewed.RESULTS: This review includes information on the following topics relevant to conducting an evidence-based risk assessment of migraine: diagnosis, prevalence, incidence, natural course, clinical presentation, triggers, comorbidities, neuroimaging, implications of family history, and efficacy of pharmacological and nonpharmacological therapies.DISCUSSION: This review summarizes current literature on migraine for use in a risk matrix approach to the aeromedical assessment of migraine in prospective and current aircrew. Awareness of the most current epidemiological data related to a variety of migraine parameters facilitates an evidence-based risk assessment of migraine in aircrew and requires iterative updates as new information becomes available.Mainland RL, Skinner CR, Saary J. Aeromedical risk of migraine. Aerosp Med Hum Perform. 2024; 95(2):101–112.

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Migraine History and Outcomes in Military Pilots and Flight Surgeons

Cited by 2 publications

References 21 publications

Sex comparisons in physiological and cognitive performance during hypoxic challenge

Sex comparisons in physiological and cognitive performance during hypoxic challenge

Aeromedical Risk of Migraine

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