It is estimated that 36 million individuals in the U.S. suffer from migraines. While pharmacological treatments are most often prescribed, adverse side effects cause nearly 70% to delay or avoid taking medication. Treatments such as exercise, that have fewer side effects than medications, are needed. While exercise is effective, not all migraineurs benefit (40% were classified as non-responders in one study), indicating certain aspects should be evaluated. The PURPOSE was to determine if exercise prescribed at a time-of-day in synchrony versus out of synchrony with circadian preference (chronotype) affected responder versus non-responder status when considering monthly migraine load. METHODS: Participants were 7 sedentary individuals who experienced migraines 8+ times per month (age = 34 ± 11 yrs, 167 ± 8 cm, 99 ± 26 kg). The Morningness/Eveningness Questionnaire was completed to determine chronotype. Participants completed one month of exercise (3 x week, 30-min, 60-70% estimated HRmax) in the morning (before 9:00am) or evening (after 7:00pm) in a randomized counterbalanced order, with a two-week washout period. ‘In Sync’ exercise was considered when a morning type exercised in the morning, and an evening type exercised in the evening. ‘Out of Sync’ exercise was considered when a morning type exercised in the evening, and an evening type exercised in the morning. migraine load was determined using the Headache Impact Test (HIT-6) and Migraine Disability Assessment (MIDAS) at the beginning and end of each month. Responders were considered as any individual with 10% or greater improvement in scores. Chi squared (c2) analysis was performed and significance accepted at pRESULTS: On the HIT-6 evaluation, 43% of participants were considered ‘responders’ after completing in sync versus out of sync exercise (14% ‘responders’) (c2 = 1.4, p = 0.24). Similarly, on the MIDAS evaluation, 57% of participants were considered ‘responders’ after completing in sync exercise, while only 29% of participants completing out of sync exercise were classified as ‘responders’ (c2 = 1.16, p = 0.28). CONCLUSION: While no statistical differences were observed, exercise prescriptions that incorporate a participant’s circadian rhythm may be a promising option toward helping chronic migraine sufferers reduce the monthly migraine load.



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