OBJECTIVES : Although migraine symptoms can interfere with many aspects of daily life, the relationship between disability burden and migraine frequency has not been fully characterized. We assessed the association between migraine frequency and patient-reported disability in a nationally representative survey.

METHODS : Using 2019 US National Health and Wellness Survey (Kantar Health) data, respondents (aged 18–65 years) reporting ≥1 migraine in the past 30 days were categorized by headache frequency: low frequency episodic migraine (LFEM, 0–4 days/month), moderate frequency episodic migraine (MFEM, 5–9 days/month), high frequency episodic migraine (HFEM, 10–14 days/month), or chronic migraine (≥15 days/month). A general population cohort (no migraine) with similar baseline characteristics was identified by propensity score matching. Outcomes across cohorts were compared using chi-square and analysis of variance tests.

RESULTS : Data from 8858 respondents (LFEM, n=1962; MFEM, n=987; HFEM, n=554; chronic migraine, n=926; general population, n=4429) were analyzed. Full-time employment was reported by 54.9% with LFEM, 50.4% with MFEM, 45.5% with HFEM, 34.1% with chronic migraine, and 45.9% of the general population; short- or long-term disability was reported by 4.4% with LFEM, 6.4% with MFEM, 7.9% with HFEM,12.3% with chronic migraine, and 6.9% of the general population (P<0.001). Migraine frequency was associated with lower productivity at work (mean missed work days in the past 6 months among those employed [n=2964]: LFEM, 1.6; MFEM, 3.1; HFEM, 3.4; chronic migraine, 7.0; P<0.001) and at home (mean missed days of household activities in the past 6 months: LFEM, 3.6; MFEM, 6.7; HFEM, 10.5; chronic migraine, 19.8; P<0.001).

CONCLUSIONS : Respondents with chronic migraine were less likely to be employed full-time and more likely to report being disabled, and miss work or household activities. There was a positive linear relationship between migraine frequency and patient-reported disability status, indicating that greater migraine frequency is associated with increased disability.