The connection between stress, computer vision syndrome, migraine and insomnia

Computer vision syndrome (CVS), defined as eye problems resulting from excessive screen time due to use of digital devices, may be significantly associated with insomnia and migraines, with stress acting as a central mediating factor, new research suggests.

The researchers used a questionnaire on the line in more than 700 adults, 71% of whom had CVS. Results showed that the presence of SVC and high stress were significantly associated with higher odds of migraine, with stress mediating the association between SVC and migraine/insomnia.

“This study would help doctors prevent computer vision syndrome by educating patients about the importance of taking breaks while using the computer,” he said. Medscape senior research associate Dr. Souheil Hallit, Doctor of Pharmacy, Master of Science and Public Health, Associate Professor at Espírito Santo University in Kaslik, Lebanon.

“Other preventive measures can be taken, such as adjusting screen brightness to ambient lighting, using screen filters and maintaining ergonomic posture,” said Dr. Souheil, who is also the director of the Cross Psychiatric Hospital in Lebanon.

The findings have been published on the line August 11 in journal Primary Care Companion for CNS Disorders .

public health issue

“Computers and monitors have become an essential part of our daily routine,” the researchers wrote. However, prolonged screen time “can lead to harmful health disorders, particularly eye problems,” known as SVC, they added.

Furthermore, the recent increase in education on the line in response to the Covid-19 pandemic turned SVC into “an important public health problem,” they noted.

Prolonged use of digital devices can lead to various signs and symptoms such as pruritus, blurred vision, diplopia, eye pain, headache, back pain, neck pain, shoulder pain, and hand or finger paresthesias. Prolonged computer use can also lead to insomnia.

In addition, the “blue light” emitted by computer screens can disrupt normal circadian rhythms, causing eye strain and insomnia, the researchers noted.

Stress is another trigger for migraine attacks and also a risk factor for progression to chronic migraine from episodic migraine, they added. Also, stressful everyday events can lead to insomnia.

“We decided to conduct this study because the use of computers has become essential in our daily lives. Furthermore, the prevalence of CVS is increasing in other populations and there are no Lebanese studies available in this regard,” said Dr. Souheil.

“We also thought that clarifying the existence of this syndrome would help implement preventive measures to reduce the high prevalence of CVS in computer users,” the researcher added.

The researchers used a questionnaire on the line in digital device users from all districts of Lebanon, and data collection took place during government-imposed restrictions due to covid-19.

749 study participants (average age 24 years; 65.6% female) were recruited using a snowball sampling technique, in which links were sent via what’s up and electronic mail. In addition, participants were asked to send connection to other users of digital devices.

The questionnaire consisted of closed and semi-open questions and covered the following items: sociodemographic characteristics, eye diseases, use of computer screens, accumulated number of hours of computer use, Computer Vision Syndrome Scale (consisting of 16 symptoms related to inappropriate computer use), Assessment Scale disability from migraine (MIDAS, from the English Migraine Disability Assessment Scale), Lebanese Insomnia Scale (LIS-18). Lebanese Insomnia Scale) and the Beirut Grief Scale (BDS-10). Beirut Hazard Scale).

the most unpleasant symptom

The results showed that 70.5% of the participants had CVS. Headache was reported as the “most unpleasant eye symptom” (34%), followed by eye burning (10.8%). Extraocular symptoms that bothered the most were neck pain and back pain (43.3% and 33.4%, respectively).

After analyzing the factors associated with insomnia, the researchers found that women had significantly more insomnia than men (P = 0.041). Insomnia was also more common in participants with a higher level of education (P < 0.001), presence of SVC (P = 0.003), high stress (P < 0.001), a higher household agglomeration index (P < 0.01) and greater disability due to migraine (P < 0.01).

Multivariate analysis using a linear regression model and considering the insomnia score as a dependent variable showed that the presence of SVC (β = 3.26) was significantly associated with a higher rate of insomnia.

The researchers also looked at factors associated with migraine and found that women had significantly more migraines than men (51.3% against 41.5%, respectively; P = 0.01) and had higher SVC rates (53.8% in regards to 35.7%; P = 0.001).

Participants with migraine had a particularly higher mean stress score compared to subjects with a lower stress score (13.90 in regards to 9.92, respectively; P < 0.001).

SVC and high stress were significantly associated with higher odds of migraine, as evidenced by the following table:


RRa for migraine (95% confidence interval)

Value P


1.66 (1.07 to 2.59)


great stress

1.09 (1.06 to 1.12)

< 0.001

Mediation analysis showed that stress mediates 52.8% of the association between SVC and migraine, and 80% between SVC and insomnia.

Doctor. Souheil noted that the study “may help clinicians” manage insomnia.

“By focusing on the fact that computer use before bed is associated with insomnia, particularly when the individual is experiencing stressful daily events, clinicians can treat insomnia without the need for medication,” he said.

“Furthermore, the finding that mesh-related headache is the most troublesome symptom of CVS would help clinicians to non-pharmacologically treat headaches with some preventive measures, such as using a blue light filter when using a computer screen,” added Dr. Souheil.

variable risk

commenting on MedscapeDr. Alison Thaler, MD, assistant professor of neurology at Icahn School of Medicinein the United States, and a member of the editorial board American Migraine Foundationnoted that stress is “an important risk factor for migraine.”

It can also “lead to poor computer posture, which over time can activate trigger points in the neck and shoulder muscles that can trigger migraines,” said Dr. Alison, who was not involved in the research.

For this reason, “it makes sense that higher levels of stress might strengthen the association between SVC and migraine. The more stress, the more likely that SVC is associated with migraine,” she said.

dr. Alison added that understanding the relationship between screen time and migraines is important because screen time can change.

“We can limit screen time when possible, avoid screen use before bed and use blue light filtering glasses to prevent CVS from causing migraine attacks,” she said.

However, she noted that the study was associative and did not establish a causal relationship between SVC and migraine.

“Future studies are needed to better elucidate the relationship between screen time and migraine,” said Dr. Alison.

The source of funding for the study was not specified. The researchers and Dr. Alison Thaler reported no relevant conflicts of interest.

Prim Care Companion CNS Disorder. Published on the line August 11, 2022. Full text

Batya Swift Yasgur is a freelance writer with a consulting practice in the US. She is a regular contributor to several medical journals, including Medscape and WebMD. She is also the author of several consumer-oriented health books, as well as “Behind the Burka: Our Lives in Afghanistan and How We Escaped to Freedom” (a memoir by two brave Afghan sisters who told her their story).

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