Managing migraines can make you feel a lot like a moderate: you need just the right amount of sleep, exercise, or caffeine to keep throbbing headaches and other migraine symptoms at bay. But your efforts to find the perfect balance in life don’t always end in a fairy tale.
As part of migraine management, it can be helpful to know that there are several common migraine triggers that may or may not play a role in headache attacks — either alone or in combination.
Information about these common triggers may help you discover patterns in your life, and you may be able to adjust certain behaviors or expectations accordingly.
What is a migraine trigger?
A migraine trigger is any factor, external or internal, that plays a role in the onset of migraine symptoms. Some triggers are nutritional — what you eat and drink — while others are behavioral, involving factors like sleep, exercise, or even sex, according to the Mayo Clinic.
Still other stimuli are associated with your physical environment, such as certain smells, sounds, or bright or flashing lights. It can be more difficult to avoid these types of triggers, as you may encounter them unexpectedly.
Whatever your personal migraine triggers, you should not expect them to always lead to migraine symptoms. But you may be able to predict the likelihood of migraine symptoms based on combinations or patterns of triggers.
Why single triggers don’t always trigger a migraine attack
Many people believe that the best bet for managing migraines is knowing your triggers and avoiding them. But one trigger may not trigger a migraine every time, and your triggers may change over time, according to the Migraine Trust.
In fact, you probably won’t have an attack unless you’re exposed to more than one trigger.
The Migraine Trust uses the example of a young woman whose triggers are stress, changes in hormone levels, and skipped meals. If you come home late from a stressful work meeting just before your period is due and then go to bed without having dinner, you’re more likely to suffer a migraine attack than if only one of these conditions were present, according to the Migraine Trust.
What researchers have called “multifactorial” causes of migraine means that it may make sense to think of your triggers as individual risk factors for triggering a migraine attack, says Robert Kaneki, MD, director of the University of Pittsburgh Headache Center and director of the Headache Center at the University of Pittsburgh. Associate Professor of Neurology.
Once you get a feel for the individual triggers that can affect you, you can learn about the combination of these risk factors that usually produce a migraine attack for you.
List of migraine trigger strikes
The list of possible migraine triggers is long, and the list of possible combinations is even longer. But paying attention to different triggers that may occur around the same time can lead to better migraine control. Here are some of the main “risk factors” that you should be aware of.
- Sleeping too much or too little Some people get migraines when they sleep less than usual, says the Mayo Clinic. But sleeping more than usual can do the same thing, for example when you sleep in at the weekend when you are sleep deprived during the week. Consistency is key when it comes to sleep for people with migraines.
- Going too long without eating Hunger is known to be a trigger for migraines, according to Johns Hopkins Medicine. As with your sleep schedule, you may benefit from eating regular meals and snacks at the same time each day. It can also be helpful to keep a snack on hand to keep you going in case the meal is late.
- Increase or decrease stress Emotional stress is one of the most common migraine triggers, according to the Cleveland Clinic. Stressful events trigger the release of certain chemicals in your brain, and these changes can trigger migraine symptoms. But the change that occurs when levels of these chemicals drop can happen, such as relaxing after a stressful day at work.
- Too little or too much caffeine If you consume caffeine on a regular basis, skipping or delaying your usual coffee, tea, or soda can lead to headaches. This is because your blood vessels get used to this expected dose of caffeine and don’t function without it, according to the Cleveland Clinic. The Cleveland Clinic advises that caffeine can also relieve migraine symptoms but should not be used for this purpose regularly.
- drying According to the American Migraine Foundation, about a third of migraine sufferers claim dehydration as the trigger. For some people, even slight dehydration can trigger a headache, so it’s important to carry water with you and keep track of your fluid intake if you think you may be prone to this problem.
- intense exercise Regular exercise can be beneficial for people with migraines because it triggers the release of natural pain-reducing chemicals called endorphins in your brain, according to the American Migraine Foundation. But suddenly getting more active or more intense activity than you’re used to can trigger a release of stress hormones or it can lead to hunger or dehydration—all possible mechanisms for triggering migraine symptoms.
- Changes in hormone levels The American Migraine Foundation reports that women are more likely to get migraines than men, and up to 75 percent of women tend to experience symptoms around the time of their menstrual periods. Some birth control methods stabilize hormone levels and prevent or reduce migraine symptoms, so this may be an issue worth discussing with your doctor.
- alcohol Alcoholic beverages, especially wine, are a common migraine trigger, according to the Mayo Clinic. It’s a good idea to pay attention to the relationship of alcohol intake to migraine symptoms, and to make any necessary adjustments to your drinking habits accordingly.
- certain foods It’s widely known that certain foods — such as aged cheese, cured meats, or anything with MSG — are migraine triggers. But any food or food ingredient, such as an additive or preservative, may be a personal migraine trigger for you, notes the Cleveland Clinic. By keeping track of what you eat over an extended period of time, you may be able to link certain dietary patterns to your migraine symptoms.
- Smoking or exposure to secondhand smoke Exposure to tobacco smoke can trigger migraines for some people — but so can exposure to smoke or fumes from other sources, according to the Cleveland Clinic.
- overheating Hot weather can be dehydrating and may be a migraine trigger on its own for some people, according to the American Migraine Foundation. You may benefit from modifying your routine if hot weather is associated with your migraine symptoms; For example, you could try running some errands early in the morning or late in the evening.
- changes in the weather The American Migraine Foundation notes that many different types and changes in weather can be migraine triggers, including temperature fluctuations, humidity fluctuations, storms, and barometric pressure changes. You probably can’t do anything to avoid these triggers, but you can be aware of them and take any medications as indicated if you feel migraine symptoms starting.
- Bright lights or loud sounds The Mayo Clinic notes that bright or flashing lights are a widely known migraine trigger, as are loud sounds from sources such as construction or music. If these triggers are affecting you, your best bet is to try to avoid situations where these lights or sounds may be present.
- neck pain While neck pain may be a symptom of a migraine, it can also be a trigger for some people — meaning that neck pain from causes unrelated to a migraine may trigger a headache or other symptoms. You may be able to avoid or improve certain forms of neck pain by adjusting your pillows or sleeping position, and ensuring good posture while working on your computer or looking at your phone.
- Aromatherapy The American Migraine Foundation notes that certain odors, from food smells to perfumes, trigger migraines in some people. If this applies to you, try your best to avoid known triggers, including by telling your co-workers of any allergy to perfume or cologne.
How much control migraine attacks?
Some migraine triggers, like the weather, are unavoidable, and even when you steer clear of avoidable triggers, you might have an attack anyway. why is that?
Dr. Kaneki explains that the reason migraine management is so challenging is because there are multiple genetic forms of migraine and the many potential triggers that can affect the genetically predisposed nervous system in a way that leads to migraines.
“So far, we have yet to identify the most common genetic variations responsible for migraine in the population,” says Kanyeki.
Although migraine disease is complex, in simple terms, people with migraines have a highly excitable brain — meaning it reacts at a lower threshold than it might in someone without migraines, according to a research paper published in the journal Neurology. NeuroImage: Clinical in 2020. This leads to an inflammatory process that results in headaches and other symptoms.
The state of hyperexcitability that leads to migraines is thought to be inherited, but there are likely hundreds — perhaps thousands — of genes that contribute to a predisposition to migraine.
Lifestyle steps to prevent migraine attacks
Healthy lifestyle habits will help an overexcited brain stay stable. In addition to looking for trigger patterns, the Cleveland Clinic says you may be able to reduce attacks or their severity by:
- Regular meals and snacks
- A well-structured sleep schedule (avoid napping and sleeping in on weekends)
- Good hydration
- regular exercise
- Relaxation techniques such as qigong or guided imagery
Lifestyle modifications can make a huge difference in managing migraines, but they are not a panacea. Work with your doctor to find a combination of medications, lifestyle habits and therapies such as neuromodulation or psychotherapy that work best for you.