Here are some common triggers to look out for and some guidance on how to find relief

Triggers

Migraine triggers are different for everyone. The way they work is complicated and involves the blood vessels, neurons, and chemicals, in and around your brain. What sets off a migraine for you may not be the same thing that sets it off for someone else. That being said, here are frequently reported triggers.

Stress

Stressful situations can often set off a migraine for a number of reasons. During stressful events, chemicals are released in the brain. These chemicals can start a cascade within the brain that results in dilated blood vessels that throb, and increased sensitivity in the pain receptors in the areas affected. Feeling anxiety or worry can also increase muscle tension, making a migraine more severe. 

Hormonal changes

Some women notice that migraines are more prevalent during certain times in their cycle. The abrupt dip in estrogen before your period can lead to a migraine. Other hormonal changes such as starting birth control pills, entering menopause, and beginning hormone replacement therapy can also cause more frequent migraines. 

Sleep changes

The link between sleep and migraines isn’t completely clear. But in one study, over 50% of participants reported lack of sleep or sleeping in late increased their chances of getting a migraine. Poor quality sleep has also been associated with increased migraines. And at the same time, many people report that sleep helps relieve their migraines once they’ve started.

Sensory stimuli

Harsh, flashing lights, as well as loud noises, can prompt migraines. Some people even find that certain smells such as strong perfume or smoke are triggers.

Food

Additives in food such as preservatives, aspartame, and nitrates are also common triggers. You may find that eating foods you are allergic or sensitive to may also cause migraines. 

Weather

People who suffer from migraines can be very sensitive to weather changes. For some, weather changes lead to changes in serotonin and other chemical levels in the brain, which can induce a migraine. Weather-related triggers include:

• Bright sunlight
• Rain or stormy weather
• Extreme cold or heat
• High humidity
• Dry air
• Barometric pressure changes

While these triggers are the most common ones, people report all sorts of things that lead to migraines such as physical exertion, decreased caffeine intake, and certain medications. It can be helpful to keep a migraine journal and jot down when you get a migraine. You can get to the bottom of your triggers by detailing the date and time the headache occurred and information about what you did or experienced in the hours leading up to the attack.

Tips for managing migraines

The best way to deal with migraines is to prevent them from happening altogether. Once you know what sets off your migraines, try to avoid those things to the best of your ability. Here are some lifestyle changes that can mitigate migraine attacks:

Sleep

Try to get a consistent eight hours of sleep every single night.

Stay hydrated

Make sure you are drinking the recommended eight glasses of water a day.

Eat regular meals

Eat when you’re hungry and be careful to not skip meals to help control the frequency of migraines.

Try acupuncture

According to research conducted by Cochrane, patients who tried traditional acupuncture to relieve chronic migraines found the frequency of their headaches was cut in half compared to those who did not receive traditional acupuncture. 

Minimize stress

This may be easier said than done, but minimizing stress in your life will definitely help ward off migraines. Don’t know where to start? Try Ovia’s Daily self-care checklist in the “More” menu. 

Finding relief

Sometimes, you are unable to avoid a migraine trigger, or you don’t notice the warning signs of an impending migraine until it hits you. Here are some ways to find relief when a migraine strikes.

• Have some caffeine: Small amounts of caffeine can help reduce pain and can help over-the-counter pain medications such as acetaminophen work better.
• Reduce noise and light: Migraines often lead to increased sensitivity to light and sound. Even regular lighting and noises can amplify the pain of a migraine, so the best thing to do in that situation is to get into a dark, quiet room.  
• Place a cool cloth or ice pack on your head: Many people find the cooling sensation of a dampened cloth or ice pack relieves some of the throbbing pain. 
• Drink water: Since dehydration can lead to migraines or make them worse, taking slow sips of water can help ease some of the tension from a migraine. 
• Medication: There are two categories of migraine medications: preventive and abortive. People who suffer from four or more migraines a month may get a recommendation from their healthcare provider to take preventative medication. Those who have migraines less frequently may be prescribed abortive migraine medication that they take when they feel a migraine coming on. 
• Sleep: We can’t stress the importance of sleep enough! Sometimes, the best way to deal with a migraine is simply to sleep it off. 

Reviewed by the Ovia Health Clinical Team

Sources

• Michael J. Arnold, MD and Jeanette M. McIntyre, MD. “Acupuncture for Migraine Prevention.” Am Fam Physician. July 1, 1996. https://www.aafp.org/afp/2017/0701/p23.html.
• Jerry W. Swanson, M.D. “Migraines: Are they triggered by weather changes?” Mayo Clinic. Mayo Clinic. May 10, 2019. https://www.mayoclinic.org/diseases-conditions/migraine-headache/expert-answers/migraine-headache/faq-20058505.
• “Migraine Headaches.” Cleveland Clinic. Cleveland Clinic. March 3, 2021. https://my.clevelandclinic.org/health/diseases/5005-migraine-headaches.
• Mayo Clinic Staff. “Migraine.” Mayo Clinic. Mayo Clinic. July 2, 2021. https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201.
• F Michael Cutrer, MD. “Pathophysiology, clinical manifestations, and diagnosis of migraine in adults.”UpToDate. UpToDate. November 5, 2020. https://www.uptodate.com/contents/pathophysiology-clinical-manifestations-and-diagnosis-of-migraine-in-adults.

Anyone who suffers from migraines knows first-hand how disruptive and debilitating they can be. While some people experience warning signs that a migraine is coming on, others are caught off guard.

While we don’t have all the information about what causes a migraine, there’s a lot we do know. Let’s review some of our most asked questions. 

What is a migraine?

A migraine is a type of headache (there are 150 kinds). While many people get headaches (roughly 50% of the U.S. adult population), migraines are less common, impacting 12-15% of people. They’re characterized by:

• A pulsing, throbbing or pounding headache that becomes moderate to severe
• Typically one-sided
• Light sensitivity
• Appetite decrease
• Changes in body temperature (feeling too warm or too cold)
• Dizziness 
• Blurry vision 
• Nausea and vomiting 

How long do they last? 

Migraines typically last from 4-72 hours. 

And will it happen again? 

Probably. Most people who get migraines will have 2-4 per month, but it’s different for everyone. 

Who is most likely to get a migraine?

Women are 3x as likely as men to experience migraines. Those who have high-stress levels, or are struggling with their sleep are also at a higher risk. And then, there is a genetic factor. If you have a relative who suffers from migraines, there’s a higher chance that you will too. While the specific genetic cause of migraines hasn’t been identified, there is a higher incidence of migraines in children of parents who suffer from them as well. 

Does my cycle impact my migraines? 

Possibly, yes. Hormone changes can be a trigger for migraines in women. If you notice that your migraines tend to come around the start of your period, this could be a sign that estrogen fluctuation is a factor in your migraines. 

Are there any signs I can look out for that a migraine is coming on?

Migraine headaches have four stages (though not everyone goes through each stage): the prodrome, the aura, the headache, and the postdrome. In the first phase, the prodrome, you might notice: 

• Mood changes
• Nausea and/or fatigue
• Muscle stiffness
• Food cravings 
• Increased need to urinate 

These signs can alert you that a migraine is coming on. Many people choose to take migraine medication during this stage or get extra rest to help mitigate the headache symptoms and possibly shorten the duration of the migraine.

What’s an aura?

About 25% of people who get migraines also get auras – also known as the second phase of a migraine. For those who miss the prodrome symptoms, the aura can be the sign that a migraine is approaching. Most often, an aura is visual. You might notice flashes of light, bright spots or shapes, or vision loss either in a single field of vision, or complete (temporary) loss of sight in one or both eyes. 

The non-visual symptoms of the aura phase are:

• Loss of other senses like hearing or feeling
• Pins and needles sensations, burning or pain
• Weakness or numbness in your face or on a side of your body
• Difficulty speaking
• Uncontrolled jerking or movements of a body part

It is important to note that these symptoms can overlap with the symptoms of a stroke and can be very frightening. The important distinction between migraine aura and stroke is the aura symptoms resolve completely and do not have a lasting effect. Whereas a stroke causes long term and often permanent changes in function.

How do I know the migraine is over?

After the throbbing headache comes the postdrome – which looks different for everyone. Some people notice when they move their head, the area that was throbbing hurts, some experience feelings of sadness, while others feel elated. It’s also common to experience difficulty concentrating and tiredness. 

What causes migraines?

Headaches are categorized as either primary headaches or secondary headaches. A primary headache means it is the sole issue and is not a symptom of a larger disease process. A secondary headache is the sign of another health issue. Migraines are primary headaches, meaning they are not a symptom of a bigger issue, they are the issue. 

Here are some common causes of migraines:

• Female hormones: Women are more likely to experience migraines due to estrogen fluctuation. Migraines are closely linked with the menstrual cycle for some women.
• Stress level: Those with a generally high stress level or those who experience stressful events are more likely to have migraines.
• Lifestyle choices: Like alcohol use (particularly wine), not eating, poor sleep
• Caffeine: If you have too much caffeine, or are experiencing caffeine withdrawal, that can bring on a migraine. 
• Food sensitivity: Some foods and beverages can be responsible for migraines. For example: aged cheese, alcohol, foods containing nitrates. 
• Genetics: If you suffer from migraines there’s a very high chance that a relative of yours does too.

Is a migraine a sign of a larger health issue? 

Not usually. Migraines themselves are the issue – they’re not typically a sign of other health issues. However, if this is new for you, it’s a good idea to check in with your provider as they can properly diagnose you and you can discuss treatment options to minimize your suffering. 

How to make a migraine go away?

The first step is to notice what’s causing your migraines. If you’re not sure, keep a journal and note the date/time of your migraine with a detailed overview of your symptoms and other factors. You can find a great list of questions to ask yourself here. That said, for some people it’s not possible to identify a consistent trigger. In either case, getting some sleep, avoiding loud and bright environments, and staying hydrated can help to ease your symptoms.  

Migraine medications?

There are many types of migraine medications. They fall into two categories: preventive medications and abortive. Preventive options are prescribed to those with severe migraines and can be taken daily to ward off migraines. Abortive options are used to treat the migraine at the first sign of it. 

Talk to your provider about your specific symptoms and they’ll be able to help you come up with a treatment plan, which might include medication and/or lifestyle changes. 

Reviewed by the Ovia Health Clinical Team

Sources

• “Migraine Headaches: Causes, Treatment & Symptoms.” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/5005-migraine-headaches.
• “Migraine.” Mayo Clinic, Mayo Foundation for Medical Education and Research. July 2, 2021. https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201.
• “How a Migraine Happens.” Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/headache/how-a-migraine-happens.
• Cutrer, MD, Michael. “Pathophysiology, Clinical Manifestations, and Diagnosis of Migraine in Adults.” UpToDate, UpToDate. November 5, 2020. https://www.uptodate.com/contents/pathophysiology-clinical-manifestations-and-diagnosis-of-migraine-in-adults.