The first step is to track your migraine symptoms in a diary. Over the course of a few months, it can help you find patterns in when you get headaches and help you pinpoint what kinds of things may make them more likely.
Keep track of things like:
- When your headaches begin, where you have pain, how long it lasts, and whether treatment works
- What you eat, when, and how much
- Vitamins and supplements
- Social and work activities
- Your menstrual cycle
- How you're feeling each day and your level of stress
- How much sleep you get
Learn Your Triggers
When you look at your diary, you might find that certain things tend to lead to a migraine, such as:
- Menstrual periods
- Changes in your sleep pattern
- Certain foods and drinks
- Too much caffeine or withdrawal from it
- Skipping meals or fasting
- Changes in the weather
- Some medications
- Bright, flickering lights
- Certain smells
What to Watch For in Foods
These foods are migraine triggers for some people:
- Those with tyramine, such as aged cheeses (like blue cheese or Parmesan), soy, smoked fish, and Chianti wine
- Alcohol, especially red wine
- Artificial sweeteners
- Monosodium glutamate (MSG)
- Caffeine, which is in coffee, chocolate, tea, and sodas
- Foods with nitrates, such as pepperoni, hot dogs, and lunch meats
- Dried fish
- Salty foods
- Breads and other baked goods
- Dried or citrus fruits
- Pizza, peanuts, and chicken livers
How Stress and Emotions Trigger Migraine
Research shows that a migraine attack often hits 2 or 3 days after a stressful event or a particularly stressful day. Scientists believe that when you're under stress, levels of certain molecules and hormones in your body may go up or down. These changes could trigger a migraine.
Many types of strong emotions are also linked to migraine. Anxiety, excitement, tension, and shock are some examples.
For some people, stress is a direct trigger of migraines. For others, it may simply make you more likely to get an attack brought on by other triggers.
Some people say they get migraines when their stress eases. They're sometimes called "weekend headaches" or “letdown migraines” because they might show up on a relaxing Saturday or Sunday at home after a stressful week at work.
Stressful situations that may trigger your migraine are:
- Tension at work
- Marriage or relationship problems
- Unemployment, financial problems, or low income
- Childhood trauma, including your parents' divorce, physical abuse, or hospital stays
- Anxiety, tension, and nervousness
- Changes in your life, such as having a baby, switching jobs, or moving to a new home
- Juggling responsibilities or struggling to balance work and life
- Lack of sleep
- Stressful surroundings, such as loud noises or harsh lights
- New routines or travel
A migraine headache itself can cause stress, which in turn triggers more headaches later on.
The Link Between Sleep and Migraine
Too little sleep can trigger a migraine, but so can sleeping too much. A migraine may start while you’re snoozing. Other times, sleep can help one go away. Sleep also plays a role in how bad they get and how often you have them.
Almost any kind of sleep issue can be a trigger. Sleep apnea is one of the more common ones. This is when your breathing stops and starts throughout the night. Another common trigger is insomnia, when you have a hard time falling or staying asleep. You may also wake up too early or just never feel refreshed in the morning.
About half of all migraines happen between 4 and 9 a.m. These are called awakening headaches. If you get them, they might have something to do with your sleeping patterns.
Sleep and stress have big effects on each other, too. That can seem like piling on when it comes to migraines. Sleep helps your body and mind recharge. When it doesn’t go well, it affects your judgment, mood, and memory -- and that’s going to affect your stress level.
On the other hand, stress is one of the leading causes of restless nights. Plus, you tend to feel stressed more easily when you don’t sleep well. Then it’s harder to manage your mood, and you’re stuck in a brutal cycle.
One of the reasons for all these links is that headaches, sleep, and mood are all controlled by the same parts of your brain. So when things are off in one area, it has a domino effect on the others. But when you get your sleep back on track and keep your stress under control, you may notice a ripple of positive changes.
Smoking and Migraine
Nicotine is a chemical in tobacco products. It narrows the blood vessels in your body, reducing blood flow to your brain. Researchers once thought that this could trigger a migraine. No controlled trials or studies have clearly tied nicotine to migraines, but some people still report a link between headaches and tobacco exposure.
Nicotine can make it harder for you to get rid of a headache once it starts. It affects how well your liver can break down headache medicine. The result is that the medication you're counting on for pain relief won't work as well, just when you need it the most.
Smokers may have high levels of carbon monoxide, another chemical in tobacco smoke, in their blood and brain. It can trigger headaches.
For some people, the smell of tobacco smoke is enough to cause a headache or migraine. You can also have an allergy to cigarette smoke, which can trigger a headache when you're around it.
It might be possible to prevent some headaches if you quit smoking or stay away from areas where other people are lighting up. For example, if you get cluster headaches, which cause sudden and severe pain around one eye or on one side of your head, you may notice fewer symptoms if you stop smoking.
Steps to Avoid Your Triggers
- Watch what you eat and drink. If you see a pattern of triggers in your diary, stay away from that item.
- Eat regularly. Don't skip meals. Eat small, healthy snacks.
- Keep water handy. Not drinking enough water is a migraine trigger for many people. Every day, aim to drink about 2 liters. Foods that have a lot of water in them, such as celery and watermelon, are also good.
- Curb caffeine. Too much of any food or drink can trigger migraines. But cutting back suddenly may also cause them. So try to slowly ease off caffeine if it seems to be one of your headache triggers.
- Be careful with exercise. Everyone needs regular activity. It's a key part of being healthy. You can still work out if it’s a trigger. Ask your doctor what would help.
- Get regular shut-eye. Set up a relaxing nighttime routine and a sleep schedule that you stick with every night, even on weekends. Don’t eat anything within 4 hours of bedtime. Don’t drink anything 2 hours before, so you don’t have to wake up to go to the bathroom. Make sure your bedroom is dark and quiet. Use it only for sleep or sex -- no screens, music, or books.
- Downsize your stress. There are many ways to do it. You could exercise, meditate, pray, spend time with people you love, and do things you enjoy. If you can change some of the things that make you tense, set up a plan for that. Counseling and stress management classes are great to try, too. You can also look into biofeedback, where you learn how to influence certain things (like your heart rate and breathing) to calm stress.
- Fight eyestrain. Use a bigger font size when you’re looking at a screen. Put a glare screen on your computer monitor. Maintain good posture to ease stress on your head, neck, and shoulders. Don't forget to get away from your computer for a few minutes every hour.
- Dim the light. Sunlight reflecting off snow or water or suddenly breaking through clouds can start a migraine. Sunglasses with polarized lenses can help dim the glare. Indoors, use soft or dim lights when you can, especially when you feel an attack coming on. You may also want to try green lightbulbs. They’re the only type of light that hasn’t been shown to make a migraine worse. They may even help once one starts.
- Block noise. If noise is a trigger and you know you’re going to be where loud sounds are common, wear earplugs. At home, listen to calming music or sounds with earbuds. Use soft fabrics like rugs and drapes to buffer noise. Plants can help with that, too.
- Avoid tobacco. Stay away from smoky areas. If you smoke, quit. Nicotine withdrawal can cause headaches when you first cut back on cigarettes. But don't let that get in the way of your no-smoking campaign. The symptoms will get better over time.
- Get rid of allergens. People who have asthma or hay fever are more likely to get migraines. To keep allergens out of your home, keep your windows shut and wash your bedding once a week in hot water. Clean carpets, rugs, and upholstered furniture often with a vacuum that has a high-efficiency particulate air (HEPA) filter. An air cleaner with a HEPA filter also may help.
- Skip the smells. If strong smells are a trigger, use unscented or fragrance-free products in your home, and don’t store any items that give off strong chemical odors. You may even want to stop cooking foods that have pungent odors. Ask friends and family to not wear heavy scents when they come over.