Migraine is a complex neurological disorder that causes moderate to severe headaches, usually on one side of the head, alongside other symptoms, such as light and sound sensitivity. About one in four people with migraine experience aura—a symptom that makes people see flashing lights or zig zag lines.
Migraine is a common condition—nearly 15% of people experience migraine globally at some point in their lifetimes. This does not make the condition any more comforting however. Migraine attacks can be very debilitating and may last anywhere from four to 72 hours. People who have chronic migraine can experience 15 or more migraine attacks per month.
While there is no outright cure for migraine, there are steps you can take to minimize attacks or even prevent the onset of symptoms altogether. Knowing what can trigger your attacks and changing any lifestyle habits that worsen your condition can help improve your quality of life.
What Causes Migraine?
Who Is Most at Risk?
While anyone can get migraine, some groups of people experience this condition at higher rates. Factors that raise your risk include:
- Sex: Those assigned female at birth are about three to four times as likely to experience migraine than those assigned male at birth. Changes in hormones, primarily estrogen, can trigger migraine attacks.
- Age: Migraine is most prevalent among adults between the ages of 30 and 39. You can get your first migraine attack as early as your adolescent years and during puberty. However, it is rare for people older than 50 years old to experience their first migraine attack at that age, as migraine typically develops much earlier.
- Family history: Research suggests that migraine may be linked to genetic factors. People who have a family history of migraine are three times as likely to experience migraine than those who do not have a family history.
Certain health conditions can also increase your risk of migraine or make you more prone to developing chronic migraine. These conditions include:
- Obesity: Having an excess amount of fat on your body
- Dyslipidemia: A condition that causes high levels of LDL (or, “bad”) cholesterol
- Diabetes: A disease that makes it difficult for your body to turn glucose (sugar) into energy
- Hypertension: Having a high blood pressure
Some mental health conditions and other neurological conditions can commonly co-occur with migraine. It's important to note that these conditions do not cause migraine. However, people with migraine may also live with one or more of these related conditions. These conditions include:
- Sleep disorders: The two most common sleep disorders that you might also experience with migraine are insomnia (an inability to fall or stay asleep) and sleep apnea (a condition that causes breathing to stop and restart while sleeping).
- Epilepsy: This neurological condition causes seizures. People who have epilepsy may also have migraine.
- Depression: Studies show that anywhere from 28.5% to 36.3% of people with migraine also have a diagnosis of clinical depression or major depressive disorder.
- Bipolar disorder: Bipolar disorder is a condition that causes recurring cycles of mania (mental state of emotional highs) and depression (mental state of emotional lows). Research suggests that more than half of people with bipolar disorder can also experience migraine attacks.
- Anxiety disorders: Anxiety-related conditions such as generalized anxiety disorder (GAD) can co-exist with migraine.
Research shows that genetic factors can increase your risk of migraine. In fact, if you have at least one family member with a history of migraine, you are three times as likely to develop migraine than those with no family history of migraine. More than 50% of all people who receive a migraine diagnosis have a family history of the condition.
Additionally, some types of migraine have a closer genetic link. A child who has at least one parent with familial hemiplegic migraine—a rarer form of migraine that causes migraine symptoms along with muscle weakness—has a 50% chance of developing the same condition.
While genetic testing isn’t currently part of the standard procedure when diagnosing migraine, genetic information and learning about your family history can help inform your healthcare provider about your condition and options for treatment.
How to Reduce the Risk of Migraine Attacks
Although there is no outright cure for migraine, understanding your triggers, making any necessary lifestyle changes, and following your treatment plan can all reduce how often you experience a migraine attack.
Tracking Your Triggers
Migraine triggers look different from person to person. Your personal triggers will depend on how your body reacts to certain environmental factors. These triggers can include but are not limited to:
- Stress and anxiety
- Bright or flashing lights
- Loud noises
- Strong odors
- Physical exhaustion or overexerting your body
- Weather changes
- Tobacco use
- Medication side-effects
- Overuse of painkillers
- Missing meals
Some people may also experience dietary triggers. These foods and drinks may include:
- Aged cheeses
- Dark chocolate
- Cured or processed meats, such as bacon or ham
- Caffeine (or caffeine withdrawal)
One way of tracking your triggers is by keeping a journal. If the traditional pen-and-paper method doesn’t work for you, you may find it helpful to keep a running note on your phone. Logging your environmental triggers and keeping track of what you’re eating can help you and your healthcare provider understand what to stay away from to reduce the frequency of your migraine attacks.
Making Healthy Dietary Choices
Your dietary choices can influence the severity and frequency of migraine attacks. Making subtle, but helpful changes to your dietary habits can help prevent the onset of symptoms.
According to the American Migraine Foundation, preventative dietary choices include:
- Limit your alcohol intake, particularly of red wine
- Reduce how much coffee you consume to less than two cups a day
- Steer clear of any of your known dietary triggers
- Make sure to eat at consistent times every day and do your best to not skip meals
- Drink enough water (13 and 9 cups a day for those assigned male and female at birth, respectively)
- Choose whole-grain foods to your increase vitamin and fiber intake
- Include fresh fruits and vegetables in your diet
- Eat fewer foods that are highly processed or high in salt or sugar
Foods That May Trigger a Migraine
Being Physically Active
While physical overexertion can be a migraine trigger, getting regular exercise can help reduce the frequency of your migraine attacks. Research suggests that aerobic (or, cardio) exercise has several benefits that can improve your migraine symptoms and prevent attacks:
- Reduces stress
- Improves sleep
- Eases anxious feelings and depressive moods
- Boosts heart rate
Exercise sometimes requires a bit more effort and motivation. On days when you’re feeling less than motivated to work out, you may try participating in organized sports or exercising with a loved one or gym partner.
If you don’t work out regularly, start small and slowly increase your workouts. Try not to go over your limit, especially if you’re first starting out with an exercise routine, as overexertion can have the opposite effect on your condition.
The important thing here is to find what works for you. Migraine prevention isn’t a one-size-fits-all plan—it’s OK to take time to learn more about your body and triggers. If you need help learning more about exercise options that are right for you, reach out to your healthcare provider for advice.
Similar to exercise, learning how to manage stress is often a personal journey. Not all stress management strategies will work for everyone, but here are a few techniques that can help get you started:
- Meditating for 10 to 20 minutes per day
- Doing deep breathing exercises
- Practicing yoga
- Stretching your body
- Writing and reflecting in a journal
- Keeping up with activities and people that you enjoy
- Being mindful about not overbooking yourself
- Making time for self-care
- Seeing a mental health professional
Looking for support?
Contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.
Because a lack of sleep or experiencing disruptions in your sleep can increase your risk of migraine attacks, it’s helpful to find ways to improve your sleep patterns and overall quality of rest. You can do this by:
- Going to bed and getting up at consistent times every day
- Aiming for at least 7 to 8 hours of sleep a night
- Making sure your bedroom is dark and quiet before going to sleep
- Avoiding watching TV or using devices in bed
- Reducing intake of alcohol, caffeine, and large meals right before bedtime
- Getting regular exercise so your body feels ready for rest at night
Some people also find that certain medications help reduce their risk of migraine attacks. These medications may include, but are not limited to:
- Beta-blockers: Inderal (propranolol) and Lopressor (metoprolol)
- Calcium-channel blockers: Veralan (verapamil) and Sibelium (flunarizine)
- Angiotensin II receptor blockers: Amias (candesartan)
- Angiotensin converting enzyme (ACE) inhibitors: Qbrelis (lisinopril)
- Tricyclic antidepressants: Effexor (venlafaxine)
- Anticonvulsant (anti-seizure) medications: Topmax like topiramate (Topamax)
- Calcium gene-related peptides (CGRPs): Aimovig (erenumab)
- Botulinum toxin: Botox injection
In some cases, you may find complementary therapies helpful for preventing migraine. These techniques include:
- Relaxation training: Learning how to relax can reduce your migraine headaches. Relaxation training is a technique some mental health professionals use to help you recognize places in your body that feel stressed. A professional will guide you through tensing up certain parts of your body and then slowly relaxing these muscles. Tense-and-release exercises can be effective in minimizing stress.
- Cognitive behavioral therapy (CBT): CBT involves working with a therapist to develop strategies that can help you change your thought patterns—especially the thoughts that you associate with migraine and stress. A 2021 study found that regular CBT can significantly reduce the frequency and intensity of attacks.
- Acupuncture: A therapy that first began in Eastern Medicine, acupuncture uses small needles that a therapist strategically places on your body to boost blood circulation. While researchers are still studying the exact relationship between migraine and acupuncture, studies have shown that people with migraine who receive acupuncture noticed a reduction in their frequency and duration of attacks.
Discuss With Your Healthcare Provider
The complex and unpredictable nature of migraine attacks can make this condition difficult to live with. If you notice you have migraine symptoms, receive a migraine diagnosis or notice changes to your migraine patterns, the first step is to speak with your healthcare provider.
Your healthcare provider can help you learn more about your triggers, help you find ways to prevent attacks, and guide you through various treatment options to improve your quality of life. You may find it helpful to be open and honest about your symptoms and lifestyle habits and keep track of your dietary habits and stress levels. Your healthcare provider will likely ask you about all of these factors before making any recommendations for treatment.
A Quick Review
Migraine is a recurrent neurological disorder that causes severe headache symptoms. While there is no cure, prevention techniques such as tracking your migraine triggers, making healthy food choices, being physically active, managing stress, improving sleep, and taking any prescribed medications on time can help you reduce symptoms and prevent the onset of migraine attacks.