Research has shown that habits such as too much or too little sleep and extreme exercise can trigger migraines, and the thinking has been that your best bet for managing migraines is to know your triggers and avoid them. But a trigger may not cause a migraine every time, and your triggers may change over time, according to The Migraine Trust. In fact, it’s likely that you won’t experience a migraine 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 skipping meals. For example, if she comes home late from a stressful work meeting right before her period is due and then goes to bed without eating dinner, she is more likely to experience a migraine than she otherwise would have, according to The MigraineTrust. What researchers have described as the “multifactorial” causes of migraine means you may need to look at your triggers a little differently. It might be better to think of your triggers as individual risk factors for bringing on a migraine instead, says Robert Kaniecki, MD, director of the University of Pittsburgh Headache Center and an associate professor of neurology. Then figure out what your migraine threshold is: what combination of those aggravating circumstances it takes to produce a migraine attack for you.
Your Migraine Trigger Hit List
The list of potential migraine triggers is a long one, and the possible combinations that could add up to a migraine is even longer. But paying attention to the various triggers that are going on simultaneously can lead to better migraine control. Here are key migraine “risk factors” to be aware of:
Too much or too little sleepOvereating or going too long without eatingChange in severity of stress levelDrastically increasing or reducing the amount of caffeine you’re used toDehydrationExtreme exerciseGetting your periodDrinking alcoholEating certain foods (chocolate, aged cheese, deli meats)SmokingBeing in excessive heatLightsExperiencing neck painCertain odors, such as perfume
Some triggers are unavoidable: You can’t stop your period from coming or control the weather. But if you know that skipping exercise and drinking too much coffee when you have your period is sure to bring on a migraine, take steps to avoid the triggers you can control. The reason managing migraines is so challenging, explains Dr. Kaniecki, is that there are likely multiple genetic forms of migraine and many potential triggers. Stress, female hormonal changes, the weather, changes in your daily schedule, and sensory stimulation from fluorescent lights, loud noise, and strong odors can all impact a genetically predisposed nervous system in a way that results in a migraine. “To date, we have yet to identify the most common genetic variations responsible for migraine in the population,” Kaniecki says. Though a migraine is complex, in simple terms it means that your brain is hyperexcitable, meaning it reacts at a lower threshold than it would in someone without migraine, according to a review published in the January 2017 issue of the journal Headache, leading to an inflammatory process that produces headaches. This hyperexcitable state is inherited, but there are likely hundreds — maybe even thousands — of genes that produce migraines.
Lifestyle Steps for Preventing Migraines
Healthy lifestyle habits can help keep a hyperexcitable brain on an even keel. In addition to looking for trigger patterns, the Cleveland Clinic says you can work to prevent attacks by:
Eating meals and snacks on a regular scheduleSleeping on a regular schedule — avoid napping and sleeping in on weekendsStaying hydrated by drinking plenty of waterExercising regularly
