More people than ever are also using apps to manage their health; according to EMarketer, a company that provides analytics and insight into digital marketing, nearly 7 out of 8 smartphone owners in the United States used a health or fitness app in 2020.
Migraine Apps’ Capabilities Are Evolving
If you’re searching for an app to help you manage migraine, it pays to do a little homework before jumping in. Even if the app is free, it will require some effort and input on your part. The capabilities of apps have evolved over time, says Mia T. Minen, MD, MPH, a neurologist and researcher who specializes in headache medicine at NYU Langone Health in New York City. “Patients are able to track their headaches, medications, various symptoms, menstrual cycles, sleep, and mood. There are some apps that even offer treatment interventions,” Dr. Minen says. When selecting an app, it’s important to be aware of what information will be useful to help your doctor in treating your migraine. “There is a lot of ongoing research examining the different ways to integrate apps into clinical care,” says Minen. It’s also a good idea to check out the privacy policy of any app before you start using it, she says. “Some of the apps may sell your data. It may be aggregated data, but that’s just something that consumers should be aware of,” she says. Whether you’re wondering if your current migraine app is worth your time or you’re just beginning your search, keep reading for expert advice on what features are important in managing your headaches. Tracking headache days can also be useful for women to see if there is a menstrual association with the headaches, she says. RELATED: 7 Top Remedies for Menstrual Migraine Entering what kind and what dose of any medications you are taking — both over-the-counter and prescription drugs — is also a way that your doctor can monitor whether you are at risk for medication-overuse headache. The International Headache Society defines medication-overuse headache as a headache occurring on 15 or more days per month for more than three months in a person with a preexisting primary headache and developing as a consequence of regular overuse of acute or symptomatic headache medication (on 10 or 15 or more days per month, depending on the medication).
Focusing Too Much on Migraine Triggers May Not Be Helpful
Many migraine phone apps are focused on identifying possible triggers that bring on an attack, says Minen. “There are certain well-known triggers such as dehydration, poor sleep hygiene, and stress, but I think many patients wind up spending a lot of time trying to figure out additional triggers,” she says, adding that there are a few issues with this. “We know from migraine studies that it’s oftentimes not just one trigger but a multitude of triggers combined, some of which may have even occurred more than 24 hours prior to the start of the attack,” she continues. “Triggers that happen a day or more before the headache may not even be on the patient’s — or the app’s — radar.” There are also situations in which it’s unclear what the association is, she says. For example, if someone consumes caffeine close to the time of a migraine attack, was the headache caused by caffeine withdrawal or was the caffeine potentially being used to try to treat the migraine? (Minen adds that caffeine is not the recommended treatment for migraine.) Minen points to chocolate as another example. “People will oftentimes think chocolate is a trigger for their headaches based on their tracking, but it could be that chocolate was just a premonitory craving prior to the migraine. They could just crave chocolate before a migraine, and that wasn’t the trigger,” she says. RELATED: The 11 Most Common Headache and Migraine Triggers, and How to Deal With Them Because you don’t know the methods behind the app development, be careful of drawing conclusions based on data that you’re putting in, says Minen. “I’m not sure that focusing the majority of your time and attention on all of the potential triggers is the best way to utilize these headache diaries and apps,” she says.
Look for Apps That Offer Evidence-Based Interventions
Minen is interested in apps and wearables that have integrated some of the evidence-based information that doctors have about managing migraine into their app. “Some of these apps aren’t necessarily designed for migraine, but they may address issues that are known migraine triggers such as sleep problems or stress management,” she says. Apps that use evidence-based treatment strategies for these and other migraine-related issues are good options for many patients because of their accessibility, she adds. For example, biofeedback has good evidence for treating migraine, says Minen. There are apps and wearables available through which you can do biofeedback virtually, she says. There is usually an upfront cost for wearables, which can run from $100 to $300. These devices can monitor variables such as heart rate, heart rate variability (HRV), and respiratory rate, which are all indicators of stress, a common trigger for migraine. Heart rate is a measure of how many times your heart beats per minute, while HRV measures the amount of time between beats. Unlike heart rate, a higher HRV is generally desirable and considered an indicator of health and cardiovascular fitness, as well as a person’s ability to adapt to stress and environmental demands. Respiratory rate is the number of breaths you take each minute. One device that uses biofeedback is the HeartMath Inner Balance sensor, says Minen. You put the sensor on an earlobe, and it collects information to determine the level of stress you are under, then uses that data to direct you how to breathe. The breathing exercises, along with an intentional shift toward a positive emotional state, aims to help users reduce stress, which can benefit many aspects of health, including the management of migraine. Minen was part of a study published in the March-April 2021 issue of General Hospital Psychiatry that looked at the app’s effectiveness in people with migraine. “We found that patients who utilized it had improvements in their migraine quality of life,” she says. There are also apps that offer interventions to improve sleep issues, which are also associated with migraine attacks, says Minen. A study published in February 2020 in the journal Headache found that digital cognitive behavioral therapy for insomnia in women showed potential benefit and should be studied further.
Apps That Support Healthy Lifestyle Habits May Be Useful
There’s a lot of potential benefit for apps that track behaviors like drinking water, sleep habits, and exercise, says Minen. “However, we conducted a study where we looked at actual interventions of the commercial apps out there, and very few of them look at interventions — they are really just collecting the data,” she says. Further research needs to be done, but apps with reminders about dehydration, sleep hygiene, and things like that may be useful, says Minen.
Apps to Help You Manage Migraine
It’s a good idea to check in with your doctor if you’re considering trying a migraine app, especially if you’re planning on sharing any data with them. One way to find an app is to check the M-Health Index and Navigation Database by Beth Israel Deaconess Medical Center. The site has filters to help you search for apps that fit your values, needs, and preferences. Here are six apps with tools to track your symptoms, triggers, headache days, and medications. It’s important to note that although all the apps are free, you may have to pay a subscription fee to access all the features.
1. Migraine Buddy
Price Free Migraine Buddy, designed by data scientists and neurologists, has everything you need to track, understand, and help prevent migraine attacks. Its features include a questionnaire to help pinpoint what could have triggered an attack, along with a diagram that allows you to note exactly where the pain is located. The app records the information you put in and produces detailed reports about your migraine disease, including number of attacks, when and where they occurred, pain intensity, and more. Migraine Buddy also offers a sleep tracker, which correlates your sleeping patterns with the onset of your migraine attacks. And the app allows you to connect with your loved ones so they can check in on how you’re feeling.
2. iHeadache
Price Free iHeadache functions similarly to many migraine apps, in that it tracks and records headache pain, intensity, and frequency. What sets this neurologist-designed app apart is its data aggregation feature. iHeadache takes the information users record and compares it with the International Headache Society’s classification criteria. That way it determines what type of headache the user is experiencing — migraine, probable migraine, tension headache, or unclassified headache — and what may have triggered it. Identifying whether your headache appears related to stress, diet, weather, or something else can be helpful in finding the right treatment.
3. Migraine Monitor
Price Free Migraine Monitor is one of two apps that are recommended by the National Headache Foundation. It offers a way to track headache days, headache duration, and migraine severity. It also provides weather data for people whose migraine attacks can be brought on by changes in the weather. There’s also a way to share the data that’s collected with your doctor.
4. HeadApp Migraine Diary
Price Free HeadApp allows you to record your pain duration, intensity, and type of migraine. You can also keep track of your symptoms, medications, and possible triggers. There’s also a sleep diary. The app uses the information to provide charts and reports (these may require a subscription to the app) that you can share with your doctor.
5. Branch (formerly Ouchie)
Price Free Branch isn’t just for people with migraine; it’s for people with any type of chronic pain. What’s more, the community-based app connects you with others who are experiencing the same type of pain, whether from a sports injury, joint pain from rheumatoid arthritis, or severe headaches. Here’s how it works: First you create a profile to record your symptoms, treatments, pain frequency, and so forth. Then the app connects you with other users who report similar data, so you’re able to swap feedback and tips. All this is part of a project that Branch labels with the hashtag #donthurtalone. MigraineManager allows you to track your headaches and headache-related events, and provides personalized summaries based on the information you provide. The app also provides tools to help manage migraine such as medication reminders and personalized tips.
The Future of Migraine Apps: Integrating Them Into Clinical Care
The next step in the evolution of migraine apps is integrating them into clinical care, says Minen. “People with migraine not only want to track information around their attacks but they also want to be able to download and share that information with their provider through an email or printout,” she says. Minen and colleagues are researching the development of an app with remote monitoring capability. “With this technology, the provider can actually monitor the data that’s going into the app in real time. In the future, the information from the remote monitoring could be used in making medical decisions in terms of medication, titration, changing medication type, or offering behavioral therapies,” she says. This app is still being developed and is not yet available to the public. Additional reporting by Jamie Putman.
