This leaflet is about how some migraine attacks (episodes) may be triggered by various things.
What are migraine triggers?
Most migraine attacks (episodes) occur for no apparent reason. However, something may trigger migraine attacks in some people. It is assumed you have some general knowledge about migraine, but would like to know more about this aspect. (See separate leaflet called Migraine for details about migraine.)
Triggers can be all sorts of things, including:
- Diet and foods. For example: dieting too fast, cheese, chocolate, red wines, citrus fruits, and foods containing a food additive called tyramine.
- Environmental. For example: smoking and smoky rooms, glaring light, computer screens or flickering TV sets, loud noises, strong smells, hot weather.
- Psychological. For example: depression, anxiety, anger, tiredness. In some people migraines occur when relaxing after periods of stress. For example, weekends or holidays.
- Medicines. For example: hormone replacement therapy (HRT), some sleeping tablets, and the contraceptive pill.
- Change in habits. For example: a change in sleep patterns (missing sleep, lying in, etc), missing meals, long-distance travel, jet lag, etc.
- Other. Periods (menstruation), shift work, the menopause.
Some notes about migraine and triggers
It may help to keep a migraine diary. A pattern may emerge, and it may be possible to avoid one or more things that may trigger your migraine attacks. (But note: too much effort trying to identify triggers may cause anxiety. In some people it may do more harm than good to search for triggers, especially if no trigger is found - which is common.)
Many people blame foods as triggers. However, foods are not thought to be common triggers. Suspect a food as a trigger if a migraine occurs within six hours of eating the suspected food and cutting out the food reduces the number of migraine attacks (episodes).
Some people need a combination of triggers to set off a migraine. For example, some women may only get a migraine if they drink red wine and are having a period. Another example is that a food trigger may only set off a migraine if a person is also overtired.
An example of a migraine diary is provided below. It may help to fill it in over 3-4 months so that you and your doctor develop a better understanding of your migraines.
Firstly, fill in the calendar part. This gives an overall picture of when the migraines occur.
- Fill in the days of the week.
- Mark when you have an attack. Note: people with migraine can also have common tension-type headaches. So, in the attack column, indicate when you have a migraine, or a tension-type headache, or if you are not sure.
- If you are a woman and have periods, put a B in the period column on the days you are bleeding.
Then, fill in a notes section for each attack. This gives details of:
- How bad the attacks (episodes) are.
- How well medication helps.
- Possible factors that may have triggered the attack.
Fill in the details of each migraine/headache attack using the following:
Further reading & references
- Diagnosis and Management of Migraine, Tension-Type, Cluster and Medication-Overuse Headache; British Association for the Study of Headache (BASH) Guidelines, (2010)
- Migraine; NICE CKS, August 2013 (UK access only)
- Headaches: diagnosis and management of headaches in young people and adults; NICE Clinical Guideline (September 2012)
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Tim Kenny
Dr Colin Tidy
Dr John Cox