The SEEDS mnemonic describes five types of lifestyle changes that can reduce environmental triggers and help manage migraine
Making changes to your daily routine, like ensuring you get enough sleep, can help decrease the frequency and severity of migraine attacks. Recent research uses the mnemonic SEEDS to outline five types of lifestyle changes you can make to manage migraine: sleep, exercise, eat, diary and stress.
To be clear, migraine is a genetic neurological disease. It’s not your fault. However, you should feel empowered to make lifestyle changes that eliminate or reduce environmental triggers and can reduce the number of migraine attacks you have. But those triggers—like stress, certain foods or poor sleep—are not the cause of migraine.
There are over 100 different genes that may be associated with migraine risk, and everyone has a slightly different combination. This means everyone’s experience with migraine is unique. Some people might not experience migraine attacks very often while others experience attacks very often and respond to small triggers. Avoiding specific environmental triggers can make it less likely you’ll have an attack.
To learn more about SEEDS and lifestyle modifications for migraine management, we talked with Dr. Amaal Starling, a neurologist and headache specialist and an associate professor of neurology at Mayo Clinic in Scottsdale, Arizona about how these five changes can help you better manage migraine triggers.
SEEDS for Migraine
While there are plenty of things out of our control—the weather, everyday stress, a random bad night’s sleep—Dr. Starling shares the five areas where patients can influence their migraine triggers.
Many people with migraine find their sleep is affected. It’s a bit of a cycle: migraine attacks and pain can make it hard to sleep. When someone with migraine doesn’t sleep well, it can trigger more attacks. That cycle makes sleep an important part of migraine management.
Keeping a consistent sleep schedule can help manage migraine. It’s best to keep your bedtime and the number of hours of sleep you get the same each night.
“The goal frequently stated is that one should get about seven to eight hours of sleep a night,” says Dr. Starling. “But the key is going to be consistency. If you find that you will consistently get five hours of sleep a night or nine hours of sleep a night and you feel rested and well in the morning, that’s okay. Keep that as your consistent number of hours.”
Good sleep hygiene is also important. Dr. Starling says the goal is that 90% of the time you’re in your bed, you should be asleep. “If you’re unable to sleep, get up, go outside your bedroom, try to do something else, read a book for a little bit and then come back and see if you can get back to sleep again,” she says.
Phones, tablets and TVs often make their way into the bedroom, but screen time can activate the brain. To help prepare your brain for sleep, avoid using electronics in the two hours leading up to bedtime. A relaxing bedtime routine and a cool, dark room will also set you up for sleep success.
For some people, exercise may trigger an attack or make an attack worse. But research has shown that exercise can reduce the frequency, severity and duration of migraine attacks. Some studies even show that exercise is more effective than the standard oral preventative treatments. It’s believed that exercise elevates levels of beta endorphins, chemicals that can reduce stress and pain, and reduce migraine attacks.
Based on these studies, the recommended amount of exercise is 30 to 50 minutes of moderate-intensity aerobic activity, three to five days a week.
If you’re not currently exercising, start small. “Especially for my patients with migraine, I recommend starting very easy, very slow with minimal impact,” says Dr. Starling. She suggests low-impact activities like water aerobics, gentle stretching, walking, gardening, cycling or using an elliptical machine.
Eat (Food and Hydration)
According to Dr. Starling, our brains thrive on consistency. So it’s important to eat regular meals throughout the day, stay hydrated and avoid fasting. Studies have linked fasting and a lower threshold for head pain and migraine attacks.
Dr. Starling often encourages her patients to eat six small meals a day to keep blood sugar levels steady. Meals that are high in protein, fiber and healthy fats and low on processed foods will help prevent dips in blood sugar that may trigger a migraine attack. Download our free guide to meal planning for migraine here.
While some people find that specific foods, such as red wine or caffeine, will trigger migraine attacks, not everyone has food triggers. This is an area of learning and research that is changing over time. Dr. Starling gives the example of the belief that chocolate is a strong migraine trigger: “With more recent studies, we’ve actually learned that there is a craving for sweet foods, including chocolate, that occurs during what we call the premonitory phase of a migraine attack,” she says. “So craving chocolate may actually be a part of your migraine attack.”
As for hydration, it’s important to drink plenty of water to account for your body’s loss of water through sweating, urination and other bodily processes. The general recommendation is eight 8-ounce glasses of water a day. Many people with migraine also need electrolytes, so incorporating sports drinks or Pedialyte can be helpful.
Keep in mind that caffeine can cause you to pee more often. If you drink caffeine, be sure to drink an additional glass of water for each caffeinated beverage you consume. In addition, caffeine intake or caffeine withdrawal can be a migraine trigger for some.
To receive an accurate diagnosis of your migraine and optimized treatment options, keep a headache diary and share it with your doctor. A diary is an important tool to identify patterns that could suggest episodic, chronic, menstrually related or other types of migraine and guide your doctor to the appropriate preventive and/or acute treatments.
Especially for people with frequent or daily migraine, keeping a headache diary can be frustrating or confusing. Dr. Starling suggests a “stoplight” diary—a paper calendar you keep next to your toothbrush and mark with a green, yellow and red pen or sticker each night.
“At the end of the day, if you had no pain at all, which is great, then you don’t put anything down,” she explains. “If you had pain that was mild but you were able to function and it didn’t impair your function throughout the day, you put a green dot. If you had moderate pain, a yellow dot. And if it was a disabling day, then a red dot.” This method helps keep track of not only headache days, but also how your migraine affects your function.
While we all experience ups and downs in our day-to-day life, managing stress is a crucial part of managing migraine because stress can be a trigger for migraine attacks. Virtual tools, such as apps like Headspace and Calm, are helpful resources that can guide you through relaxation techniques, mindfulness exercises, meditations, breathing techniques and biofeedback.
In addition, try to limit the amount of time you spend watching TV or reading the news because it can be stress-producing. Dr. Starling recommends keeping it to 30 minutes in the morning and 30 minutes in the evening. “Because I can get sucked in myself, I literally keep a timer to tell me when my 30 minutes are up and then I turn it off and do some deep breathing and then move on with the rest of my day,” she says.
Find activities that decrease your stress, and if possible, avoid or limit those things that increase your stress. Making small lifestyle changes can have a significant impact on your migraine management.
The American Migraine Foundation is committed to improving the lives of those living with this debilitating disease. For more of the latest news and information on migraine, visit the AMF Resource Library. For help finding a healthcare provider, check out our Find a Doctor tool. Together, we are as relentless as migraine.