Migraine “Let Down” Headache

Find out why a decrease in stress can actually trigger a migraine attack and how to avoid these “let down” headaches.

While increased stress poses a threat to those with migraine, the opposite can also be true. Known as “let down” headaches, the decompression from stress can trigger an attack for someone living with migraine.

For many, not being able to relax for the fear of experiencing a migraine attack is all too real. Overcoming “let down” headache starts with understanding what it is, how stress and migraine are related to each other, and how to break the cycle of migraine triggers.

What is a “let down” headache?

People with migraine may experience an attack after they finish a tough day or week at work or school or as they start a vacation. This attack is called a “let down” headache because it starts as stress levels decrease. The phenomenon is backed by science.

One study found that people with migraine who have a drastic decrease in stress levels are at a higher risk of getting a migraine the next day. During the first six hours of a decline in stress, the risk of a migraine attack was almost five times higher than at other times. In the 12 to 24 hours after a person’s mood shifts from ‘sad’ or ‘nervous’ to ‘happy’ or ‘relaxed,’ the likelihood of a migraine attack increases by 20%.

The Relationship Between Stress and Migraine

For many people, stress is a common migraine trigger. But the pain from migraine can also add more stress—creating a frustrating cycle. However, research also found that relaxation after times of heightened stress can be a trigger for migraine attacks. In some cases, even good or happy events can trigger an attack. So, why does this happen?

Researchers believe the hormone cortisol may play a role in triggering a headache. Cortisol is the body’s main stress hormone and helps reduce pain. Cortisol levels tend to increase in times of stress and fall during periods of relaxation. Unfortunately, a migraine attack is often a stressful event and chronic pain like migraine can create high-stress levels. This stress can continue the cycle, triggering future migraine attacks and head pain. As a result, this constant fluctuation of cortisol levels can trigger an attack.

How to Avoid “Let Down” Headaches

There is no true cure for “let down” headaches, but there are effective ways to reduce attacks and manage symptoms. Here are our top tips for avoiding this type of headache:

#1 Maintain a Routine

The migraine brain thrives on consistency. Be sure to stay hydrated and eat regularly throughout the day. Practice good sleep hygiene and set regular sleep and wake times. To help achieve this, avoid caffeine and screens too close to bedtime. Regular and restful sleep paired with lifestyle consistency helps maintain a good routine.

#2 Make Time for What Matters

Prioritize what is most important to you—relationships, personal growth, hobbies or exercise. Your needs are important, so block out time for those activities and, if possible, say no to obligations that add more stress to your life. Slowing down your daily schedule, rather than always rushing from one thing to the next, can help reduce stress.

#3 Monitor and Manage Your Stress Levels

Because “let down” headaches happen as stress declines, it’s important to stay aware of your stress levels. For example, to help prevent that letdown, make an effort to relax during times of stress, not just after them. It can also be helpful to practice good time management, like chipping away at big tasks every day instead of procrastinating and feeling stressed at the last minute.

#4 Practice Relaxation Techniques

Deep breathing, mindfulness exercises, biofeedback, and meditation are a few great ways to relax. Making these techniques a part of your everyday life will help keep your stress levels as steady as possible.

#5 Move Your Body

Physical movement has the power to help your body and mind. It can improve your overall health, sleep, mood, stress levels, and focus. All these help reduce the frequency of migraine attacks. Carve out time for regular exercises, such as walking, yoga, stretching, or even higher intensity exercise if it is not a migraine trigger for you. Many experts recommend 30 minutes of physical activity five days a week, but work out a schedule that will not affect your migraine symptoms.

#6 Let Go of Anxiety

People with migraine can experience a vicious cycle of “let down” headaches. They experience the anxiety of not knowing when their next attack will come and can’t ever truly relax because that relief is a migraine trigger. Though it is easier said than done, reducing the anxiety of uncertainty and incorporating regular relaxation is key to avoiding those ups and downs that trigger pain.

#7 Engage in Cognitive Behavioral or Relaxation Therapy

Cognitive behavioral therapy can help with pain and stress management. This includes activities like meditation and breathing exercises. A therapist may provide guidance on relaxation techniques that can help you manage stress and cope during periods of tension or pressure.

Healthy lifestyle habits can help prevent migraine attacks and “let down” headaches. While these strategies won’t eliminate stress from your life completely, they can regulate your body’s response to changing stress levels. You can better manage your stress levels and migraine by keeping a consistent routine and taking care of your body and mind.

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.

Reviewed for accuracy by the American Migraine Foundation’s subject matter experts, headache specialists and medical advisers with deep knowledge and training in headache medicine. Click here to read about our editorial board members.