Migraine Triggers

The management of migraines include identification of certain events or things that can be associated with your migraines—called triggers. The majority of migraine patients have known triggers. 1 The most common types of triggers include stress, menstruation, missed meals, weather changes, and sleep disturbances. 2 Migraine triggers are different for each person, and it is usually a combination of triggers that can make people more likely to experience a migraine. The brain of a migraine patient is sensitive to any type of change, whether in your body or in the environment, and exposure to certain triggers can set off a migraine.

Some common triggers of migraine:

Foods: Alcohol (red wine), artificial sweeteners (like aspartame), caffeine, citrus fruits, monosodium glutamate or MSG (found in canned foods, processed foods, or Asian foods), nitrates (found in processed meats like deli meat, hot dogs), nuts, and skipping meals.

Hormones: menstruation, ovulation, menopause, pregnancy, birth control pills, and hormone replacement therapy.
Lifestyle: emotional stress (anger/depression), changes in sleep pattern, dehydration, and lack of exercise.
Environmental: weather changes, bright or flickering lights, high altitudes, strong odors (perfumes or cleaning agents), and tobacco smoke.

Try to recognize any potential triggers that may cause your migraine attacks. You should record what you think could be a trigger in a headache diary or calendar and review it with your doctor at your next visit. Women should also remember to write down their menstrual cycle to see if this is associated with migraines. Sometimes one type of trigger may not always cause a migraine headache. It is usually exposure to two or more triggers that may make migraine patients more vulnerable to a migraine. For example, drinking red wine during menstruation may trigger a migraine.1

Simple things like drinking plenty of water, eating regular meals, exercising, and a regular sleep schedule, can also be helpful for decreasing the number of migraines you experience. Keeping a healthy lifestyle and knowing your triggers may help reduce your migraine frequency.

Resources:

  • 1. Rothrock, JF. The truth about triggers. Headache. 2008 Mar;48(3):499-500.,
  • 2. Pavlovic JM, Buse DC, Sollars CM, Haut S, Lipton RB. Trigger factors and premonitory features of migraine attacks: summary of studies. Headache. 2014 Nov-Dec;54(10):1670-9.

Adelene Jann, MD, Headache Medicine Fellow, The Headache Institute at Mount Sinai Roosevelt Hospital, New York, NY. April 2012.