How to manage chronic migraine: Understand the triggers

Chronic migraine can have very simple, everyday triggers. If you know how to manage them, you may find relief from migraines.
Triggers of chronic migraine
Know what may be sparking your chronic migraine. Image courtesy: Shutterstock
Dr Sumit Singh Updated: 23 Oct 2023, 11:39 am IST
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Migraines are severe headaches that can be debilitating. In most cases, migraines cause people to retreat to a dark room, bed and a quiet place. While a typical migraine lasts for a few hours, then several weeks may pass between another attack. An even more extreme form of migraine is chronic migraine, which lasts for at least 15 days in a month with at least 8 days of having headaches with migraine features, for more than 3 months. About 2 percent of the world’s population is affected by it. Come, let us know how to manage chronic migraine by understanding likely triggers.

Many people feel that these attacks seem to appear out of nowhere, but there are often signs before an onset. By studying these signs, one can identify patterns in your migraine symptoms, and even learn the ways to manage chronic migraine attacks effectively. Each person experiences migraines differently, but there are a few common triggers that affect most people living with chronic migraines. Identifying your migraine triggers will help you avoid future migraine attacks and
effectively manage them.

If you want to learn how to manage migraine, you’ve got to start by making a decision to incorporate key lifestyle changes. Follow a disciplined exercise plan, manage your stress levels, stay hydrated, and identify what sparks your headache triggers. Maintaining a migraine diary can be the first step towards managing the attack. Logging the details of migraine attacks, sleeping pattern and eating habits, things that stress you, can prove helpful in diagnosis
and creating a preventive treatment. You should also avoid being ignorant, and know the difference between headache and migraine.

migraine symptoms
Don’t ignore a headache always. Image courtesy: Shutterstock

There is no clear cause for migraines. But you may find some common triggers.

Common causes of chronic migraine

1. Stress can increase risk of chronic migraine

An increase in physical or psychological stress can trigger migraines. A study shows that 50 to 80 percent people suffering from chronic migraine, report stress as a precipitating trigger for their migraine headaches. Some people may experience migraine as a post event of the stress.

2. Lack of sleep may lead to migraine

Inadequate sleep or disturbance in sleeping pattern is one of the most common triggers for chronic migraine attacks. According to National Library of Medicine, 48
to 75 percent of migraine sufferers say that lack of sleep is linked to the onset of their migraine. Sleep disturbance has been consistently identified as a headache trigger.

3. Hormones can spark migraine headache

Migraine headache is said to be thrice more common in women as compared to men. Headache disorders, in fact, rank tenth for women, one level lower than
gynaecological diseases, in a list of global causes of disability-adjusted life years (DALY), and first for young women. Blame it on the fluctuation of a hormone called estrogen, which in women, contributes to the development of chronic migraines.

Also read: Suffering from migraine? 5 ways it impacts your body and life

hormones can affect migraine
Hormonal imbalance is a vital migraine trigger among women. Image courtesy: Shutterstock

4. Eating habits can trigger a migraine attack

There’s a list of foods that are known to trigger migraine attacks. Some of the most common among these are chocolate, cheese and alcohol. Skipping meals can also be a reason for migraine attacks. Research consistently shows that fasting or skipping meals are linked to the arrival of migraine attack. However, it is unclear how fasting-induced migraine headaches work.

5. Beware of excess caffeine consumption

Excessive caffeine consumption can trigger migraine. Hence, it is always recommended to mind your intake of coffee, tea, soft drinks, and energy drinks.

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6. Excessive exercising can also be a cause of chronic migraine

Intense exercise may trigger migraines. According to a study of The Journal of Headache and Pain, 38 percent of people with migraine experience exercise-triggered migraine attacks at some point. People reported neck pain as an initial migraine symptom too.

7. Lights can be the enemy for you

Bright, flickering, or fluorescent lights may lead to a migraine attack. For some migraine patients, natural light is also one of the enemies. Sunlight may trigger a migraine attack in people. Hence, it is recommended to wear a sunglasses or a hat while travelling on a hot day.

Sunlight leads to migraine
Sunlight can lead to migraine! Image courtesy: Shutterstock

8. Certain smells may lead to chronic migraine

An odour may trigger a migraine attack or aggravate an existing one as it activates certain nerve receptors in the nasal passages. Migraine sufferers often experience osmophobia (aversion to odours). During a migraine, perfume or cigarette smoking or food odour are usually found to be troubling smells.

The last word

Chronic migraine is an under-recognized and under-treated disorder. Timely diagnosis and appropriate management by a specialized neurologist, can lead to a significant improvement in the quality of life. Determining your triggers can help in identifying the correct mode of treatment.

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About the Author

Dr Sumit Singh Director Neurology- Headache and Neuromuscular Disorders, Agrim Institute of Neurosciences, Gurugram
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