Understanding Headache Triggers & The Importance of Tracking Headaches

We all want our headaches to have a defined cause. Even more so, a cause we can avoid. Most often the cause is found in a good family history. The actual cause involves our genes, while any given headache has one or more possible triggers. When in acute pain, we think about what triggered it. We normally connect the pain to the closest negative event. This may be a bad night’s sleep, stress from that next test, a menstrual period, or a weather front moving through. In conjunction with our health care providers, we want to find the triggers so we can avoid them. Too often everyone thinks: remove the “cause and stop the attacks.” Sometimes, we go to the Internet to learn about the cause. We may obtain lists of “known” triggers for headache. The lists are endless, and this process is a problem when there is little to no truth to the trigger. Many known triggers have no proof. 1

According to the healthline.com "By identifying and avoiding specific triggers, you can minimize your chances of having a migraine." 2

The list of possible triggers is long, and to avoid them all is unrealistic. The goal is to find out which ones significantly affect your headaches. The next logical step is to use trigger avoidance (see below). 3

The importance of understanding your trigger(s)

It may not be easy to identify what is triggering your migraine if your attacks are linked to a number of different things. A trigger may not cause an attack every time which may confuse the situation even more. 4

Imagine you are a young woman and your triggers are skipping a meal, stress and a change in hormonal levels. If you come home late from a very stressful meeting at work, your period is just about to start and you go straight to bed without eating a proper meal, you may almost certainly have an attack. If you skipped dinner another time when the other triggers were not present, you will probably not get a migraine. Many people find that they have long periods of time without a migraine between attacks. During this time, the body seems to be in a less sensitive state and you may find that even a combination of triggers does not start a migraine. 4

Sometimes triggers can be wrongly identified. For example, at the beginning of an attack, you may experience a craving for sweet things. If you eat some chocolate to satisfy this craving, and then get a headache, you may identify chocolate as one of your triggers. In fact, you were starting to get a migraine before you ate the chocolate. One of the best ways of identifying triggers is to keep a detailed diary. 5

Trigger Avoidance

If your migraine attacks are triggered by a single thing that is easy to avoid, you may be able to stop most of your attacks from happening. It may be harder to avoid attacks that are triggered by a combination of factors. 6

It is important to be clear about what you expect to achieve from a routine for managing migraine and that what is realistic to achieve. For example, aiming to reduce how often the headaches happen may be realistic but wishing for a life without headaches may not be attainable. A realistic goal will give you something to aim for. As mentioned above, you should not feel bad or guilty, if you cannot control all your attacks by avoiding triggers. Many sufferers require other management methods to bring their condition under control. 6

Triggers you CAN and CANNOT control

Interestingly, the number of modifiable triggers, far outweighs triggers that you cannot control.

CAN control

  • Proper Sleep Cycles (too much sleep or not enough sleep can cause headaches)
  • Caffeine Overuse (excessive caffeine use can cause headaches.)
  • Routine Meals (skipping meals is a huge trigger)
  • Moderate Exercise (see chapter 6 Managing Your Migraines)
  • Sensory Overload avoiding bright lights, loud noises, or strong odours (like perfumes)
  • Smoking
  • Reducing Stress (Incorporating Relaxation Techniques)
  • Medical or Psychiatric Conditions - Controllable (Anxiety, Depression)
  • dehydration - drinking water regularly 7

CANNOT control

  • Weather changes or storm fronts
  • Barometric Pressure or Altitude Factors
  • Heredity
  • Menstruation (in women) 7

Dr. Joel Saper on the importance of keeping a headache diary

A headache diary helps us identify the frequency of the pain, what may “trigger” the headache, and various other patterns related to duration (of pain felt), response to medication, and so forth. “Pain memory” is notoriously poor because during severe painful attacks, memory is not functioning well and trying to remember back a month or two with respect to headache frequency or other related details is generally poor for everyone. A diary helps to correct that. 8

By keeping a headache diary, you will be able to identify some triggers for your particular headaches. Once you have identified triggers, it will be easier for you to avoid them and reduce your chances or having a migraine attack. 9


Paper Headache Diaries (Printable)


Headache APPs

REFERENCES

  1. American Migraine Foundation, ABCs of migraine triggers, 2020
  2. Healthline, identifying and avoiding triggers - 2019
  3. The Migraine Trust, trigger avoidance, 2018
  4. The Canadian Journal of Medicine, the importance of learning your trigger 2018
  5. The Canadian Journal of Medicine, triggers that are incorrectly identified 2019
  6. Reduction of headaches, The Migraine Trust, 2019
  7. Healthline, triggers you can and cannot control - 2019
  8. Dr. Joel Saper, the importance of a headache diary, 2018
  9. Migraine.com, why keep a headache diary?
  10. Migraine Canada, paper headache diary, 2019
  11. The Migraine Trust, paper headache diary 2019

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The book Chronic Daily Headache features
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