Migraine: finding your triggers with a simple diary
Patterns emerge over six to eight weeks
Dr. Antoine Mercier
Neurologist
In simple terms
Sleep changes, missed meals and hormonal timing show up more often than chocolate.
Why keep a diary
Memory is unreliable about attacks. Writing down the date, duration, intensity, what you ate, sleep, stress and menstrual cycle for six to eight weeks reveals patterns that guesswork misses.
Triggers that come up most often
- Changes in sleep, too little or too much, including weekend lie-ins
- Skipping meals and dehydration
- Falling oestrogen just before a period
- Alcohol, particularly red wine
- Stress, and often the release after stress
- Weather and pressure changes for some people
The caffeine trap
Caffeine can relieve an attack but daily painkiller or caffeine use can create medication overuse headache, where the treatment itself keeps the headache going. Taking acute treatment on more than 10 to 15 days a month is the danger zone.
When to consider preventive treatment
Four or more attacks a month, or attacks that disable you despite good acute treatment. Options include beta-blockers, certain antidepressants, topiramate, and the newer CGRP-targeted treatments.
Seek urgent care
A sudden explosive headache reaching maximum in seconds, headache with fever and a stiff neck, or new neurological weakness needs emergency assessment.
The words explained
Medical terms used above, in everyday language.
- Acute
- Something that starts suddenly and lasts a short time.
- Prevention
- Steps taken before a problem starts, to make it less likely.
When should you see a doctor?
- Your symptoms last more than a few weeks or keep coming back.
- They get worse quickly, or stop you doing everyday things.
- You notice sudden pain, breathing trouble, fainting or bleeding — seek urgent care.
- You already take medication and want to change anything about it.
This article explains general health information. It does not replace advice from your own doctor.
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