Figuring out what triggers your migraine attacks can feel as if you’re involved in a never-ending game of Clue. First, you suspect that the culprit is chocolate. However, even after giving it up, your migraine attacks continue.
Rest assured; you’re not doing anything wrong.
“There are countless potential migraine triggers, and they vary from person to person,” says Amaal J. Starling, M.D., anassociate professor of the Department of Neurology with Mayo Clinic. “That’s one reason it can be so difficult to identify the specific lifestyle factors involved.”
On top of that, while the severe throbbing of migraine attacks may be influenced by lifestyle choices, they’re not caused by them.
“Migraine is a genetic, neurologic disease,” says Dr. Starling. “Because of that, in addition to changing your lifestyle, you also may need medication to treat and prevent them.”
By modifying your lifestyle, you can help medication to work more effectively, as well as reduce the frequency and severity of your migraine attacks.
“Even if you can’t completely eliminate migraine attacks, you can reclaim your life and put yourself back in the driver’s seat,” says Dr. Starling.
What to do — and what not to do
To remember the many lifestyle habits that can help you manage migraine, use the SEEDS mnemonic. It stands for the following:
Both poor sleep and changes in sleep can trigger a migraine attack. “Maintaining a regular sleep schedule and practicing good sleep hygiene is important,” says Dr. Starling.
To practice good sleep hygiene:
- Go to bed and wake up at the same time every day.
- Avoid screens — such as TV, tablet, phone and so on — while in bed. Use your bed only for sleep and sex.
- Talk to your healthcare professional about underlying disorders that could disturb sleep.
Follow a well-balanced diet that features minimally processed whole foods like fruits, vegetables, unprocessed meat, fish, legumes, tubers, whole grains and seeds. Make sure to stay hydrated and eat regular meals on a set schedule.
You’ll also want to pay attention to how food makes you feel. Common food triggers include:
- Foods that contain nitrates, such as hot dogs and lunch meat.
- Foods that contain monosodium glutamate (MSG).
- Foods that contain tyramine, an ingredient found aged cheese, soy and red wine.
- Foods and beverages that contain caffeine.
- Foods and beverages that contain artificial sweeteners.
In people with celiac disease, foods that contain gluten also can be problematic.
In a study of 91 people, participants who exercised for 40 minutes three times a week reduced their migraine attack frequency almost as effectively as people who took prescription medication.
If 40 minutes sounds overly ambitious, however, know that any amount of exercise can help. Start with what’s doable and slowly increase your duration over time.
A migraine diary can help you and your headache specialist better understand how to optimize your treatment regimen.
However, don’t worry about capturing dozens of details about your diet, sleep, stress level or other lifestyle factors.
“People often spend too much time writing everything down to identify triggers,” says Dr. Starling. “But often there aren’t specific triggers.”
Instead, Dr. Starling recommends keeping what she calls a “stoplight diary,” marking days as red, yellow or green based on how you feel.
- Green days: mild impairment in function.
- Yellow days: moderate impairment in function.
- Red days: severe impairment where you may be bedbound.
In addition to tracking how you feel, take note of the number of days you use medications to treat attacks. Bring your diary with you to medical appointments. Talk with your healthcare professional about what has worked and what hasn’t.
Stress-management strategies may help you reduce the frequency and severity of your migraine attacks. Experiment with biofeedback, cognitive behavior therapy, mindfulness and meditation until you find a solution that works for you.
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