What Triggers Migraine Headaches?
Migraines are caused by an abnormal brain activity, which makes any kind of sensory stimuli like light, sound, or touch painful for you. These worsen the pounding headaches that migraines cause. The most common triggers are foods or drinks like cheese, soy, and alcohol, stress, lack of sleep, dehydration, weather change, and hormonal change during periods. Any change in routine that upsets your sleep-wake pattern or meal times can also cause migraines. Keep a diary to know and avoid your triggers.
If you’ve suffered from the throbbing headaches brought on by a migraine, take comfort in the fact that you’re not alone. Migraines are fairly common, with about 1 in 5 women and 1 in 15 men suffering from migraine headaches, vomiting, nausea, increased sensitivity to sound or light, and sometimes, the infamous migraine aura.1
What Causes Migraine Headaches?
Cortical Spreading Depression
Migraine is a very complex phenomenon, and researchers are still trying to find the exact cause and progression of the condition. The standing theory is that migraines involve cortical spreading depression (CSD), an abnormal electrical phenomenon in the brain where neurons in a part of the brain become hyperactive and then get depolarized or inactive one after another, like in a wave.
An abnormal electrical phenomenon in the brain, called cortical spreading depression, makes the pain receptors on a certain nerve very sensitive, making almost everything from light to touch painful for you.
This releases chemicals that dilate blood vessels in the meninges (outer covering) of the brain. They also make the pain receptors on the trigeminal nerve extremely sensitive, thus lowering your pain threshold. The trigeminal nerve is responsible for sensations on your face. So stimuli like light, sound, or touch that didn’t cause any pain previously become extremely painful for you when a migraine attack is under way.2 3
Genes And Other Factors
It is now known that genes also play a part in migraines. Scientists have identified mutations in as many as 12 locations in the DNA of people with migraine that make them susceptible to the condition.4
It is also thought that the pain centers of the brain could be dysfunctional in people who experience migraines and that the neurotransmitter serotonin could play a part in this.5
What Causes Migraine Aura?
Cortical spreading depression progresses through your brain at a speed of 3 mm per minute. And this is what you may perceive as migraine aura in the form of flashing lights or distorted or blurry vision.6 An aura may or may not progress into headache. Conversely, the CSD may progress into a headache without any aura at all. In fact, auras occur only in 25% of migraine cases.7
8 Common Migraine Triggers
Though we are not clear on what causes migraines, many factors that can trigger them have been identified. Each person has specific individual triggers, but looking at some common factors can help you identify what sets off your migraine attacks.
1. Diet: Certain Foods And Dehydration
Around 10% of people with migraine have food-related triggers.8 But be careful to distinguish between a trigger and a symptom. For instance, some people crave sweet foods like chocolate right before a migraine starts, which may lead them to think that chocolate is a trigger. But sometimes the craving itself is a symptom signaling the beginning of an attack.9 Some common dietary factors that can lead to migraines are:
- Skipping meals or eating irregularly
- Additives found in some foods such as the sweetener aspartame, monosodium glutamate (MSG) which is a flavor enhancer found in fast foods and seasoning, and nitrates in salami, bacon, hot dogs, and cured meats
- Citrus fruits, avocados, and bananas 10
- Tyramine, a substance that naturally occurs in foods like aged cheeses, fava beans, soy products, hard sausages, wine, and smoked fish11
- Caffeinated drinks like tea or coffee12
Do note that you shouldn’t quit caffeine drinks cold turkey; that too can trigger an attack. Wean yourself gradually.14
2. Emotional Factors: Anxiety And Stress
Migraines can be strongly linked to emotional factors. Anxiety, excitement, shock, or any kind of tension can set off an attack. Stress too is commonly found to lead to migraines. But some people also find that migraines start when their stress levels fall. This is because the high cortisol levels during stress also act as buffers for pain. Once the cortisol levels drop, migraine pain can attack in its full fury. This could be a reason some people experience “weekend headaches” where they get migraines on the weekend when they’re more relaxed after a stressful week.15
3. Physical Factors: Poor Posture And Lack Of Sleep
- Poor posture and tension in your neck or shoulder muscles can cause migraines. So if you’re sitting at a desk or in front of a computer screen for long periods, sit comfortably and be sure to take short breaks regularly.16
- Both too little sleep and too much of it can trigger migraines. Being tired can also be a factor.17
- Strenuous exercise can be a factor in migraines especially if you’re not used to it. However, regular exercise can help prevent migraines as it helps release endorphins, your body’s natural painkillers.18
- Some people have also found sexual activity to be a trigger.19 But believe it or not, sex can relieve migraine headaches too.
4. Environment: Strong Light And Weather Change
Climate changes like a drop in temperature or changes in humidity levels can trigger migraines. Loud noises, strong smells, smoky rooms, or a stuffy atmosphere may also do this. Some people also find that flickering screens (like computer or TV screens) and bright lights can set off a migraine.20
But do keep in mind that an increased sensitivity to sound and light can also be an early symptom of migraines.21
5. Hormonal Changes: Menstruation And Menopause
Migraines have been linked to female hormones like estrogen and progesterone. Some women may experience migraines around the time they get their periods, usually between a couple of days before their period and 3 days after it because of sudden drops in estrogen and progesterone during this time. This type of migraine is even known as menstrual migraine.
It has also been seen that women can experience an improvement in migraines after menopause, though in some, menopause may trigger migraines or make them worse.22
6. Change In Routine: Jet Lag Or Holidays
Changing your routine can sometimes lead to migraines. For instance, some people get migraines when their routine is disturbed on long journeys or on holiday. This could be another reason for weekend migraines since daily routines regarding your meal timings and nap times typically change on the weekends. Jet lag is also another common trigger.2324 This is because all of these affect your body’s natural balance (homeostasis) and sleep-wake pattern. And upset in homeostasis has been linked with triggering a migraine.25
7. Medical Factors: Contraceptive Pills
Contraceptive pills that contain hormones and some kinds of sleeping pills can trigger migraines. Hormone replacement therapy (HRT), which is used to deal with symptoms of menopause, has also been known to do this.26
Meanwhile using cocaine too can trigger an attack as can withdrawing from it. Cannabis addiction can make migraines more difficult to treat.27
8. Health Factors: Head Trauma And Low Sugar
- Some people who grind their teeth at night find themselves waking up with a migraine. But if teeth grinding is a trigger, your dentist can fit you with mouth plates (known as occlusal splints) designed to help this condition.28
- Head injuries can sometimes lead to headaches and migraine.29
- Repeated coughing and low blood sugar have also been found to initiate migraines in some people.30
Identify Your Triggers With A Headache Diary
Since different factors seem to act as triggers for different people, it could help to identify your individual triggers. Keep a headache diary and in it
- Jot down the dates and times that you got migraines.
- Make a note of what you ate and drank in the past 24 hours, how much sleep you got, where you were, and what you were doing when your migraine started.
- Keep a record of how long the migraine lasted and what made it stop.
Over time you should be able to notice patterns associated with your migraines and identify your triggers. You can then work on avoiding your triggers to reduce your migraines.31
What To Do When You Get A Migraine
Migraines usually last from 4 to 72 hours and can seriously affect your productivity. If you don’t want to take painkillers, try out these home remedies.
- Drink water to prevent dehydration, particularly if you’ve vomited. Vomiting often helps as it increases the serotonin levels in your blood, which can narrow the dilated blood vessels and reduce pain.32
- Rest in a quiet, dark room.
- Place a cool cloth on your head.
- Take painkillers and medications for nausea and vomiting.33
- Try natural remedies like relaxation techniques, for instance, breathing exercises and meditation.
- Have herbs like feverfew and ginger.
References [ + ]
|1.||↑||Migraine. National health Service.|
|2.||↑||Aggarwal, Milan, Veena Puri, and Sanjeev Puri. “Serotonin and CGRP in Migraine.” Annals of neurosciences 19, no. 2 (2012): 88.|
|3, 25.||↑||Burstein, Rami, Rodrigo Noseda, and David Borsook. “Migraine: multiple processes, complex pathophysiology.” Journal of Neuroscience 35, no. 17 (2015): 6619-6629.|
|4.||↑||Anttila, Verneri, Bendik S. Winsvold, Padhraig Gormley, Tobias Kurth, Francesco Bettella, George McMahon, Mikko Kallela et al. “Genome-wide meta-analysis identifies new susceptibility loci for migraine.” Nature genetics 45, no. 8 (2013): 912-917.|
|5.||↑||Migraine. Harvard Health Publications.|
|6.||↑||Costa, Cinzia, Alessandro Tozzi, Innocenzo Rainero, Letizia Maria Cupini, Paolo Calabresi, Cenk Ayata, and Paola Sarchielli. “Cortical spreading depression as a target for anti-migraine agents.” The journal of headache and pain 14, no. 1 (2013): 62.|
|7.||↑||Migraine Facts. Migraine Research Foundation.|
|8, 9, 14, 15, 17, 18, 21, 23, 27, 28, 29.||↑||Common triggers. The Migraine Trust.|
|10, 31, 33.||↑||Managing migraines at home. National Institutes of Health.|
|11.||↑||Migraine fact sheet. National Institutes of Health.|
|12, 13, 16, 20, 22, 24, 26, 30.||↑||Migraine – Causes. National Health Service.|
|19.||↑||Kelman, L. “The triggers or precipitants of the acute migraine attack.” Cephalalgia 27, no. 5 (2007): 394-402.|
|32.||↑||Aggarwal, Milan, Veena Puri, and Sanjeev Puri. “Serotonin and CGRP in Migraine.” Annals of neurosciences 19, no. 2 (2012): 88.|