Trigger identification and management is an integral part of migraine management. Some triggers can be avoidable, allowing us to avoid some migraines. Other triggers can’t be avoided, but knowing that we have those triggers is still helpful in our efforts to have fewer migraines. Another consideration is that triggers can be “stackable” or “cumulative.” This means that some triggers might not bring on a migraine if we counter just one, but “stack” two or more together, and they do bring on a migraine.
Triggers vary from one person to the next. What triggers a migraine for one person, may not trigger one in another. Here are some of the most common potential migraine triggers along with links to more information on our site:
- Changes in weather or barometric pressure. This is a very common trigger and, unfortunately, one that can’t really be avoided. Many people find, however, that migraine preventive treatment can help reduce their sensitivity to this trigger. Fore more information, see _Migraines Often Triggered by Change in the Weather _.
- Hormonal fluctuations. The hormonal fluctuations associated with a woman’s menstrual cycle, pregnancy, and menopause can be very strong triggers. Sometimes, hormone supplementation or oral contraceptives can help, but they can also make migraines worse or make no difference at all. For more on this topic, see Role of hormones in triggering migraines? and Managing Migraines During Pregnancy? Reproductive hormones aren’t the only ones that can be involved in migraine. Thyroid problems can also be a strong migraine trigger. For more on this, see Migraines, Headaches, and Thyroid. Also, check out our video, _Migraines and Hormones _.
- Some foods and beverages. Some of us have migraine food triggers; some don’t. Since the migraine can occur up to 48 hours after eating a trigger food, they can be hard to identify. The easiest and most effective way to see if any foods are a migraine trigger for you is through an elimination diet where you eliminate common food triggers from your diet, then add them back, one at a time. You can read more and download a free workbook in our article, _Managing Migraine - Migraine Food Triggers _.
- Skipped meals or irregular eating schedule. For some migraineurs, skipping meals or not eating on time can trigger migraines.
- Bright or flickering lights. Bright light; flickering light such as fluorescent lighting, strobe lighting, older computer monitors that have a flicker rate, sun flickering through trees along the road – all of these can be migraine triggers for some of us. Sunglasses can help. Adding a cap or sun visor to block the light that comes in above sunglasses can also help. If fluorescent lighting at work is an issue, your employer is required by law to make “reasonable accommodations” for you. You can find more information in Tips for Handling Migraines at Work and _Good Sunglasses - Vital for Migraine and Eye Health _.
- Sounds and noises. For some people, loud noises are a migraine trigger. For others, the sound doesn’t have to be loud, but even a soft sound of a particular pitch or tone can be a trigger.
- Sleep issues. Too much sleep, too little sleep, interrupted sleep, irregular sleep schedules, and otherwise poor quality sleep can all be very strong migraine triggers. Waking with a migraine is often an indication that a sleep issue is the trigger. It’s recommended that migraineurs get up and go to bed at the same time every day, including weekends and holidays. Even when we think we’re sleeping well, we may not be. Check out our video, _Migraines, Headaches, and Sleep _, and talk with your doctor if you’re waking with migraines or have other reasons to think your sleep may be a problem.
- Dehydration. Some of us are more susceptible to dehydration than others, and it’s something we often overlook as a potential migraine trigger. Alcohol and caffeine can be dehydrating, so we need to be careful to consume enough liquids that don’t contain them. You can learn more in _Dehydration - An Avoidable Migraine Trigger _.
- Fragrances, chemical fumes, odors. Perfumes, room fresheners, fumes from cleaning products, and other odors can trigger migraines, especially if encountered in a small space. This trigger can cause many problems for migraineurs. Many have had problems with coworkers wearing fragrance at work.** Employers should be willing to enact and enforce an office policy to prevent this problem in the workplace**. There was a court case regarding this issue. You can read more in _Migraines, Perfume, and the Americans with Disabilities Act _.
- Physical exertion including orgasm. Exercise, sports, orgasm, and other physical exertion can be migraine triggers. It’s important that migraine triggered by physical exertion be checked out by a doctor when they first occur to be sure that they are migraine and not a physical issue such as aneurysm. Depending on how frequently you participate in exertional activities, doctors can usually prescribe a medication to prevent these migraines, either on days you exert yourself or every day. You can read more in: _Preventing Exercise Triggered Migraines? and Orgasm, Headache and Migraine: Does the “Big O” Affect Headaches and Migraines? _
- Heat_._ Hot rooms, hot days, and becoming overheated are very common migraine triggers.
- Cold. Being outside in very cold weather or in rooms air conditioned to very cool temperatures can trigger a migraine.
- Temperature fluctuations. Going outside into high heat or low temperatures or in and out of heated or air-conditioned rooms can be a trigger.
- Some medications. I’m not talking about** medication overuse headache here**. I’m talking about medications that, for some people, can trigger a migraine very quickly. Some of those medications are nitroglycerin, albuterol, and some oral contraceptives.
- Stress? There’s still some controversy about this, and stress may be a trigger for some people. BUT, I hate to see anyone accept that stress is a trigger without at least trying to see if they encounter other triggers during stressful times that they either don’t encounter at other times or are triggers only when the body is stressed. I’d have sworn stress was a trigger for me until I kept a very detailed diary for a few months. More information in _Is Stress a Migraine Trigger? _ I hope you’ll thoroughly investigate this as I think we do ourselves a real disservice by thinking stress is a trigger for us and not looking closely for other triggers during stressful times.
Migraine triggers vary so greatly from one person to the next that compiling a list of all possible triggers is virtually impossible. You may have triggers that are not on this list. One of the best ways to identify triggers is to keep a migraine diary. You can find information about migraine and headache diaries and a free downloadable diary workbook in _Your Migraine and Headache Diary _.
More Helpful and Interesting Information:
10 Common Triggers of Migraine (Infographic)
Teri Robert is a leading patient educator and advocate and the author of Living Well with Migraine Disease and Headaches. A co-founder of the Alliance for Headache Disorders Advocacy and the American Headache and Migraine Association, she received the National Headache Foundation’s Patient Partners Award and a Distinguished Service Award from the American Headache Society. Teri can be found on her website, and blog, Facebook, Twitter, StumbleUpon, Pinterest, LinkedIn, and Google+.