Figuring out what triggers your migraine attacks can feel like playing a never-ending game of Clue. First, you suspect the culprit is chocolate. However, even after you quit, the migraine attacks continue.
Stay calm; you are not doing anything wrong.
“There are countless potential triggers for migraines, and they vary from person to person,” says Amaal J. Starling, MD, associate professor of the Department of Neurology at the Mayo Clinic. “This is one reason it can be so difficult to pinpoint the specific lifestyle factors involved.”
Furthermore, although severe migraine attacks may be influenced by lifestyle choices, they are not caused by them.
“Migraine is a genetic, neurological disease,” says Dr. Starling. Because of this, in addition to changing your lifestyle, you may also need medication to treat and prevent them.
Read more: How to weigh the pros (and cons) of migraine medications
By changing your lifestyle, you can help medications work more effectively and 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 migraines, use the SEEDS mnemonic. It represents the following:
- I eat.
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 sleeping and sex.
- Talk to your health care professional about underlying disorders that could be disrupting sleep.
Eat a well-balanced diet that includes minimally processed whole foods such as fruits, vegetables, unprocessed meat, fish, legumes, tubers, whole grains and seeds. Make sure you stay hydrated and eat regular meals on a set schedule.
You’ll also want to pay attention to how the food makes you feel. Common food triggers include:
- Foods that contain nitrates, such as hot dogs and lunch meat.
- Foods containing monosodium glutamate (MSG).
- Foods containing tyramine, an ingredient found in aged cheese, soy and red wine.
- Foods and drinks that contain caffeine.
- Food and drinks containing artificial sweeteners.
In people with celiac disease, foods containing gluten can also be problematic.
In a study of 91 people, participants who exercised for 40 minutes three times a week reduced the frequency of migraine attacks almost as effectively as people who took prescription drugs.
However, if 40 minutes sounds too ambitious, know that any exercise can help. Start with what is feasible 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 logging 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 are no specific triggers.”
Instead, Dr. Starling recommends keeping what she calls a “stop light diary,” marking days as red, yellow, or green based on how you feel.
- Green days: mild discount in operation.
- Yellow days: moderate discount in operation.
- Red days: severe impairment where you may be bedridden.
In addition to keeping track of how you feel, note the number of days you use medication to treat attacks. Bring your diary with you to medical appointments. Talk to your healthcare professional about what worked and what didn’t.
Read more: Migraine treatment: What to tell your neurologist
Stress management strategies may help reduce the frequency and severity of your migraine attacks. Experiment with biofeedback, cognitive behavioral therapy, mindfulness, and meditation until you find a solution that works for you.
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