Managing migraine can make you feel a lot like Goldilocks: You need just the right amount of sleep, exercise, or caffeine to keep the throbbing headaches and other migraine symptoms away. But trying to find the right balance in life is far from a fairy tale.
Why Single Triggers Don’t Always Lead to a Migraine Attack
Research has shown that habits such as too much or too little sleep and extreme exercise can trigger migraine attacks, and the thinking has been that your best bet for managing migraine is to know your triggers and avoid them. But a trigger may not cause a migraine attack every time, and your triggers may change over time, according to The Migraine Trust.
In fact, it’s likely that you won’t experience an attack unless you’re exposed to more than one trigger. The Migraine Trust uses the example of a young woman whose triggers are stress, changes in hormone levels, and skipping meals.
For example, if she comes home late from a stressful work meeting right before her period is due and then goes to bed without eating dinner, she is more likely to experience a migraine attack than she otherwise would have, according to The Migraine Trust.
What researchers have described as the “multifactorial” causes of migraine means you may need to look at your triggers a little differently. It might be better to think of your triggers as individual risk factors for bringing on a migraine attack instead, says Robert Kaniecki, MD, director of the University of Pittsburgh Headache Center and an associate professor of neurology.
Then figure out what your migraine threshold is, or what combination of those aggravating circumstances it takes to produce a migraine attack for you.
Your Migraine Trigger Hit List
The list of potential migraine triggers is a long one, and the possible combinations that could add up to a migraine attack is even longer. But paying attention to the various triggers that are going on simultaneously can lead to better migraine control. Here are some key migraine “risk factors” to be aware of:
How Much Control Do You Have Over Migraine Triggers?
Some triggers are unavoidable: You usually can’t stop your period from coming or control the weather. But if you know that skipping exercise and drinking too much coffee when you have your period is sure to bring on a migraine attack, take steps to avoid the triggers you can control.
The reason managing migraine is so challenging, explains Dr. Kaniecki, is that there are likely multiple genetic forms of migraine and many potential triggers. Stress, female hormonal changes, the weather, changes in your daily schedule, and sensory stimulation from fluorescent lights, loud noise, and strong odors can all impact a genetically predisposed nervous system in a way that results in a migraine.
“To date, we have yet to identify the most common genetic variations responsible for migraine in the population,” Kaniecki says.
Though migraine disease is complex, in simple terms, it means that your brain is hyperexcitable, meaning it reacts at a lower threshold than it would in someone without migraine, according to a paper published in the journal NeuroImage: Clinical, leading to an inflammatory process that produces headaches. This hyperexcitable state is inherited, but there are likely hundreds — maybe even thousands — of genes that contribute to a predisposition for migraine.
Lifestyle Steps for Preventing Migraine Attacks
Healthy lifestyle habits can help keep a hyperexcitable brain on an even keel. In addition to looking for trigger patterns, Cleveland Clinic says you may be able to reduce attacks or their severity by:
Lifestyle modifications can make a big difference in migraine management, but they’re not a cure-all. Work with your doctor to find the combination of medications, lifestyle habits, and approaches such as neuromodulation or psychotherapy that works best for you.
This content was originally published here.