Table of ContentsView AllTable of ContentsEmotional StressPhysical StressVigorous SexMenstrual CycleFood and BeveragesExcessive ChewingSleep DisturbancesHungerDehydrationPain MedicationsSensory OverloadWeather Changes
Table of ContentsView All
View All
Table of Contents
Emotional Stress
Physical Stress
Vigorous Sex
Menstrual Cycle
Food and Beverages
Excessive Chewing
Sleep Disturbances
Hunger
Dehydration
Pain Medications
Sensory Overload
Weather Changes
Migraine triggers are not the reason you get migraines, although it may seem like it. These triggers—ranging from foods like peppermint to stress, flashing lights, and strong smells—are thought to overstimulate thetrigeminal nervethat runs along the side of your head, instigating an attack.
Migrainetriggers differ from one person to the next, although they commonly fall into six categories: stress, hormonal changes, sleep problems, diet, sensory disturbances, and weather.Studies suggest that around 76% of people with migraines report specific triggers for an attack.
Migraine
Some studies suggest that this is due tocentral sensitization, also known asnociplastic pain. This is a condition in which thecentral nervous systemis overreactive to stimuli that generally do not cause pain.
With emotional stress, the brain releases a hormone calledcortisolthat helps your body cope with stress. In people with central sensitization, cortisol can inadvertently activate already overreactive pain receptors, leading to a migraine attack.
The same may be seen withextreme fatigue, which triggers attacks in up to 70% of people with migraines.
Physical stress can also trigger migraines in the absence of emotional stress. Studies suggest that up to 38% of people with migraines may experience an attack during vigorous exercise. This is especially true if the body is severely overheated.
The causes of this are many. Extreme physical exertion causes the dilation (widening) of blood vessels in the head that can overstimulate the trigeminal nerve.
Vigorous exercise also increases the production oflactic acid, the same substance that causes “muscle burn” during and after exercise. In people with migraine, high lactic acid levels may serve as a trigger for an attack.
On the other hand, moderate-intensity exercise (in which you can talk but not sing during exercise) has been shown to lower the frequency of migraine attacks compared to doing no exercise at all.
Up to one-third of people with chronic migraines report a worsening of symptoms during sex. However, it is important to determine whether you are experiencing an actual migraine (generally felt on one side of the head) or an orgasmic headache (felt on both sides as well as the back of the head).
On the flip side, some studies have reported that up to 60% of people with acute migraine symptoms find relief after having sex.
Menstruation and Hormones
Migraines are three times more common in females than males. The disparity is mainly attributed to natural fluctuations of the sex hormoneestrogenduring themenstrual cycleorpregnancy.
It’s unclear exactly how estrogen levels provoke a migraine attack. It is thought that estrogen interacts withserotonin, a hormone that, among other things, causes the narrowing of blood vessels throughout the body, including the head and brain. The dysregulation of serotonin is regarded as a major contributing factor to migraine attacks.
Birth control pillsandhormone replacement therapy (HRT)also influence estrogen levels and inadvertently trigger a migraine attack.
Among the range of foods that commonly trigger migraine attacks are:
Some studies have found that prolonged or excessive chewing, such as chewing gum or chewing tough meats or jerky, can set off a migraine attack.
According to a 2017 study inPain Research and Management,daily gum chewers with chronic headaches or migraines experienced 87% improvement in their symptoms within two weeks of stopping the habit. When gum chewing was restarted, 100% reported symptoms returning within days.
The mechanical stress placed on thetemporomandibular jointof the jaw can trigger inflammation which, in turn, overexcites the trigeminal nerve, leading to migraine pain.
Nearly 75% of people with migraines identifysleep deprivationas a trigger. In addition to this, altered sleep schedules (such asjet lag) and excessive sleep can also trigger migraines.
Specific sleep disorders are also linked with migraines, includingrestless leg syndrome,insomnia,shift work disorder, andnarcolepsy.
Sleep problems are thought to cause migraines due to the overproduction of a chemical messenger calledhypocretinthat helps regulate arousal and wakefulness. Inappropriate increases in hypocretin due to the lack of sleep can trigger abnormal brain activity, leading to a migraine attack.
The relationship between poor sleep quality and migraine attacks is bidirectional, meaning that sleep problems can trigger migraines, while migraine attacks can promote sleep disturbances.
Hunger and Malnutrition
Hypocretin is also involved with appetite, which is why hunger may also cause migraine attacks in some people. When you are hungry, hypocretin levels are at their highest, while eating causes levels to plummet dramatically.Skipping meals and fasting are among the most common causes of hunger-induced migraines.
Even when you are not hungry, sudden food cravings can stimulate the production of hypocretin in the brain, triggering a migraine attack.
Dehydrationcauses migraine for reasons unrelated to hunger. When you are dehydrated, your brain and surrounding tissues will start to contract (shrink), placing pressure on nerves within the skull. This can lead to a type of headache known as anorthostatic headache.
In people with migraine, an orthostatic headache can have a knock-on effect, causingneuroinflammation(inflammation in the brain) which overstimulates the trigeminal, leading to a migraine attack.
Maintaining ample hydration has been shown to reduce the frequency of migraines in some people. Drinking water may also help ease symptoms during an active migraine attack.
Overuse of Pain Medications
The excessive use of pain-relieving medications is another common trigger for migraine attacks. This usually occurs when you take painkillers for 10 or more days per month for over three months.
Among the drugs commonly implicated are:
Daily doses of caffeine can induce overuse headaches (as can the sudden discontinuation of caffeine).
The good news is that migraines generally improve after a person stops pain medications. The responsiveness topreventive migraine drugsalso tends to improve.
Strong smellscan also trigger a migraine, typically within minutes. This is thought to occur when theolfactory nerve(which enables smelling) is overloaded, leading to the overstimulation of the trigeminal nerve.
Commonly migraine-triggering odors include:
Bright light, including sunlight or fluorescent light, can also trigger a migraine, as can flickering lights or the glare of aphoneorcomputer screen.Loud everyday noises, such as the sirens and railroad crossing bells, can also do the same.
In the same way that the overstimulation of the olfactory nerve can induce migraine pain, the overstimulation of thecochlear nerve(which enables hearing) oroptic nerve(which enables vision) can also trigger a migraine in some people.
Sensory overload from bright lights and loud sounds can also aggravate an existing attack. This is why people with migraines often prefer to rest in a dark, quiet room until the pain subsides.
Weather changesare one of the most commonly noted triggers of a migraine attack, often experienced when there is:
Weather changes can independently trigger a migraine (such as changes in air pressure that can affect the inner ear and cochlear nerve). Even so, studies suggest that these environmental triggers tend to occur in combination with other triggers, such as diet, hunger, or fatigue.
Summary
Many different things can provoke a migraine attack, including stress, exercise, food, hunger, dehydration, menstrual periods, sleep deprivation, and the overuse of pain medications. Even excessive chewing and sex can occasionally trigger migraine. By identifying your triggers and avoiding them, you may be able to reduce the frequency of these attacks.
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