There are a number of factors that could progressively increase the frequency of migraines from episodic (fewer than 15 per month) to chronic (15 or more per month). Medication overuse is a major one, but other culprits can include obesity, depression, excessive caffeine use, snoring, and sleep disorders.
Verywell / Emily Roberts
Implement Good Sleep Hygiene
Interestingly, the vast majority of people with migraines also deal with insomnia, a risk factor associated with the likelihood of progressing from episodic migraines to chronic. Because of this close connection between sleep and migraines, research is continuously being done on the relationship between the two.
Behavioral Sleep Modification
Changing your sleeping behaviors and habits can help keep the frequency of your migraines in check. The American Migraine Foundation recommends the following behavior modifications:
Try Cognitive Behavioral Therapy for Insomnia
Cognitive behavioral therapy for insomnia (CBTI) is a short, structured, and evidence-based approach to combating the symptoms of insomnia. CGTI is considered a first-line approach for insomnia, meaning it should be tried prior to introducing other treatments.
CBTI usually consists of a combination of these components:
Multiple studies show that an average of 70% to 80% of people who undergo CBTI have decreased insomnia and report sleeping better, with about 40% to 60% of these patients still experiencing these results long-term.
Talk to Your Healthcare Provider About Sleep ProblemsTreatment for an underlying sleep disorder may make all the difference in the frequency and severity of your migraines.
Talk to Your Healthcare Provider About Sleep Problems
Treatment for an underlying sleep disorder may make all the difference in the frequency and severity of your migraines.
Talk to your healthcare provider about getting diagnosed, and consider finding a sleep specialist who uses CBTI. Even implementing behavioral sleep modifications on your own and working to improve your sleep hygiene may have a significant impact.
Take Your Migraine Preventive Medications
There are several options that have been proven to be effective, including:
Newer medication options include:
It is important to be patient with the medication process and to be communicative with your healthcare provider about any side effects you are experiencing. Finding the right preventive medication can be tricky and you may end up trying several different types before finding the best one for you.
What Medication Will Prevent My Migraines?
Stop Overusing Your Migraine Medications
Overusing your pain-relieving migraine medications for acute migraines—whether it’s a prescription medication like atriptanor an over-the-counter medication like a nonsteroidal anti-inflammatory drug (NSAID)—is a common trigger for the development of chronic migraine.
In addition, when you overuse pain-relieving medications, this can render your migraine preventive medications ineffective.
Stopping a medication you’ve used too much can eliminate your headaches and reverse your chronic migraines. But again, only do this under the guidance of your healthcare provider.
Important WarningWhile most medications can be stopped immediately, be sure to talk with your healthcare provider if your medication contains butalbital compounds or if you’re taking large amounts of an opioid, as these medications need to be stopped gradually under the guidance of a healthcare provider.
Important Warning
While most medications can be stopped immediately, be sure to talk with your healthcare provider if your medication contains butalbital compounds or if you’re taking large amounts of an opioid, as these medications need to be stopped gradually under the guidance of a healthcare provider.
Get Regular Exercise
Exercising may feel like the last thing you want to do when it comes to managing migraines, but evidence does suggest getting enough aerobic movement can help play a role in preventing migraines.
An additional bonus is that, since obesity is considered a risk factor in the transformation from episodic to chronic migraine, regular aerobic exercise can help keep your weight under control. As a preventive treatment, exercise is also a great option because there are no side effects and it doesn’t need to be too costly.
Aerobic exercise has also been shown to improve your overall quality of life, as well as help with other conditions that tend to be comorbid with migraine, including:
Choose Exercise You EnjoyRemember, exercise doesn’t necessarily mean going to the gym—walking briskly with a friend, swimming,Zumbaclass, biking, hiking, or joining a competitive sports league are all great choices for aerobic exercise. Choose an activity that you enjoy so you’ll stick with it and make it a part of your daily routine.
Choose Exercise You Enjoy
Remember, exercise doesn’t necessarily mean going to the gym—walking briskly with a friend, swimming,Zumbaclass, biking, hiking, or joining a competitive sports league are all great choices for aerobic exercise. Choose an activity that you enjoy so you’ll stick with it and make it a part of your daily routine.
A Word From Verywell
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Migraine Foundation.Understanding chronic migraine.Smitherman TA, Walters AB, Davis RE, et al.Randomized Controlled Pilot Trial of Behavioral Insomnia Treatment for Chronic Migraine With Comorbid Insomnia.Headache. 2016 Feb;56(2):276-91. doi: 10.1111/head.12760.American Migraine Foundation.Sleep, Insomnia and Migraine.The Sleep Foundation.Cognitive Behavioral Therapy for Insomnia.Anderson KN.Insomnia and cognitive behavioural therapy-how to assess your patient and why it should be a standard part of care.J Thorac Dis. 2018 Jan;10(Suppl 1):S94-S102. doi: 10.21037/jtd.2018.01.35.UptoDate.Acute treatment of migraine in adults.Amin FM, Aristeidou S, Baraldi C, et al.The association between migraine and physical exercise.J Headache Pain. 2018 Sep 10;19(1):83. doi: 10.1186/s10194-018-0902-y.Additional ReadingAmin FM, Aristeidou S, Baraldi C, et al.The association between migraine and physical exercise.The Journal of Headache and Pain. 2018;19(1):83. Published 2018 Sep 10. doi:10.1186/s10194-018-0902-y.Anderson KN.Insomnia and cognitive behavioural therapy-How to assess your patient and why it should be a standard part of care.Journal of Thoracic Disease. 2018;10(Suppl 1):S94–S102. doi:10.21037%2Fjtd.2018.01.35.Rains JC, Poceta JS.Sleep-related headaches.Neurologic Clinics.November 2012;30(4):1285–98. doi:10.1016/j.ncl.2012.08.014.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Migraine Foundation.Understanding chronic migraine.Smitherman TA, Walters AB, Davis RE, et al.Randomized Controlled Pilot Trial of Behavioral Insomnia Treatment for Chronic Migraine With Comorbid Insomnia.Headache. 2016 Feb;56(2):276-91. doi: 10.1111/head.12760.American Migraine Foundation.Sleep, Insomnia and Migraine.The Sleep Foundation.Cognitive Behavioral Therapy for Insomnia.Anderson KN.Insomnia and cognitive behavioural therapy-how to assess your patient and why it should be a standard part of care.J Thorac Dis. 2018 Jan;10(Suppl 1):S94-S102. doi: 10.21037/jtd.2018.01.35.UptoDate.Acute treatment of migraine in adults.Amin FM, Aristeidou S, Baraldi C, et al.The association between migraine and physical exercise.J Headache Pain. 2018 Sep 10;19(1):83. doi: 10.1186/s10194-018-0902-y.Additional ReadingAmin FM, Aristeidou S, Baraldi C, et al.The association between migraine and physical exercise.The Journal of Headache and Pain. 2018;19(1):83. Published 2018 Sep 10. doi:10.1186/s10194-018-0902-y.Anderson KN.Insomnia and cognitive behavioural therapy-How to assess your patient and why it should be a standard part of care.Journal of Thoracic Disease. 2018;10(Suppl 1):S94–S102. doi:10.21037%2Fjtd.2018.01.35.Rains JC, Poceta JS.Sleep-related headaches.Neurologic Clinics.November 2012;30(4):1285–98. doi:10.1016/j.ncl.2012.08.014.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Migraine Foundation.Understanding chronic migraine.Smitherman TA, Walters AB, Davis RE, et al.Randomized Controlled Pilot Trial of Behavioral Insomnia Treatment for Chronic Migraine With Comorbid Insomnia.Headache. 2016 Feb;56(2):276-91. doi: 10.1111/head.12760.American Migraine Foundation.Sleep, Insomnia and Migraine.The Sleep Foundation.Cognitive Behavioral Therapy for Insomnia.Anderson KN.Insomnia and cognitive behavioural therapy-how to assess your patient and why it should be a standard part of care.J Thorac Dis. 2018 Jan;10(Suppl 1):S94-S102. doi: 10.21037/jtd.2018.01.35.UptoDate.Acute treatment of migraine in adults.Amin FM, Aristeidou S, Baraldi C, et al.The association between migraine and physical exercise.J Headache Pain. 2018 Sep 10;19(1):83. doi: 10.1186/s10194-018-0902-y.
American Migraine Foundation.Understanding chronic migraine.
Smitherman TA, Walters AB, Davis RE, et al.Randomized Controlled Pilot Trial of Behavioral Insomnia Treatment for Chronic Migraine With Comorbid Insomnia.Headache. 2016 Feb;56(2):276-91. doi: 10.1111/head.12760.
American Migraine Foundation.Sleep, Insomnia and Migraine.
The Sleep Foundation.Cognitive Behavioral Therapy for Insomnia.
Anderson KN.Insomnia and cognitive behavioural therapy-how to assess your patient and why it should be a standard part of care.J Thorac Dis. 2018 Jan;10(Suppl 1):S94-S102. doi: 10.21037/jtd.2018.01.35.
UptoDate.Acute treatment of migraine in adults.
Amin FM, Aristeidou S, Baraldi C, et al.The association between migraine and physical exercise.J Headache Pain. 2018 Sep 10;19(1):83. doi: 10.1186/s10194-018-0902-y.
Amin FM, Aristeidou S, Baraldi C, et al.The association between migraine and physical exercise.The Journal of Headache and Pain. 2018;19(1):83. Published 2018 Sep 10. doi:10.1186/s10194-018-0902-y.Anderson KN.Insomnia and cognitive behavioural therapy-How to assess your patient and why it should be a standard part of care.Journal of Thoracic Disease. 2018;10(Suppl 1):S94–S102. doi:10.21037%2Fjtd.2018.01.35.Rains JC, Poceta JS.Sleep-related headaches.Neurologic Clinics.November 2012;30(4):1285–98. doi:10.1016/j.ncl.2012.08.014.
Amin FM, Aristeidou S, Baraldi C, et al.The association between migraine and physical exercise.The Journal of Headache and Pain. 2018;19(1):83. Published 2018 Sep 10. doi:10.1186/s10194-018-0902-y.
Anderson KN.Insomnia and cognitive behavioural therapy-How to assess your patient and why it should be a standard part of care.Journal of Thoracic Disease. 2018;10(Suppl 1):S94–S102. doi:10.21037%2Fjtd.2018.01.35.
Rains JC, Poceta JS.Sleep-related headaches.Neurologic Clinics.November 2012;30(4):1285–98. doi:10.1016/j.ncl.2012.08.014.
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