Know your triggers

A trigger is a condition that acts as a precursor to set off a migraine attack. This trigger is unique for each sufferer. Environmental factors appear to play a significant role in triggering a migraine attack…however other things may also act as triggers.

Some of the common triggers of migraine are:

  • Strong odours such as perfumes or insecticides
  • Bright and fluorescent lights
  • Loud sounds
  • Weather Changes
  • Stress
  • Sleeping more or less than usual
  • Some food items (Nuts, cheese, chocolate, sugar, alcohol, artificial sweeteners like aspartame, caffeine)
  • Certain medications (like birth control pills, nitroglycerin and atenolol)
  • Alcohol intake
  • Caffeine withdrawal
  • Dehydration
  • Hormonal changes in women

Migraine is more prevalent among women, with about 15-18 percent of women worldwide getting them, compared to six to seven percent of men. In women, migraines are sometimes triggered by hormonal changes such as those experienced during menstruation and pregnancy. This type of migraine is called as ‘Menstrual migraine’ and can occur in upto 50% of women. Migraines tend to intensify during puberty and disappear during menopause.

It is very important that you identify your triggers so that you can either avoid them totally or take precautionary treatment if they are unavoidable.

There are certain things that can help you keep a check on your triggers and reduce the risk of an attack:


Maintain a Diary

Human memory is very unreliable. A diary can help you list down all that you ate, drank or experienced just before your attack which will help you to accurately pinpoint your set of triggers over a course of time. Identifying your triggers means you can take steps to avoid them.


Eat and drink regularly

Skipping meals or irregular intake of food can also act as triggers. So can fasting and fad dieting. Stick to a time-bound diet routine to reduce the chances of an attack. Having your meals at roughly the same time each day may reduce the chance of a migraine. Studies have proven that eating high protein meals can reduce migraine attacks.


Follow a regular sleep routine

Hectic lifestyle may throw sleep patterns into disorder and this can act as a trigger for migraine. Make the habit of going to bed and waking up at the same time each day. Get enough sleep seven to eight hours is sufficient –but do not oversleep.


Exercise

Stay fit and active. Put on your running shoes, go jogging or join a gym. Regular physical activity can reduce migraines.


Control stress

Stress may be difficult to avoid, However make an attempt to control stress as much as possible. For some individuals exercising, deep breathing , yoga, and transcendental meditation may act as stress busters, while for others music can also work wonders in relieving stress. For others, simply calling a friend may help in putting the lid on stress.


Avoid overstimulation of senses

For many people, migraine is triggered due to the overstimulation of senses. For such people, loud music and disco lights may bring on an attack. Avoid using fluorescent lights. Always wear sunglasses when you venture out in bright sunlight. Avoid using richly scented beauty products, incense sticks and room fresheners.


Stop smoking

Smoking is a confirmed migraine risk factor. One out of three smokers complains that smoking initiates or intensifies their migraines. The odour of cigarette smoke can also trigger attacks.


Focus on Behavioural techniques

If the trigger cannot be avoided, the sufferer should learn and adapt relaxation techniques, thermal and electrical stimulation of the head and management skill programs to reduce attacks.


Reach out for Psychological support

This method is effective after trigger identification. Cognitive behavioural therapy (stress coping) can teach sufferers problem-solving and coping skills to manage triggers.


Keep yourself well hydrated

Water deprivation, in addition to impairing concentration and increasing irritability, can serve as a trigger for migraine and also prolong migraine attacks. So be sure to drink plenty of pure water.


Physical therapy

In some sufferers, migraines are induced by physical trauma like head injury. Hot packs, ultrasound and therapeutic massage can help diminish pain.

Remember that some migraine triggers are unavoidable but can be managed.

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References

  • Davidoff RA. Migraine: Manifestations, Pathogenesis, and Management. 2nd Ed. Oxford University Press.1994.
  • Pryse-Phillips WEM et al. Guidelines for the nonpharmacologic management of migraine in clinical practice. CMAJ 1998;159:47-54.
  • Brandes JL. The influence of estrogen on migraine: a systematic review. JAMA 2006;295(15):1824-1830.
  • Zacur HA. Hormonal changes throughout life in women. Headache 2006;46 Suppl 2:S49-54.
  • Wöber C, Wöber-Bingöl C. Triggers of migraine and tension-type headache. Handb Clin Neurol. 2010;97:161-72.
  • Blau JN. Water deprivation: a new migraine precipitant. Headache. 2005 Jun;45(6):7579.
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