Many people with migraines suspect that their headaches happen when they experience certain things: a sudden change in the weather, a sleepless night, or a dinner of MSG-laden Chinese food. They're probably right, because an enormous number of factors have been identified as potential triggers for migraine headaches.
It's important to understand that triggers don't actually ‘cause' migraines. The cause or causes of migraines are related to the unique physiology of the brains of migraine sufferers, and the exact changes within your brain that result in pain are complex and still not completely clear. Your triggers only help to set these changes in motion.
You can more accurately think of triggers as lowering your brain's threshold for migraines. The lower your threshold, the more likely you are to experience a migraine.
There typically isn't a one-to-one correspondence between triggers and headaches. Instead, the effects of triggers tend to add up. On any given day, the higher your overall exposure to all your triggers, the more likely you are to have a headache.
For instance, if your overall trigger exposure is high, it may take just one piece of chocolate to tip you into a chasm of pain. On another day, when your overall load is lighter, you might be able to enjoy the same piece of chocolate with no problem.
No matter what your particular triggers are, identifying and avoiding them is key to minimizing the number of headaches you experience. If you're not sure what triggers your headaches, keep a journal and make a record of what you did, ate, and experienced around the time of a migraine. Over time, you'll begin to see a pattern as certain things appear repeatedly in your list of possible triggers.
Here are some ways to avoid many common migraine triggers.
Watch what you eat and drink. Being careful about your diet is an important way to limit your intake of many known migraine triggers, like tyramine (found in aged cheeses and meats), monosodium glutamate or MSG (a common flavor enhancer in processed foods), aspartame (NutraSweet®). Read labels on the foods you buy and, if you're eating out, ask if the kitchen uses MSG. Avoid aged cheeses, cured meats, and processed foods, which contain more chemical and additives—potential triggers.
Gradually reduce your caffeine intake. Many people with migraines find that one or two cups of coffee a day are fine; others can't tolerate it. Reducing your intake gradually prevents a ‘rebound' migraine from caffeine withdrawal.
Limit your alcohol intake, particularly of beer and red wine.
Manage your stress. Migraines commonly occur when you're under stress—or just afterward, when you finally let go. Use relaxation techniques to keep your overall stress load under better control.
Maintain regular sleeping habits. Going to bed and getting up at roughly the same time every night minimizes the chance that not enough sleep—or too much of it—will go to your head.
Limit your use of over-the-counter pain medications. If you're using a product like ibuprofen or naproxen more than twice a week, you may be suffering from rebound headaches. These occur when the pain reliever leaves your system. In pain again, you take more medication, and the cycle repeats. If you need pain relievers more than twice a week, see your doctor.
Avoid strong sensory stimulation. For many people, bright lights, strong smells, and even persistent noise can help bring on a headache. Wear sunglasses to avoid glare, cut a wide margin around secondhand smoke—and, by all means, stop smoking yourself if you haven't already. Limit the amount of time you spend in noisy environments or wear earplugs.
Identifying and avoiding your migraine triggers is an important step toward reducing the number of headaches you have.