Migraine triggers: what the evidence says

Many people with migraine notice that certain things seem to set off an attack. The evidence on triggers is mixed, and what acts as a trigger varies from person to person.

Commonly reported triggers

People often report that attacks follow things such as:

• Too little or disturbed sleep
• Missed or delayed meals
• Not drinking enough fluid
• Stress, or the let-down after stress
• Alcohol, and for some people certain foods
• Hormonal changes, such as around periods
• Bright or flickering light

These are reported associations. For many of them the evidence is not settled, and a suspected trigger does not cause an attack every time.

What a headache diary can show

Keeping a simple record of attacks, along with sleep, meals, and other factors, can help you and the neurologist see patterns that apply to you. It is more reliable than trying to recall triggers from memory.

What the evidence tends to support

Regular sleep, regular meals, and staying hydrated are reasonable steps with reasonable support. It is worth being cautious about cutting out many foods at once, as strict diets rarely help and can be hard to keep up.

When to see a neurologist

If attacks are frequent, severe, or changing, a neurologist can assess them and discuss options. Migraine care is planned for each person.