Sleep hygiene, diet, lack of exercise and stress are just some of the triggers reported by people living with migraine. In the fourth episode of Beyond Migraine, a six-part podcast series brought to you by the Migraine Association of Ireland and Teva Pharmaceuticals Ireland, the triggers to the onset of a migraine attack are discussed. Discussing migraine triggers are Aoife Walsh, former Miss Ireland and social media influencer who lives with migraine and Dr Sinead Beirne, GP at Dublin City GP practice, GP Lead at St. Vincent’s University Hospital Headache Clinic and medical expert on TV and radio.

Stress or emotional upset

The principal force of stress is mainly to blame for catalysing migraine attacks, according to Dr Beirne: “I think really top of the list has to be stress. With stress, there are negative, daily life stresses, but also positive stresses, like looking forward to things. So maybe a stressful deadline has been met and the stress seems to have abated and it’s what happens afterwards when there’s a sort of a relief – that’s often a time when somebody will end up experiencing a migraine.”

Sleep

Sleep, or lack thereof, is a big migraine trigger for many people, including Aoife Walsh. Aoife said her migraines only really started around 2018. “I was travelling over and back between Dublin and New York a lot. My sleep pattern was all over the place. I was either getting too little sleep or too much, and I was also jet-lagged – so that’s when I really started to see it come on.” She won’t ever forget the pain. “I actually remember the first time I got a migraine, I was at home in Dublin after a trip to New York, and it was the middle of the night. I couldn’t sleep because I didn’t know what time of day it was. My body-clock was all over the place and I got hit by this excruciating pain in my head. When you haven’t experienced a migraine before, you’re like, what is going on, my head is about to explode.”

Hormones

Dr Beirne knows how, particularly in women, hormones play a huge role in migraine. “I always ask women what age they were when they got their first period? I always ask when they noticed their headaches, and it’s often in secondary school. I always ask about mid-cycle headaches, because we know that oestrogen dips just before you get your period in a normal cycle. That dip of oestrogen is linked with triggering a migraine and you get another dip again in mid-cycle when it comes to ovulation time.”

‘The Migraine Threshold’

A term commonly used in the migraine community is ‘migraine threshold’. This describes a boundary of multiple triggers that, when crossed, leads to a certain migraine. Everybody will have a different threshold – for some it may only be missing a night’s sleep while for others they may need to have multiple triggers occurring for a migraine to come on. “I kind of hate saying it”, says Dr Beirne, “but, you’ve got to have a boring life when you’ve got a migraine. When life is busy and you are lacking sleep or are stressed – anyone who lives with migraine needs to be sensible during these times and to eat regularly to control your blood sugars and keep hydrated.”

Diet

Dr Beirne says that diet can play a role in migraine – but has noticed people misdiagnosing certain foods as their trigger, when actually, they were the subject of a prodrome craving. “I think there can be a little bit of confusion – 24 hours before somebody gets a migraine, they often will experience what we call a “prodrome” which is where they can crave certain foods. Typical signs of prodrome would be yawning, craving carbohydrates, certain sugary foods, or other cravings. Sometimes the person can think that the food that they craved actually caused the migraine when, in fact, they were having what we call a “prodrome” that was about to lead into a migraine.”

What advice is there to alleviate migraines?

Dr Beirne has some general tips and advice for people to help alleviate their migraines:

– Routines

“Go to bed at the same time every night. Get up at the same time every morning. It’s really important to always eat a breakfast. Drink water as soon as you wake up and with your breakfast. Eat three square meals and two healthy snacks per day. Limit caffeine – one coffee or tea a day is enough”.

– Gentle, regular exercise

“A mild to moderate amount of exercise helps keep migraine at bay, but also helps us cope with stress. Don’t push yourself too hard. Listen to your body so you don’t overdo it. Prepare to exercise as well, eat an hour and a half before you exercise.”

– Mindfulness

“Do whatever helps you, whether it’s talking to a friend, whatever it is that you find gets rid of those daily stresses. Try not to let that emotional stress bother you.”

If this advice is not quite bespoke to your needs, visit your GP, or contact the Migraine Association of Ireland.

You can listen to the Beyond Migraine episode featuring Dr Sinead Beirne and Aoife Walsh here. 

The series can be streamed via the Migraine Association of Ireland website as well as wherever you listen to your podcasts.

If you experience migraines, speak to your GP. For more information about migraines, visit migraine.ie.

People living with migraine can also check out Life Effects. Life Effects is an initiative shaped by patients, for patients. It explores the latest science and thinking around your condition, it contains tips and patients share stories about the reality of living with chronic conditions. Find out more about migraine on lifeeffects.teva/eu/migraine.

This article is part of a sponsored series linked to each Beyond Migraine podcast episode brought to you by the Migraine Association of Ireland and Teva Pharmaceuticals Ireland.

The Beyond Migraine podcast is supported by funding from Teva Pharmaceuticals Ireland. Speakers have received an honorarium for their contribution to the podcast.