What Can Cause a Migraine: What Triggers a Migraine

Many things can bring on a migraine, from stress, poor sleep and skipped meals to hormone changes, alcohol, bright light and some foods. Migraine itself is an inherited brain condition, and these triggers set off an attack in someone who is prone to it. Knowing what can cause a migraine for you, and keeping a diary of attacks, is the first step to having fewer of them. A GP can help you find what sets yours off and plan treatment.

Key takeaways

• Migraine is an inherited brain condition, and something sets off each attack.
• Common triggers include stress, poor sleep, missed meals, alcohol and periods.
• Taking pain relief too often can lead to medication overuse headache.
• A headache diary helps you and your doctor spot patterns.
• Call 000 for a sudden, severe headache or weakness, numbness or trouble speaking.

Medication Overuse Headache From Frequent Pain Relief

Medication overuse headache is a daily or near-daily headache caused by taking pain relief too often for migraine or other headaches. It is one of the most common causes of headache that keeps coming back, and it can turn occasional migraines into chronic ones. The table shows how often is too often.

The fix is to cut back, ideally with a doctor's help, as the headache often gets worse for a week or two before it improves. Alcohol and headaches are linked too: drinking can trigger a migraine, and a hangover adds its own headache on top, so cutting back on both pain relief and alcohol often helps.

Symptoms of a Migraine Attack

A migraine is more than a bad headache. The main symptoms are a moderate to severe throbbing pain, often on one side of the head, that lasts from 4 to 72 hours and gets worse with movement. Nausea, vomiting and sensitivity to light and sound are common, and many people need to lie down in a dark, quiet room.

About a quarter to a third of people with migraine get an aura first: flashing lights, zigzag lines, blind spots, or tingling in the face or hand, lasting up to an hour. The difference between headache and migraine lies mostly in these extra symptoms. In a headache vs migraine comparison, a tension headache is a dull, pressing band on both sides with no vomiting, while migraine brings the throbbing and the need to stop. Medication overuse can blur the picture, and stress can make both worse. Knowing what can cause a migraine, and what an attack looks like, helps a doctor tell them apart.

How the Brain Responds to Migraine Triggers

Migraine is a neurological condition in which the brain is more sensitive than usual to change. When something tips it over a threshold, nerve pathways in the brain and the trigeminal nerve in the face become overactive and release chemicals that inflame the blood vessels and linings around the brain, which causes the pain. In people with aura, a slow wave of nerve activity across the brain causes the visual changes first.

Migraine triggers are not the root cause; an inherited tendency is. Many people with migraine have a parent or sibling with it, which is why the causes of migraine are partly inherited. What triggers a migraine differs between people and from one attack to the next, and triggers often add up: a late night alone may not set one off, but a late night, a skipped meal and a glass of wine together might. That is why the answer to what can cause a migraine is different for everyone. Frequent attacks can make the brain more sensitive over time, which is how occasional migraine becomes chronic, with headache on 15 or more days a month.

Everyday Lifestyle Factors That Bring On Attacks

Stress is the trigger people report most, and many people get migraine headaches as stress eases, such as on the first day of a holiday or at the weekend. Other everyday factors include:

• too little or too much sleep, or a change in sleep times
• skipped or late meals, and not drinking enough water
• too much caffeine, or suddenly cutting back on it
• hard exercise without warming up
• long hours at a screen with a tense neck and shoulders

Hormone changes and certain foods play a part too, and a chronic pattern of poor sleep makes every other trigger stronger. A steady lifestyle, with regular meals, sleep and exercise, lowers the number of attacks for many people.

Getting Same Day Migraine Care From a GP

A GP can help on the day of an attack and over the longer term. By phone, a Medio GP can talk through your symptoms, check whether they sound like migraine, a tension headache or cluster headaches, and advise on treatment, including an eScript where the doctor thinks a medicine is right. Migraine-specific medicines and medicines that prevent attacks are only available on prescription in Australia. If you are unsure about headache vs migraine, note how long the pain lasts, where it sits, what you ate and how much caffeine you had.

Call 000 straight away for a sudden, severe headache that peaks within a minute; a headache with weakness, numbness, a drooping face or slurred speech, which can be signs of a stroke; or a headache with fever, a stiff neck, confusion, a seizure or any new neurological symptom.

What Can Cause a Migraine?

Migraine is caused by an inherited tendency in the brain, set off by triggers that differ from person to person. There is rarely one answer to what can cause a migraine; it is usually a mix of daily habits, hormonal changes, food and drink, and surroundings such as bright light, strong smells, loud noise and the weather.

Hormonal migraine is common in women: attacks often come just before or during a period, when oestrogen falls, and can change with the contraceptive pill, pregnancy and menopause. Some people also notice nausea and neck tension in the hours before the pain. Headaches alongside a chronic illness or a weak immune system, a recent head injury, or a new pattern of attacks after the age of 50 needs a doctor's diagnosis, as other causes need ruling out. Cluster headaches are a separate condition, with short, severe attacks around one eye.

Food, Drink and Surroundings That Can Spark an Attack

Food and drink triggers are less common than many people think, but certain foods do set off attacks in some people: aged cheese, chocolate, processed meats, MSG and artificial sweeteners. Alcohol, especially red wine, and too much or too little caffeine are the drinks most often blamed.

Surroundings matter too. Bright or flickering light, screens, loud noise, strong smells such as perfume, smoke or paint, and weather changes, heat and storms can all bring on an attack in people with a sensitivity to them. Keeping a diary of food, drink, sleep, stress and attacks for two or three months shows which triggers matter and helps a doctor with the diagnosis. Cutting out foods without good reason can leave you hungry, which is a trigger in itself, so a diary is the clearest way to learn what can cause a migraine for you in particular.

Summary

This article covers the brain changes behind migraine, the symptoms of an attack, headaches from taking painkillers too often, and the everyday, hormonal, food and surrounding causes. A Medio GP can assess your headaches by phone consult, help you find what sets off your attacks and advise on treatment and prevention.

Frequently asked questions

What kinds of things cause migraines?

The things that most often cause migraines are stress, changes in sleep, skipped meals, hormone changes around periods, alcohol, too much caffeine, bright light, strong scents and weather changes. Underneath them is an inherited brain tendency, which is why some people get migraine and others get only occasional headaches from the same things.

How do migraines affect children during puberty?

Migraines often start or change around puberty. Before puberty boys and girls are affected about equally, but afterwards girls are affected more often, as periods begin and hormones shift. Attacks in younger people can be shorter and may come with tummy pain. Medio cares for adults only, so a child or teenager with headaches should see a GP in person.

What are the typical prodrome symptoms of migraine?

The prodrome is the early warning phase, from a few hours to a day or two before the pain. Typical signs are yawning, tiredness, food cravings, mood changes, a stiff neck, trouble concentrating and passing urine more often. Noticing them gives you a chance to rest, drink water and take your usual treatment early.

What could be causing my unexplained migraines?

Hidden causes are the usual answer: poor sleep, frequent pain relief, too much coffee, not drinking enough water, jaw clenching or the time of your period. Stress and headaches feed each other, and some medications can cause headache as a side effect. Treatment for headaches that keep coming starts with a diary, which shows what can cause a migraine in your case, and a review with your doctor, especially if attacks are new, changing or getting worse.

What is the 5 4 3 2 1 rule for migraines?

The 5 4 3 2 1 rule is a grounding exercise for anxiety, not a migraine treatment: you name five things you can see, four you can touch, three you can hear, two you can smell and one you can taste. Some people use it to stay calm during a migraine, as worry can make pain feel worse, but it does not stop an attack.

Why does coke help migraines?

Cola drinks contain caffeine and sugar. Caffeine can ease migraine pain a little and helps some pain relief work faster, and the sugar helps if a skipped meal was the trigger. Regular caffeine can itself trigger attacks and rebound headaches, though, so keep it occasional. During an attack, rest in a dark room and avoid screens and repeated doses of pain relief.