A journal sits on a bedside table next to an iPhone, pen and Apple Watch.
Keeping a migraine diary can help uncover triggers such as caffeine, fasting, dieting, dehydration, weather changes, lack of sleep, odors, fluorescent light or hormonal changes. (For Spectrum Health Beat)

A migraine diary may help you pinpoint—and avoid—headache triggers, a neurologist says.

About 12 percent of people in the United States suffer from migraines, according to the Migraine Research Foundation.

“A migraine can be debilitating and can impact daily activities, your family and social life. Unfortunately, migraine often goes undiagnosed and undertreated,” said Dr. Sait Ashina. He’s a neurologist and headache specialist at Beth Israel Deaconess Medical Center in Boston.


Our Take

Migraines aren’t just an American issue—they’re a human issue, says Jared Pomeroy, MD, a headache specialist with Spectrum Health Medical Group Neurology.

The World Health Organization lists migraines among the Top 20 illnesses that cause a disability.

The disorder has a disproportionate economic impact as well, typically affecting people in the prime of their lives.

A bout with migraines can cause an otherwise healthy person to miss work or school, and in some cases it can lead to job loss. It can also cause a person to miss out on precious family time.

It’s truly an ailment that knows no social or economic boundaries, striking the rich and famous just as often as it strikes everyday people. In a New York Times article, tennis star Serena Williams said she has lost matches because of menstrual migraines.

People with migraines can sporadically—and temporarily—escape the battle.

When they seek treatment, however, they sometimes find it difficult to gain understanding from people who have never suffered a migraine, Dr. Pomeroy said.

“A lot of people who don’t suffer from migraines see them as a character flaw, not as a physical ailment,” the doctor said.

Society’s conventional knowledge of migraines doesn’t always mean the public, or even employees in the medical field, will understand the nature of the beast.

While the exact causes of migraines remain unknown, doctors can help patients identify their triggers.

“Triggers are what can set off the symptoms of a migraine headache, which is different than the mechanisms of the head pain,” Ashina explained in a hospital news release. “Triggers are usually individualized — what could bring on a migraine in one person could not be the case in another person.”

Keeping a migraine diary can help uncover headache triggers, Ashina said. Common ones include caffeine; fasting, dieting and dehydration; weather changes; lack of sleep; odors; bright or fluorescent light; and hormonal changes, especially for women.

“Your doctor is going to want to know what you did or ate or how you felt right before a migraine attack,” Ashina said. “By tracking these occurrences and any details you remember ahead of time, your doctor will be able to find patterns that will guide an individualized treatment plan.”

List each migraine in the diary, when it happened, how long it lasted and possible triggers.

The American Headache Society offers headache diary resources, as do several mobile apps.

“Your headache diary will be your doctor’s best resource for avoiding any of these triggers,” Ashina said. “By controlling what you can, you may reduce the frequency and severity of your headaches.”