Dr. Marissa Lagman, a headache neurologist at Women’s College Hospital’s Centre for Headache, discusses common migraine triggers and how to manage them.

If you’ve spent countless hours searching for ways to keep migraines at bay, you’re not alone - migraine is a neurological brain disorder that has been associated with significant disability affecting women three times more than men. While there is no cure for migraine, there are ways to reduce its frequency and severity, most importantly being aware of your personal triggers. Here are a few ideas to get you started:

1. Start taking notes: Keep a migraine diary and note potential triggers, like food, sleep, stress level etc., and then make adjustments as needed. For example, if you notice specific foods trigger your migraines, try to avoid them as much as possible.
2. Manage Stress: If you’re also susceptible to migraine, any increase in life stress, worry or anxiety can trigger a migraine. Stress is an everyday part of life, so focus on self-management practices such as cognitive behavioural therapy (CBT), mindfulness, meditation and relaxation techniques, which are very helpful in reducing stress and managing migraine.
3. Take frequent screen breaks: The bright and blue light from your screens can trigger a migraine. Turn your screen brightness to “night mode” and take frequent breaks throughout the day. Consider the 20-20-20 rule: Looking away from your screen every 20 minutes for 20 seconds at something 20 feet away.
4. Sleep: Sticking to a consistent sleep schedule—going to bed and waking up at the same time each day even on weekends and avoiding long naps—may prevent a migraine from surfacing.
5. Stay hydrated: One way to trigger a horrible headache—including migraine—is to let yourself get dehydrated.  Drink 1.5 to two litres of water a day and avoid drinks with artificial flavours and colours.
6. Get moving: Exercise releases the natural painkillers in our brain called endorphins. It can also reduce stress and help us sleep better at night—two other migraine triggers.
7. Don't skip meals: Skipping a meal can lower your blood sugar, which can incite a migraine attack. Also, eating a high protein breakfast is recommended for migraine patients.
8. Avoid strong scents: It may not be possible to avoid odours on those around you, but it's best to avoid spritzing yourself with heavily scented perfumes. You may also need to skip home fragrance sprays or scented candles.

Identifying potential triggers can provide you with important clues as to how and why you experience a migraine. It also gives you insight into possible prevention and treatment options. On the flip side, it's possible that after a long search, you may not find a trigger; there are triggers like weather changes, for instance, which we can't control. That said, there are far more migraine triggers you can avoid or control. The most important thing to remember? No one knows your migraines as well as you do. So, if something doesn’t feel right, seek help right away. The sooner you act, the faster you will feel relief.

Dr. Marissa Lagman is a headache neurologist at Women’s College Hospital’s Centre for Headache in Toronto, Ont. She is a Fellow of the American Headache Society and UCNS Diplomate in Headache Medicine, an Assistant Professor at the University of Toronto, Department of Pediatrics (Neurology) and Director of the Pediatric and Young Adult Headache and Concussion Program at WCH and Director of the Headache Program at the Hospital for Sick Children. She joined the Centre for Headache in 2015 and is actively involved in research and teaching. Her main areas of interest include pediatric and young adult migraine and headache disorders, childhood migraine variants, post-traumatic headache, medication overuse headache, migraine in women, and neuromodulation therapies. 

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