Headache Triggers and Tips

Stress

Stress is the most common headache trigger, affecting most people at some point in their lives. Physical or emotional stress, including major life events, can bring on headaches and sometimes migraines. Some other facts:

  • There are certain chemicals that when released in the brain can cause the vascular changes that lead to a migraine headache
  • Anxiety, worry, shock, depression, excitement, and mental fatigue can lead to stress induced headaches
  • Chronic or repeated stresses can cause daily headaches
  • Stress related headaches, typically in a "hat-band" distribution, can accompany sleep disturbances

Lowering stress through relaxation, various forms of psychotherapy, behavioral modification, and the even the use of antidepressant drugs (under the watchful eye of a physician) can help provide relief for stress headaches.

Alcohol

Alcohol may trigger headaches immediately, or following prolonged periods of drinking. Some other facts:

  • Ethanol, the key ingredient of alcohol is a natural diuretic, causing the body to lose vital salt, vitamins and minerals
  • Over-consumption of alcohol can cause dehydration and chemical imbalances in the body and brain, leading to headaches that last for hours to days. Those who suffer from migraines and cluster headaches can be especially sensitive to alcohol, even in very small amounts, triggering a reaction in the body leading to a headache

Alcohol should be used in moderation but those who suffer from headaches should avoid alcohol to prevent worsened headache symptoms.

Allergies

Frequently, patients with migraine headaches attribute their symptoms to allergic reactions to certain foods or environments. In most cases this assumption is incorrect.

When a true allergy exists, the nasal or respiratory tissues react due to the white blood cells or inflammation involved with the allergy. Other facts:

  • Patients with frequent migraines may have a sensitive nervous system that triggers attacks provoked by specific smells or lighting situations, leading them to believe this is a symptom of the allergy
  • Migraine and other headache patients may get headaches related to allergic problems because of the stress caused to the body associated with the allergy
  • Some migraine sufferers will experience nasal congestion or sinus type symptoms as part of their migraine attack, but these headaches should not be confused with “sinus headache” or “sinus infection” but diagnosed and treated as migraine

Caffeine

Caffeine can both help and hurt the headache sufferer and should be used carefully. Patients sometimes find relief from headaches by consuming caffeine, however they should still try to refrain from excessive daily use of caffeine. Some other facts:

  • Coffee, energy drinks, tea, cola, certain soft drinks, and some pain relieving and migraine abortive medications use caffeine as an additive
  • Caffeine is a very common ingredient in prescription and over-the-counter headache medicines because caffeine helps the body absorb headache drugs more quickly, bringing faster relief
  • Many headache sufferers can consume up to 200 mg. per day
  • Overstimulation from caffeine can trigger headaches and the “rebound” effect from overconsumption can also cause minor headaches, where body “comes down” from the caffeine effects

Eyestrain from Watching TV / Computer

Long hours looking at television, computers, tablets, cell phones, video games can lead to exhaustion, lack of circulation and eyestrain which can cause headaches. Rarely is eyestrain the sole cause of headaches. However if eyestrain is suspected, an ophthalmological exam is recommended. Tips to consider:

  • Take frequent short breaks and making sure to stretch your neck, arms and back while watching TV or using the computer and walking a few minutes to aid circulation
  • Try closing your eyes and taking a few deep breaths. If you feel headache or migraine symptoms coming on, stop and relax

Hormones

Most headaches related to hormonal imbalance typically occur in women due to fluctuations in estrogen levels. Few women (less than 10 percent) experience headaches only with menses. However, for most women hormones are just one of many migraine triggers. Some other facts:

  • Estrogen levels drop around menstruation causing up to 60 percent of women with migraine to experience attacks around their periods
  • Fluctuating estrogen levels cause more women than men to suffer with migraines
  • After menopause, most women experience fewer migraines. However, women utilizing hormone replacement therapy may experience a continuation of their migraines

Pregnancy

Typically, migraine symptoms will improve during pregnancy, but some women experience the onset of frequent migraines while pregnant. Some other facts:

  • Development of new headaches or any change in headaches patterns during pregnancy should always be discussed with your obstetrician to make sure there is not a more serious underlying cause
  • The safety of medications used for migraine, including over-the-counter medication, during pregnancy cannot be assured. You should always discuss use with your obstetrician before taking any medication
  • Additionally, there are many non-medication treatment options that can help during pregnancy including supplementation with magnesium and biofeedback

Hypertension (High Blood Pressure)

High blood pressure has been frequently called the "silent killer," due to the lack of many physical or visible symptoms of high blood pressure. Some other facts:

  • High blood pressure can cause many health problems like headaches by increasing stress levels
  • Blood pressure usually has to be quite elevated, above 200/110, to be responsible for headache symptoms
  • Discuss your blood pressure and the issues surrounding it with a doctor to determine if it could be responsible for your headaches

Light and Sensitivity

During a headache or migraine, sufferers are frequently very sensitive to light. Bright lights or flashing lights are more likely to trigger migraine headaches, and it’s been shown that a slow flicker is more irritating than a rapid one.

  • Those with migraine often are sensitive to light outside of a migraine attack and find that certain types of light can even trigger an attack
  • Flickering light given off from standard florescent bulbs and computer screens are common triggers and can be avoided by using anti-glare screens on computer monitors and daylight spectrum florescent bulbs

Smoking

Smoking contributes to headaches for both smokers and nonsmokers alike. Some other facts:

  • Nicotine, one of the substances found in tobacco, and the scent produced by burning tobacco both contribute to triggering migraines
  • Exposure to second hand smoke can be a trigger for those with sensitivity and history of migraine
  • In addition to triggering attacks, smoking increases the risk of stroke in those with migraine

Smoking appears to play a causal role in cluster headache appearance and quitting can help control attacks. Those with migraine should quit smoking and avoid places where second hand smoke is present.


Contact Us

Tel: 212-241-7076
Fax: 646-537-8513

Center for Headache and Pain Medicine
The Mount Sinai Hospital
Faculty Practice Associates
5 East 98th Street, 7th Floor
Box 1139
New York, NY 10029

Dr. Mark Green on Migraine Triggers