The season of cheer can be a pain — literally — for the 13 percent of adults in the U.S. who get migraines. Triggers that set off attacks can vary greatly from person to person. But some common causes have emerged through decades of patient diary studies, with many factors converging this particular time of year to give migraineurs quite the headache.
Doctors still can’t explain what these triggers do biologically to the brain, but people who get migraines appear to have systems that are highly sensitive to change. Like canaries in 20th century coal mines, migraine sufferers are often affected by triggers in much smaller doses than those who have regular headaches.
“It’s thought that triggers may alter the brain environment and homeostasis, making a patient more susceptible to a migraine attack,” explains Sarah Vollbracht, MD, clinical director of Montefiore Headache Center and assistant professor of neurology at the Albert Einstein College of Medicine in the Bronx, N.Y.
For example, inclement cold weather patterns including rain, sleet and snowstorms can bring in low barometric pressure, which coincides with higher migraine frequency for many patients. “Weather factors may even interact with each other and operate synergistically to trigger headache,” says Brian Grosberg, MD, director of Hartford HealthCare Ayer Neuroscience Institute Headache Center in Connecticut. Meaning, that while a passing rain shower may not be enough to cause a migraine, an overcast, cloud-heavy day combined with cold rain may converge, causing migraine sufferers to break out the pain pills.
Other common triggers can crop up during the holidays. The stress of travel — plus pressure changes during air travel — fluctuations in sleep schedules, exposure to holiday party foods like aged cheese, chocolate and alcohol, and even “let down” periods where you go straight from overworked and haggard to fully relaxed on weekends or holidays can all bring on migraines, say both experts.
Irregular eating patterns are another big factor. Have you ever “held out” by skipping a meal in order to leave room for that big holiday dinner? This is a bad idea for the migraine sensitive, warns Grosberg.
That doesn’t mean these factors will automatically bring on a migraine. If sometimes you’re able to get away with only a few hours of sleep or eating chocolate, but other times you get hit with a migraine, this isn’t unusual. “Often a single trigger by itself may not be sufficient to lead to a migraine attack, but a combination of triggers, such as poor sleep on a day when the barometric pressure drops, for example, may lower the threshold and lead to a migraine,” explains Vollbracht.
Short of living in a bubble, it would seem tough to avoid these kinds of triggers altogether — but the trick to preventing as much pain as possible this time of year is to lower your trigger load in the days leading up to bad weather or a hectic travel or holiday schedule, suggests Grosberg. “Examples of this include preparing holiday meals further in advance of the holiday, getting enough sleep, maintaining adequate hydration, eating regular meals on time, and leaving enough time for travel to avoid a stressful trip,” advises Grosberg.
The good news is that you don’t have to be a meteorologist to figure out weather pressure changes. Apps such as Migraine Buddy and WeatherX Forecast can help you track your migraines against barometric pressure changes to help determine if it’s a trigger for you — and if so, at what level — as well as give you alerts ahead of time when pressure is going to drastically change so that you can more mindfully decrease your trigger load.
For the migraine sufferer, particularly during the holidays, preparation and prevention are essential for keeping pain at bay.
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