What Causes Migraines? How to Identify What Sets Off Your Headaches

Migraines are one of the most misunderstood health conditions. While some people are able to identify what triggers these debilitating headaches clearly, other sufferers note that their migraines are seemingly random in nature. Here is what the experts have to say about the most common causes of migraines and how sufferers can track these episodes to identify possible triggers.

How Migraines Differ From Other Headaches

A migraine is more than just a terrible headache. They are instead classified as a neurological disease that combines head pain with nausea and sensitivity to light and sound. Migraine episodes are often so painful that it is impossible to continue with daily activities.

According to Dr. Nada Hindiyeh, board-certified neurologist, UCNS-certified headache specialist, and chief medical officer at Haven Headache & Migraine Center in California, a migraine is completely different from a tension headache. “The underlying cause of migraine is a genetically-influenced neurological susceptibility involving altered sensory and pain processing," explains Hindiyeh. She goes on to say that “A trigger does not create that disease; it may help initiate an individual attack in someone who is already susceptible.”

This means that migraines are not necessarily caused by a specific event or exposure to a triggering environment. Instead, a migraine itself is the underlying condition, and triggers can set off attacks in people who already have it.

Hindiyeh is an advocate of a screening tool that helps patients to distinguish between common headaches and migraines.  She details that “The validated ID Migraine screening tool focuses on three particularly useful clues: nausea, light sensitivity, and headache-related disability. Having two of these three features makes migraine much more likely, although a clinician must make the final diagnosis.”

This distinction is important, as it is easy to confuse migraines with more common tension headaches. It is important to understand that tension headaches present more like pressure or tightness in the head. Unlike migraines, tension headaches do not make people nauseous, nor do they worsen with daily activities.

Migraines are not always the crippling headaches that most people associate with this condition. Instead, migraines can range in severity from completely incapacitating events to mild headaches that are easy to power through. Some sufferers have also found that they can treat the migraine and stop it in its tracks if they catch it early enough.

Identifying Common Migraine Triggers

Understanding some of the most common migraine triggers is the first step in helping to control these violent intrusions into life. However, not all migraines are associated with a specific trigger. Hindiyeh notes that the most common triggers that she sees in patients are “changes in sleep, stress or the letdown after stress; skipped meals; dehydration; hormonal fluctuations; alcohol; inconsistent caffeine intake; bright or flickering light; strong odors; and weather changes.”

Hindiyeh also said that triggers can have a cumulative effect. For example, while one night of poor sleep may not be a problem, two consecutive restless nights can lay the groundwork for a migraine episode. Understanding the base trigger can provide insight into how to lower your specific risk.

Many migraines are also blamed on hormone fluctuations. Some of the most common offenders in women include pregnancy, menopause, and overall menstrual cycles. It is not unusual for women to report a higher incidence of migraines during the two days leading up to the start of menstruation, as well as the first three days of bleeding.

Certain foods have also been identified as migraine triggers. This is typically a personal experience, with one individual's experience not being indicative of what someone else might experience. Keeping a food journal can help you to identify what specific food may be causing the onset of the migraines.

Some of the most common food triggers include alcohol, caffeine, aged cheese, cured meats, chocolate, and artificial sweeteners. The effects of each of these foods vary vastly between individuals, which is why personal food journaling can be instrumental in helping to isolate what it is that is most bothersome to you.

In addition to maintaining a trigger journal, experts recommend that those prone to migraines aim for consistency in their lifestyle. This means keeping a regular sleep and meal schedule, staying well-hydrated, and practicing stress-reduction techniques to keep these severe headaches at bay.

Hindiyeh advises patients to work to identify overall patterns without getting caught up in trying to avoid every single trigger. As she explains, “Patients can experience attacks even when they do everything right. The goal is to identify meaningful patterns while also treating the disease effectively.”

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