Migraines are triggered when certain environmental, dietary or lifestyle-related factors impact the transmission of sensory information to the brain.
Each migraine trigger has a unique effect on the network of sensory nerves in the face and head which help regulate pain perception. This can result in various symptoms such as a headache and sensory sensitivity that can be managed using migraine treatments.
This guide details the scientific mechanisms behind various migraine triggers and offers proven tips on how to avoid them to reduce the frequency, duration and severity of migraines.
What is a migraine trigger?
Migraine triggers refer to environmental, dietary, or lifestyle-based factors that can initiate the prodrome phase of a migraine, which typically occurs at the beginning of a migraine attack.
Environmental migraine triggers
Barometric pressure
Barometric pressure refers to the pressure of the atmosphere on the surface of the Earth. Changes in barometric pressure can be caused by weather patterns, such as an incoming storm, as well as when taking a flight, as the cabin pressure in an aircraft is lower than the pressure at sea level.
Barometric pressure changes can cause air trapped within blood vessels and cavities in the skull to expand, triggering a migraine[1]. Barometric pressure changes can also affect how quickly water vapour is lost from the respiratory tract in the body, leading to dehydration - a common migraine trigger.
Air quality
Studies suggest that exposure to certain air pollutants such as sulphur dioxide can irritate the respiratory system, triggering inflammatory responses that may affect the trigeminal nerve, contributing to the onset of a migraine.
Loud noises
Research indicates that loud noises can trigger stress responses which can activate the trigeminal nerve, contributing to the onset of a migraine.
Dietary migraine triggers
Food additives
Certain food additives such as amines can cause migraines due to their effects on the nervous system.
For example, tyramine, a natural compound found in aged and fermented foods, and phenylalanine, an additive in certain artificial sweeteners, can affect the release of chemicals such as serotonin and noradrenaline in the body[2][3].
Fluctuations in the body’s levels of these chemicals can cause blood vessels in the brain to constrict and dilate at a rapid rate, leading to changes in blood flow and pressure in the brain. This can subsequently activate pain pathways and overstimulate the trigeminal nerve - a key nerve involved in triggering migraines.
Alcohol
Alcohol tends to cause an excessive loss of fluids, dehydrating the body and increasing the risk of triggering a migraine as a result. Some alcoholic drinks also contain additives such as tyramine that can further increase the risk of triggering a migraine.
Caffeine
Caffeine blocks a neurotransmitter called adenosine from widening the blood vessels[4]. If caffeine consumption is stopped abruptly, the body’s levels of adenosine can increase, causing a larger amount of blood to flow through the brain. This can subsequently cause a throbbing pain in the head, triggering a migraine in some individuals.
Lifestyle-based migraine triggers
Irregular sleep patterns
Irregular sleep patterns and insufficient sleep can affect the body’s levels of serotonin, a neurochemical involved in mood regulation and pain perception. This disruption can affect the central nervous system, potentially altering the brain’s sensitivity to pain and contributing to the onset of a migraine[5].
Stress
Stress can trigger the release of several hormones such as cortisol, adrenaline, and serotonin. Cortisol and adrenaline can contribute to an increase in systemic blood pressure, while serotonin can affect pain pathways in the brain. Therefore, changes in the body’s levels of these hormone levels can trigger a migraine.
How do migraine triggers work?
Migraine triggers affect the body through a series of complex processes. Current scientific research suggests that migraines can be triggered by any factor which influences the interaction between the trigeminal nerve, a key pain pathway, and blood vessels connected to the brain and spinal cord which supply blood to the protective tissues encasing the central nervous system (known as the ‘meninges’)[6].
Migraine triggers are thought to activate the trigeminal nerve, causing blood vessels in the meninges to become inflamed, resulting in painful symptoms such as headaches and nausea.
What can trigger a migraine?
Environmental factors such as changes in barometric pressure, exposure to bright sunlight, and air pollution levels can trigger migraines. Additionally, dietary choices, including the consumption of caffeine, alcohol, and certain foods, can trigger migraines in some individuals.
Lifestyle factors, such as smoking, stress, and the number of hours slept each day, can trigger migraines, as well as physiological factors like hormonal imbalances and other health conditions.
Recommended reading: Migraines - Everything You Need to Know
How to cope with common migraine triggers
Environmental migraine triggers
Sunlight:
- Wear sunglasses with a high enough tint to reduce glare and shield the eyes from sunlight.
- Wear a wide-brimmed hat to further reduce how much sunlight reaches the eyes.
- Avoid going from dark to bright environments suddenly, as the effect of a change in light exposure on the retinas of the eyes can trigger migraine symptoms.
Changes in barometric pressure:
- Stay hydrated to avoid dehydration associated with a change in barometric pressure.
- Check weather forecasts frequently to prepare for potential changes in barometric pressure and stock preventive migraine medication in advance.
Air pollution:
- Check the air quality index before going outside and plan activities on days when it may be lower to reduce the risk of air pollution triggering a migraine.
- Wear a mask to reduce how much particulate matter is inhaled, including air pollutants that may trigger a migraine.
Dietary migraine triggers
Food additives:
- Keep a food journal to track foods eaten each day and cross-check this against occurrences of migraines to ascertain which foods may be triggering migraines.
- Avoid foods containing nitrates, tyramine, and phenylalanine by reading food labels carefully and limiting the consumption of processed foods that tend to contain these additives.
Alcohol:
- Avoid alcoholic beverages that contain tyramine and other additives such as red wine.
- Stay hydrated while drinking by following each glass of alcohol with a glass of water to mitigate its dehydrating effects.
Caffeine:
- Maintain consistent but moderate caffeine consumption to avoid withdrawal symptoms.
- If you intend to decrease your caffeine intake, do so gradually over several weeks, as opposed to quitting suddenly.
Lifestyle-related migraine triggers
Irregular sleep patterns:
- Try going to to bed and waking up at the same time every day as this can help keep the body’s serotonin levels balanced.
- Ensure your bedroom environment is conducive to sleep by keeping it dark, quiet, and cool.
- Avoid long naps during the day to prevent nighttime sleep disruptions.
Stress:
- Implement stress management exercises such as meditation and deep breathing.
- Consider professional counselling if you experience chronic stress.
Recommended reading: Is Stress Causing Your Migraines
How a migraine diary can help to cope with migraine triggers
Documenting the various environmental, dietary, and lifestyle-related factors that are causing migraines can help individuals identify and prevent triggers.
A migraine diary should contain information about potential triggers and the symptoms that are experienced on a day-to-day basis so that it can be viewed by medical professionals such as pharmacists or doctors to help them recommend appropriate migraine treatments.
This can subsequently help in creating personalised migraine treatment plans and determining whether lifestyle changes or the use of certain medications can help prevent migraines.
Summary
Avoiding migraine triggers can be challenging, as certain triggers, such as weather changes, are out of an individual’s control. However, some triggers, such as diet and lifestyle factors, are more manageable and can contribute to reducing the risk of migraines.
It is therefore important for individuals to be aware of the root causes of migraines to take the correct steps and incorporate the right changes in their daily routines to avoid migraine attacks.
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