What are Lifestyle Issues For Migraine Prevention? 2023
Migraine is a genetic neurological condition that has a strong familial link. 12% of the world’s population has migraine and women have three times more migraine than men do. Migraine is the most frequent medical condition for women and it comes with the menstrual cycle in over half of women.
Migraine is the seventh most disabling condition among all diseases and the leading cause of disability among all neurological disorders. Persons with Migraine need to learn how to treat it, yet studies show that 56% of persons have Migraine and have never been given a medical diagnosis by a doctor.
Could Migraine be improved by paying close attention to lifestyle issues? This is a question with a certain answer.
This is an article by Britt Talley Daniel MD, member of the American Academy of Neurology, the American Headache Society, migraine textbook author, podcaster, YouTube video producer, and blogger.
Lifestyle Issues For Migraine Prevention are important and should be performed by all persons with Migraine. The important lifestyle issues are:
Limiting Caffeine
Eating regularly
Getting regular physical exercise
Getting regular sleep
Learning to deal with stress
Avoiding food triggers
Avoiding your known Migraine triggers
Checking barometric pressure levels
Keeping a Migraine diary
The lifestyle suggestions don’t just help Migraine, they also improve general health and longevity.
The treatment for Migraine is: Doing the Lifestyle, taking Acute therapy medication at onset of a Migraine attack, and starting Preventive medication for Migraine patients with frequent attacks.
These ideas are basic, dogma, like, they have got to be done.
Click to get my little Migraine book.
Related Issues.
Caffeine is a double-edged sword.
Most persons like to drink caffeine and although it is an addictive drug according to the Diagnostic and Statistical Manual of Mental Disorders V, drinking caffeine can be a very pleasant experience for most people.
The problem is that caffeine is a vasoconstrictor and can aggravate Migraine or give medication overuse headache if too much is used. This issue is especially important to persons with Migraine.
The American Headache Society has stated that caffeine is the number one drug in America causing an increase in the intensity and frequency of migraine. Caffeine use is confusing because many persons know that caffeine may be used to treat headache, but they need to learn that if taken frequently, more than 2 days a week, it can cause medication overuse headache, previously called--rebound headache.
As a neurologist and headache doctor I know that many people with Migraine do drink some caffeine and they get by with it and probably do OK, but it’s the slow, sneaky addictive quality of the drug that bothers me as a doctor and I think bothers many Migraine patients.
Overall, I advise Migraine patients to not drink caffeine.
Coffee, coffee, coffe, coff, cof, ……
Diet issues.
Avoid fasting or missing a meal.
A small breakfast will suffice, but usually for mostly young women, who fill the offices of neurologic headache doctors all over the world, the advice to eat breakfast will be met by a vacant look and denial many times.
Did you know that the word “breakfast: means “to break the fasting of sleep.” If you don’t eat and without your knowing it, your pituitary gland will sense your low blood sugar and send out a hormonal signal that will cause vasodilatation of your cerebral arteries and start your “hungry headache” migraine.
Three meals a day is advised by all medically accepted weight loss programs (Jenny Craig/Weightwatchers) but my experience is that most mothers will feed their children three meals a day but not themselves.
Migraine generators
Exercise.
The American Heart Association has recommendations for Adults and here it is straight copy and paste from the AHA website.
Recommendations for Adults
Get at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, or a combination of both, preferably spread throughout the week.
Add moderate- to high-intensity muscle-strengthening activity (such as resistance or weights) on at least 2 days per week.
Spend less time sitting. Even light-intensity activity can offset some of the risks of being sedentary.
Gain even more benefits by being active at least 300 minutes (5 hours) per week.
Increase amount and intensity gradually over time.
The above are recommendations for general health, but did you know that one may improve migraine, anxiety/panic disorder, depression, tension headache, and sleep problems with aerobic exercise?
There are hundreds of scientific articles over the past 20 years proving that exercise works for headache therapy. Aerobic exercise is: dance aerobics, jogging, cycling, swimming, rowing, cross-country skiing, and stair-stepping.
It is not walking, lifting weights alone, stretching, or playing most games, like tennis or racquetball. If you are already exercising and still have bad headaches, consider increasing your exercise program.
Exercise is something you can do for yourself to take control of your headaches. It takes determination, time, and effort.
Overweight can increase the frequency of Migraine attacks.
Some migraine patients get a “work-out headache” if they get hot. If this happens to you then try to work out so you don’t get so hot. Exercise in front of a fan or in air conditioning.
Take ibuprofen, Excedrin, or a half of a Triptan drug before you work out, remembering to limit all painkillers and triptans to no more than 2 days per week.
If you still get a work-out headache, then try swimming.
So, here we go, 1,2.3,4. Very good 2,3,4
Adequate Sleep.
Migraine persons often don’t sleep well. 50% of Migraine patients are depressed or 40% have GAD (generalized anxiety disorder) which both have insomnia as one of their cardinal symptoms.
Regulate your sleep. Set your sleep/wake cycle to rise and go to sleep at the same time every day-even through the weekend. Adults should sleep between 7 to 8 hours every night.
Wake up early on Saturday and Sunday mornings.
Migraine may be treated by sleep RESTRICTION. Avoid oversleeping Saturday morning or falling asleep for that seductive two-hour nap on Sunday afternoon. Set an alarm for 15-20 minutes for a short, energy restoring nap. If you never learned how to take a short nap, then learn. It can be done.
There are stages of sleep. Most persons with Migraine only get to a light stage of sleep at night, not deep sleep. Too much sleep or not enough sleep can set off a Migraine.
Unwind at the end of the day. Listen to soothing music, take a warm bath, read a favorite book.
Hard exercise, big meals, caffeine, nicotine and alcohol can interfere with sleep.
Minimize distractions. Save your bedroom for sleep and intimacy. Don't watch television or take work materials to bed. Close your bedroom door. Use a fan to muffle distracting noises.
Be sure that none of your medications can interfere with sleep. Look up drug side effects on the internet.
A wake up Migraine in a poor sleeper
Dealing with Stress
Many patients I talk with deny having any stress. Talking with them is like “It’s somebody else’s problem, not mine.” They either don’t understand what stress is or are willing to discuss it with a “regular, non- psychiatric doctor.”
These are the stressful events in life:
Change of environment-leaving home to go to school or start a new job.
Death, accident, or major illness of a parent, grandparent, sibling, close friend, spouse, or sweetheart.
Birth of a new child.
Loss of a job; starting a new job.
Financial stress, mortgages due, old bills, unexpected financial responsibilities.
We all go through these types of things. They are the ebb and flow of our lives.
Therefore, learn to talk over your daily life problems with your spouse, friends, family, preacher, priest, or rabbi.
Develop a support system to sustain you in life, built up of key people that are there for you when you need them.
Plan time to relax and spend on hobbies or interests. Normal people have hobbies which is something you do for fun and relaxation, that is creative and not goal or money-making oriented. Children and family are not hobbies. Please look up the word “hobby” in the dictionary if you think this.
Turn off that cell phone, computer, or iPad and get a life. Plan three day weekends several times a year rather than one two-week holiday in August. Leave that depressing, stressful job, or get counseling and try to change a personal relationship that is causing problems.
Try avoiding deep breathing, family or personal counseling, or learn CBT—cognitive behavioral therapy.
Overworker with a happy face and a bloody Migraine
Avoid Overtreatment with Medication.
Don’t take too much caffeine, over the counter drugs, triptans, or painkillers for headache. In general, all migraine patients should limit all such drugs to no more than 2 days per week.
The migraine process generates neurochemicals which are released in the brain and that inflame the thalamus, trigeminal nerve, and cerebral arteries. These neurochemicals stay in the body 3 days and once they inflame the brain they are repeatedly released every time other pain killers, caffeine, Advil, Tylenol are consumed, starting a process of continuous headache.
I once saw a man who told me he had been taking 10 Excedrin migraine pills for over fifty years (10 X 65= 650 mg/day) and he had a headache all that time until I convinced him to stop Excedrin. Then his headaches cleared up.
There is no data that opioid narcotics help migraine headache, they just cause problems and shouldn’t be used for “rescue treatment.” The U.S. is now going through a change in the use of opioid narcotics and barbiturate drugs since they cause people to die in their sleep, are addictive, and cause medication overuse headache.
Narcotics should be used never or only for persons who are in severe pain and near the end of life, for acute trauma, or surgery, only for a short time and then stopped. Death from opioid narcotics is a top problem now in America.
Butalbital found in Fiorinal, Fioricett has been banned in every country in the world except Canada and the U.S. because it causes medication overuse headache. The word “narcotic” comes from the Greek word that means “sleep.” In Texas the number one reason for the State Medical Board to restrict physicians concerns their use of opioid medications and more licenses are restricted or revoked regarding this issue than any other.
Frowny face from too many pills and too many migraines
Avoid Food Triggers.
People with Migraine may have their own individual foods that seem to set off their headaches and the subject of food triggers is a controversial, still poorly researched subject.
Common food triggers are: alcohol, chocolate, aged cheeses, MSG, and red wine. If you know certain foods are a problem for you, don’t eat them.
See my article on Food-Triggered Migraine at www.doctormigraine.com.
Eat regular, balanced meals. Basing your diet primarily on fruits, vegetables, whole grains, lean protein, and healthy fats (and limiting foods that trigger an attack) is a good way to prevent migraines and/or headaches. Also, don't skip meals. Skipping meals makes you hungry, which can trigger a migraine.
Food and Migraine is tough, we just don’t have the right data even though a lot has been written about it. My latest summary on this is at www.doctormigraine.com, “Migraine Food Triggers.” Click here to read.
Avoid all your known Migraine Triggers.
Migraine triggers may be:
Stress 79.7%
Hormones (in women) 65.1%
Not eating 57.3%
Weather 53.2%
Sleep disturbance 49.8%
Perfume or odor 43.7%
Neck pain 38.4%
Light (s) glare 38.1%
Alcohol 37.8%
Smoke 35.7%
Sleeping late 32.0%
Heat 30.3%
Food 26.9%
Exercise 22.1%
Sexual activity 5.2%
Reference. Kelman writing in Cephalalgia in 2007 on “The triggers or precipitants of the acute migraine attack.”
Well, I”ve got a whole article on “Migraine Triggers” on my website, www.doctormigraine.com.
Check Barometric Pressure changes aggravating Migraine.
There are scientific articles verifying that Migraine attacks occur with changes in barometric pressure. I think this has been established, but the reason for the attacks and how pressure affects the brain is not understood.
Modern cell phones or computers can report current barometric pressure changes for where you live. If you get attacks with barometric pressure changes, then keep a pressure diary and watch out for a Migraine that may occur then. Migraineurs may pretreat with a triptan for some attacks.
Pressure dropping. Watch out here it comes. Your next Migraine headache
What to do when a Migraine does start.
Treat early with a Triptan when a Migraine starts. Find a cool, dark, quiet space. Get off TV or your cell phone. Rest your eyes.
Relax. Deep breathing from your diaphragm can help you relax. Focus on inhaling and exhaling slowly.
Think positively. Learn how to deal with a Migraine interrupting your day. Learn CBT skills. “It’s not the end of the world; it’s just a migraine headache.”
6mg Sumatriptan. The first and still the best—highest dose, fastest dose.
Keep a migraine diary
There are a number of free cell phone apps for migraine.
Patients can plot life issues—menstruation, weather change, stress, missed meals, occurrence at night or a “wake up headache.”
Study carefully any trigger that seems important and recurrent. Living with migraines is a daily challenge, but making healthy lifestyle choices can help. Ask your friends and loved ones for support.
Free Migraine cell phone apps
Pray to God for help with your life and your health.
Consider getting my large MIgraine book.
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All the best.
Britt Talley Daniel MD
