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Before, during and even after a migraine attack, a number of people living with migraine report an overall lack of energy. For some, the tired feeling is a disabling migraine fatigue that interferes with daily activities and reduces the overall quality of life.

Migraine and fatigue

  • Migraine fatigue impacts 70 percent to 84 percent of people living with migraine, according to studies
  • Fatigue can trigger migraine
  • Fatigue can accompany head pain
  • Fatigue may be a warning sign that a migraine attack is right around the corner
  • Fatigue may surface after head pain goes away
  • Fatigue can also trigger additional migraine symptoms, a study found that half of people who experience vertigo with migraine said fatigue made it worse or triggered the vertigo symptoms
  • Fatigue is often associated with depression in people with migraine

What is fatigue?

  • Extreme weakness, tiredness, malaise or sluggishness
  • Exhaustion for unusually long periods of time after any physical or mental activity
  • Constant desire to sleep
  • Difficulty performing ordinary tasks
  • The feeling often continues even after sleep, which when fatigued doesn’t refresh the body
  • It is disabling when it interferes with daily activities and reduces quality of life

A 2002 study of 63 people living with migraine found that 67% of them met the criteria for chronic fatigue syndrome. In the 2018 In America survey, 7% of 4,356 respondents reported “chronic fatigue” as an additional health condition but as much as 79% of respondents listed fatigue as a top migraine symptom just below head pain, sensitivity to light, difficulty concentrating, sensitivity to sound, and brain fog.

The Centers for Disease Control and Prevention consider it chronic fatigue syndrome when the fatigue is:

  • Not due to activity
  • Not relieved by rest
  • A relatively new symptom and not a lifelong condition
  • Causes a significant reduction in previous levels of activities

Also, four of the following symptoms must be present for six months or more:

  • Impaired memory or concentration
  • Extreme prolonged exhaustion following physical or mental activity
  • Unrefreshing sleep
  • Muscle pain
  • Pain in multiple joints without swelling or redness
  • Head pain of a new type or severity
  • Frequent sore throat
  • Tender cervical (in neck) or axillary (in arm pits) lymph nodes

Fatigue accompanies many ailments. When it strikes as a symptom of a migraine attack, it can make it very difficult to perform normal activities. Often, fatigue doesn’t go away with the pain. The person living with migraine may experience fatigue the days following a migraine episode.

Talking to your doctor about migraine and fatigue

Your doctor will ask you questions about your migraine symptoms, how often they occur, how severe they are and how long they last. Keep a migraine journal to record information on your symptoms, including migraine fatigue.

Community experiences of migraine and fatigue advocates frequently write about their experiences with fatiuge. The spoon theory is a popular way to explain the difference between the energy available for someone living with migraine compared to someone without a chronic disease. This migraine lingo can include discussing the challenge of managing spoons or one’s capacity to complete activities with migraine fatigue. Even though fatigue is a common symptom for many people living with migraine, attempting to get extra sleep isn’t always as easy as it sounds since insomnia can be a common side effect of the migraine pain. People with migraine share feelings of running on empty as this disease can drain the life out of you. The community has also shared their tips on how to manage fatigue.


Written by: Otesa Miles | Last review date: November 2010
Fatigue in chronic migraine patients, Peres Cephalagia 2002