Migraine Triggers

Reviewed by: HU Medical Review Board | Last reviewed: April 2024 | Last updated: April 2024

A migraine trigger is anything that leads to a migraine attack. Triggers can be internal, such as stress and hormone changes. They can also be external, such as food and weather changes. For people with migraine disease, exposure to a trigger increases the risk of having a migraine.1-3

A trigger for 1 person with migraine may not trigger symptoms for another person. In some people, symptoms happen after only 1 trigger. In other people, migraine symptoms happen after a combination of triggers. Your triggers can also change over your lifetime.1

The uncertainty of migraine triggers can increase stress and anxiety. It can be hard to identify and avoid your triggers. Talk to your doctor about finding your triggers or reducing exposure to common triggers.1

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What are common migraine triggers?

Many internal and external things can trigger symptoms in people with migraine. Some of the most common migraine triggers include:1-4

  • Certain drinks, including alcohol (especially red wine) and caffeine (especially coffee)
  • Caffeine withdrawal
  • Missing meals
  • Changes in the weather, especially changes in barometric pressure
  • Certain medicines
  • Light, including bright sunshine, indoor fluorescent lights, and glares
  • Smells, including perfumes, chemicals, gasoline, and secondhand smoke
  • Dehydration
  • Exercise or sex

Stress is the most common trigger. Over 70 percent of people with migraine report stress as a trigger. Concern about future migraine attacks can increase stress. This can cause a difficult cycle that is hard to break.1,3

About half of people with migraine report sleep disturbance as a trigger. Almost half of migraine attacks happen in the early morning. This can disrupt sleep even more.1,3

Women are 3 times more likely to have migraine than men. Up to 75 percent of women experience increased migraine attacks during menstruation. Changes in hormone levels during this time can lead to menstrual migraine.1,3

Why do triggers cause migraine symptoms?

Triggers cause a series of events in the brain that lead to symptoms. The exact reason is complex and depends on the specific trigger. For example, some weather changes seem to cause an imbalance in certain brain chemicals. At the start of menstruation, estrogen levels drop. Both of these changes can trigger migraine attacks.3

How can I manage migraine triggers?

The first step to managing migraine triggers is to identify and list your triggers. Keep a migraine journal that lists detailed information about migraine attacks. Write down details about your mood, sleep, food, and environment before symptoms started.1

This journal can help you identify triggers that contribute to migraine attacks. It may also help you learn which symptoms are part of your prodrome stage, symptoms or sensations that mean a migraine attack is coming. The journal may also reveal symptoms of the aura phase. Auras usually happen before or during an attack. They are caused by changes in your nervous system.1,4

Learning your triggers may help you reduce exposure. This can improve symptoms and quality of life. Work with your doctor to find ways to avoid your triggers. This may include:1

  • Stopping or reducing the dose of certain medicines
  • Limiting alcohol and caffeine consumption
  • Staying inside or adjusting your schedule during weather changes
  • Trying diets that eliminate common food triggers
  • Drinking plenty of water and avoiding water pills (diuretics)
  • Wearing sunglasses outside
  • Finding light bulbs that emit green light

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