Behavioral Changes for Migraine Prevention

“The gold standard of migraine treatment is to address lifestyle first: exercise, sleep, diet,” says neurologist Kiran F Rajneesh, M.D., director of the Neurological Pain Division at The Ohio State University Wexner Medical Center in Columbus. “We attack those before we add on a medication.” First, see a doctor with whom you can build a relationship, he advises. “It’s important to have a provider who knows and understands your condition. Coming up with a game plan that’s right for you is really important,” Dr. Rajneesh adds.

Keeping records of your headaches can help, so start a diary, suggests Salman Azhar, M.D., a neurologist at Lenox Hill Hospital in New York City. Migraine headaches often follow patterns and occur because something—or a combination of things—triggers them. “Go through the process of having a headache diary so that you really understand what your triggers are and what are the things that might help you,” says Dr. Azhar. “What are the diet triggers? What are the environmental triggers?” Consider downloading an app likeMigraine BuddyandMigraine Mentorto help you identify trouble spots.

Common dietary triggers include chocolate, aged cheeses, alcohol, and monosodium glutamate (MSG), a flavor enhancer often found in canned soups and vegetables as well as processed meats, according to the American Migraine Foundation. These are just a few examples. “You might want to stop these things and then add them back one at a time to see if any are a trigger for you,” says Dr. Azhar. Be sure to include potential food triggers in your migraine diary to learn which ones to avoid.

There's no particular diet thateasesmigraines—but some foods might help you avoid them. “We don’t have a big study that says this particular food class helps [migraine symptoms] more than these other food classes,” says Dr. Rajneesh. But he recommends a healthy diet with lots of green leafy vegetables and proteins, like poultry and fish. Research shows that vitamin B2 (a.k.a. riboflavin) and magnesium may actually help prevent migraine. “Choose foods that are high in those,” advises Dr. Azhar. Dairy, salmon, and lean meat are good sources of B2, while black beans, spinach, soybeans, and peanuts provide magnesium.

A frequent problem for those with chronic migraine: poor sleep. “Getting eight hours of sleep is really important,” says Dr. Rajneesh. But according to a 2018 study, people with migraine are five times likelier to have insomnia than people who don’t suffer from migraines. Chronic migraine also appears to increase the risk ofsleep apnea, “which makes your brain receive less oxygen, and when you wake up in the morning you’ll have more headaches,” explains Dr. Rajneesh. Tell your doctor if you have trouble sleeping—and consider doing asleep study以确定睡眠呼吸暂停可能引发哟ur migraines.

Stress is a common migraine trigger. And it creates a vicious cycle. “The headache itself can be stressful, which can lead to more disability, and that triggers additional headaches,” says Dr. Azhar. Learn to manage your stress and you just might manage your migraines. Practicing tai chi and yoga can ease stress, says Dr. Azhar. Aerobic exercise—think walking, swimming, and running—can decrease the number of days you experience migraines, according to a 2019 review of scientific studies. The effect is small but significant and may help augment the benefits of your other migraine treatments.

Stress can be countered by cognitive behavioral therapy (CBT), a type of psychotherapy that aims to improve your ability to cope with pain and to change the types of negative thinking that can contribute to, and come from, stress, anxiety, and depression, all of which are common among people who experience migraine. Working with a therapist one-on-one or in a group—usually over just a few weekly sessions—you’ll learn to replace worry about future headaches with more positive thoughts. “About two-thirds of people with chronic pain like migraine have either under-treated or untreated depression or anxiety,” says Dr. Rajneesh.

Dr. Rajneesh also recommends mindfulness meditation and biofeedback for migraine management. In mindfulness meditation, you focus judgment-free attention on the present moment as you sit (or lie) in a comfortable position, tuning in to your breathing and your body. This practice can counter depression, stress, and the negative thoughts you have about pain while improving quality of life, according to a 2021 study. With biofeedback, you’re trained to recognize and adjust the way your body responds to stress, also easing migraine symptoms. “Mind over body gives you control not just over the physiology but also the psychology of pain,” says Dr. Rajneesh.

Your migraine is one more excellent reason to quit smoking, which keeps your whole body in a constant state of inflammation, says Dr. Rajneesh, rendering your migraine medication less effective. “When you have a migraine, there are certain inflamed areas that are like bull’s eyes for the medication,” says Dr. Rajneesh. “But if your whole body is a bull’s eye, that medication is going to get dispersed all across your body, and you’re not going to get that same amount of relief.” Smoking also impedes blood flow to your brain, increasing the odds of a migraine headache.Get help quitting here.

Lifestyle changes like these can be hard to make and maintain, and it may be months before you notice improvements. The effort will be worth it because medications by themselves are not enough, says Dr. Azhar. Taken together, the many changes you make to improve your sleep, your diet, your level of physical activity, and your frame of mind, will offer a great deal of protection in tandem with your the medications you take. “So,” says Dr. Azhar, “while you may encounter a number of triggers, like weather changes and others, the actual migraine won’t happen.”