how to track migraine attacks

How To Track Your Migraine Attacks

If you didn’t write down each time you had a migraine attack, do you think you could accurately estimate the number of headache days or migraine attacks each month? To help reduce recall bias, migraine diaries are widely used by the migraine community. This is a tool to keep a record of not only your migraine attacks but also a variety of factors related to them. A diary can help you track the number of headaches or migraine attacks, reveal patterns or potential triggers, monitor the effectiveness of treatments and record the number of days you are using acute medications.

If you are looking for answers, trying to share information with your healthcare providers, or want your loved ones to understand what you are facing, tracking your migraine attacks could be a meaningful way to reveal your story. Your migraine journey is important.

What is a Migraine Diary?

If you recently started having headaches, your provider may suggest that you begin a diary. There are many options on the Internet (we have one you can download and print here) but electronic versions and free apps are also available. Be sure to choose one that is easy to use and fits your lifestyle. Are you a tech-savvy person that is always on your phone? An app might be a better option for you. If you prefer to track your attacks on a paper calendar, that works too! You may want to try out a few different options. The point is that you want a diary that you will use and can easily be taken with you to doctor appointments and used in conversations with others you want to share information with.

What to Include in a Migraine Diary?

After you decide which type of diary you want to use, you may wonder what to include. This will vary from person to person depending on where they are in their migraine journey. Someone who has been living with migraine for 30 years will likely know how often they have attacks and their triggers but may be using a diary to track the effectiveness of their new medication. In contrast, newly diagnosed people may need to track more information to understand their disease better.

A few important details to track include:

  1. Headaches – Are they occurring around the same time of day? How long do they last? Are they mild, moderate or severe?
    • If you haven’t been officially diagnosed with migraine, you will also want to write down what your attack feels like. Does your headache throb, feel like pressure or stabbing? Does it occur on one side or both sides of the head?
  2. Associated symptoms – What other symptoms do you have during an attack? Do you experience aura (ex. seeing flashing or sparkling lights before an attack), nausea, vomiting, dizziness, vertigo, light sensitivity or sound sensitivity?
  3. Functional impairment – Were you able to take part in daily activities during an attack? Did you miss work or have reduced productivity?
  4. Medication use – Take note of the number of days you use acute medications each month and their effectiveness. Don’t forget to include over-the-counter medications! Also, note when you begin a new acute or preventive medication and/or increase or decrease the dosage.
  5. Potential triggers – Note any additional factors such as menstruation, particular ‘trigger foods, high-stress days, lack of sleep, etc.

Each of these pieces of information tells part of your migraine story. The data you track may reveal that you need to change your medication or avoid a potential trigger that you didn’t even realize was contributing to an attack. Triggers are a debatable topic in the migraine community and there is limited evidence that they cause attacks. Rather, certain cravings may be signs of the migraine prodrome. However, if using a diary helps you identify a potential trigger and avoiding it improves your quality of life then it’s a win!

The Power of a Migraine Diary

Make your migraine diary work for you. During an attack, you may not feel like filling out each part. Do your best to write down what you can and fill in the missing parts when the attack has ended. Try to follow up before too much time has passed so you don’t forget the details. Be consistent with how you fill out the migraine diary. For instance, decide what severe means to you and be able to communicate that to your doctor. Use that same point of reference each time you record your migraine attack. This will make your information more accurate and meaningful. 

You may also decide to focus on one area at a time, such as headache days, triggers or your associated symptoms. Tracking your migraine attacks is not meant to be a burden.¹ Instead, it should be a helpful tool that leads to better recognition of attacks and, subsequently, a better life. Once you are in a stable state, you may not need to track them or may resume again when starting or discontinuing a treatment.³ This is a personal decision and one you may choose to discuss with your healthcare provider. When you start seeing patterns, don’t hesitate to reach out to your doctor if you feel you have questions that should be addressed, or take those with you to your next appointment.

Share Your Migraine Diary

Collecting the information about your attacks is empowering. Being able to share some of what you have learned and know that you have taken extra steps to help manage your care is encouraging. Sometimes, what we learn from migraine is that we are stronger than we think. 

Next, share this with your healthcare providers. They can only help you when they know the whole story. They need to know exactly what you are facing and how things are going. They won’t know the missing pieces unless you tell them. The migraine diary is a powerful and tangible way to keep the conversation going and move in a positive direction. Your doctor will appreciate your initiative, and you can see progress over time. 

Additional Resources

Everything You Need to Know About Migraine with Aura

How to Prepare for Your Appointment

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References

1. (n.d.). Everything You Need to Know About Migraine Auras. Association of Migraine Disorders. Association of Migraine Disorders. https://www.migrainedisorders.org/podcast/s5ep9-everything-you-need-to-know-about-migraine-auras/

2. (n.d.). Improving Medical Communication in Migraine Management: A Modified Delphi Study to Develop a Digital Migraine Tracker. The Journal of Head and Face Pain. Retrieved December 10, 2023, from https://headachejournal.onlinelibrary.wiley.com/doi/abs/10.1111/head.13426

3. Jessica Schroeder, Chia-Fang Chung, Daniel A. Epstein, Ravi Karkar, Adele Parsons, Natalia Murinova, James Fogarty, and Sean A. Munson. 2018. Examining Self-Tracking by People with Migraine: Goals, Needs, and Opportunities in a Chronic Health Condition. In Proceedings of the 2018 Designing Interactive Systems Conference (DIS ’18). Association for Computing Machinery, New York, NY, USA, 135–148. https://doi.org/10.1145/3196709.3196738


Author 

Lindsey de los Santos is a patient advocate, writer specializing in migraine, and a teacher. She has lived with migraine for 30 years and understands how debilitating this disease can be. This is why she is passionate about supporting others living with migraine. She started her own website, migraineroad.com, to be a community to encourage others and provide information for people who wanted to learn more. She is also an advocate with the American Migraine Foundation. Lindsey takes every opportunity to make a positive impact and believes there is power in advocacy.

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