Migraine: knowledge is prevention

The migraine brain is more sensitive to sensory input. To stay healthy and work properly, it needs a stable supply of energy. Migraine attacks happen when an energy deficit occurs in the brain of a person who is genetically prone to migraine. Avoiding those energy deficits is a good way to prevent migraine attacks. There’s a lot you can do to accomplish that. If you stick to a few basic lifestyle rules, you can stop a lot of migraine attacks before they happen.

Where should I start?

There is no cure-all for migraine. Everyone has their own personal triggers. That’s because we all have a different set of genes and a different lifestyle. The information and advice below is based on the latest research. Figure out your migraine triggers!

  • Nutrition

    A key factor in migraine: the brain's energy supply

    • Your brain needs carbohydrates to work in a healthy way
    • Never skip breakfast
    • 3 main meals, 2 snacks, 1 bedtime snack

    Nutrition

    Your eating habits have a big impact on migraine attacks. The migraine brain needs exceptional amounts of energy. To work in a healthy way, it requires a permanent supply of energy it can use quickly. Complex carbohydrates are very good at giving the brain the energy it needs. Keeping your blood sugars stable prevents energy deficits in your brain and prevents migraine attacks. The best way to do this is to eat 3 meals spread out over the day and 2 to 3 snacks containing plenty of carbohydrates. Cereals like bread, pasta and rice – preferably whole grain – legumes and potatoes contain carbohydrates.

    Breakfast

    Breakfast is the most important meal of the day. Your energy stores are empty after not eating all night. Spend at least 30 minutes eating a proper breakfast. A hot breakfast containing complex carbohydrates (muesli with hot milk, for instance) gives your nervous system lots of energy. Other whole foods such as whole grain bread are also very good at filling up your energy stores.

    Regular meals

    Try to schedule your workday so that you take breaks at certain times (ideally the same times every day) to eat in peace and quiet. Mindful eating helps us to eat right. Chew your food slowly and thoroughly. It’s good for your health and makes it easier to stop eating when you’re full. Even if you can’t always manage to get the peace and quiet, never skip a meal altogether. The sudden drop in your blood sugar levels can trigger a migraine attack.

    Bedtime snack

    A snack before bed is a good way to prevent migraine attacks the next morning. Have a snack (a small slice of whole grain bread and honey, for instance) half an hour before going to bed. This will keep your brain supplied with energy all night, and you won't wake up the next morning with an energy deficit that could trigger a migraine.

  • Drinking

    Your brain needs water

    • Rule of thumb: 2–3 liters of fluids per day
    • Keep it regular: Start your day by drinking plenty in the morning, then at least every 2 hours afterward
    • Water is best. Avoid sugary drinks and alcohol.

    Drinking

    Your body needs fluids to be able to perform all the functions that keep you alive. If you don’t drink enough, your blood will not be able to transport nutrients to your brain. Your brain will not get the energy it so badly needs.

    Drink regularly

    Drinking regularly is important. Be sure to drink enough first thing in the morning and have something to drink at least every 2 hours afterward.

    How much is enough?

    Drink 2–3 liters of fluids every day. If you do a workout, you will need even more. Water and other unsweetened beverages are best. Enjoy coffee, black tea and alcoholic beverages in moderation. If your work does not provide drinks, carry drinks from home.

  • Sleep

    Sleep refreshes the brain

    • Go to bed and get up at the same time every day
    • Stick to your sleep schedule on weekends
    • Die eigene ideale Schlaflänge herausfinden
    • Rule of thumb: 7–9 hours

    Sleep

    Your body rests and recharges while you sleep. If you don’t get enough sleep, your body and brain will not get the rest they need. Lack of sleep can cause headaches. But too much sleep can also trigger a migraine attack. Your brain works hard at night, sorting and processing the day’s events while you sleep. It needs energy for this. Your energy stores run out over time and need refilling. If you sleep too long, your brain will have run out of energy by the time you get up and have something to eat. That brain energy deficit can trigger a migraine attack.

    Regular sleep

    Try to go to bed and get up at the same time every day – including weekends. How much sleep do you need to feel refreshed in the morning? 7– 9 hours is a good rule of thumb.

  • Physical activity

    Exercise helps to balance your nervous system

    • Integrate movement into your day: go places on foot or ride your bike
    • Rule of thumb: Half an hour of vigorous exercise 3 to 4 times a week
    • Elite sport can be a problem for migraineurs

    Physical activity

    Exercising is a tried and trusted way to prevent headaches. The right mix of concentration and relaxation helps to balance your nervous system and keep your levels of stress hormones down.

    Daily exercise

    Walking or biking to get around is good for your brain as well as your body. Half an hour of vigorous exercise another 3 to 4 times a week is recommended in addition, but don’t overexert yourself Regular healthy exercise such as swimming, cycling or hiking is good for you and helps you and your brain to relax.

    Migraine and competitive sports

    Competitive training demands a lot from the body. High-performance athletes need extra energy to prevent a brain energy deficit. Additional healthy meals and lots of fluids to stay hydrated are essential – especially for migraineurs. Some migraineurs are vulnerable to exercise-induced migraine even if their energy intake is adequate. High levels of exertion stress your body and may trigger a migraine attack. If you are prone to exertion headaches, it’s better to step away from competitive training and choose a more moderate level of exercise.

  • Workplace

    Balance at work is important

    • Have regular short breaks
    • Also plan longer breaks of at least 30 minutes
    • Screen-free time: at least 3 long breaks
    • Avoid fluctuations in lighting if you can
    • Noise and smell sensitivity: take it seriously

    Workplace

    How you arrange your working day is key to headache prevention. Overtaxing your brain non-stop is not a good idea – especially if you need to get a lot done. To be productive, you need balance. Mindful, regular breaks spent away from a screen are essential for a healthy brain. A few changes to your workspace layout can also help you get through the day without a headache.

    Breaks

    Working without a break increases your risk of a migraine attack. Incorporate frequent short breaks (2-3 minutes) into your working day, and schedule longer breaks of at least 30 minutes. It gives your brain a chance to reboost and you can focus better afterward.

    Make the most of your breaks:

    • interrupt your work posture
    • move around
    • close your eyes and take a couple of deep breaths in and out
    • get yourself a drink
    • eat an apple
    • go over to a window and get some fresh air
    • pandiculate (yawn and stretch like a cat!)
    • a good yawn can help you recharge too!

    Create reminders to help you remember – a buzz from your phone or other recurring sound/event may be useful. The 'Headache Facts' app has a reminder feature for regular breaks.

    Screen-free time is essential

    Staring at a screen all day fatigues the eyes and the brain. Frequent breaks are essential to give your eyes and brain a rest. These moments should be completely screen-free – no phone, tablet, computer or TV. You need 3 screen-free breaks of at least 30 minutes a day. If you need more time to recover from screen fatigue, take that time.

    Lighting in the workplace

    Fluctuating workplace lighting can be an additional burden. For some migraineurs, it’s a key trigger. Working outdoors, you are exposed to the natural fluctuations of daylight. The same goes for a workstation by a window. Some migraineurs are sensitive to fluctuating indoor lighting and flickering lights (which includes fluorescent lights). Try to avoid fluctuating light conditions. Consider moving your desk so that you are not facing a window.

    Noise sensitivity

    Noise can trigger or worsen a migraine. If you are sensitive in this way, try to avoid noise sources and protect your ears.

    Smells and headaches

    Some migraineurs are sensitive to strong smells. If strong smells are a triggering factor for you, try to avoid them.

  • Relaxation

    Conscious relaxation helps balance the nervous system

    • Reserve slots specially for relaxation in your weekly schedule
    • Tip: Learn relaxation techniques

    Relaxation

    Incorporate dedicated relaxation periods into your weekly routine. Conscious relaxation helps balance the nervous system and is a good way to prevent migraine attacks.

    Learn relaxation techniques

    Research studies have demonstrated the effectiveness of certain relaxation techniques. Jacobson’s progressive muscle relaxation gets great results in real-life use. It’s easy to learn and, with practice, you can do it almost anywhere. Use the step-by-step guide in the 'Headache Facts' app or access it from the 'Resources' part of this website.

  • Stress

    Stress and migraine attacks are related

    • The way each person experiences stress is individual
    • Stress can be emotional or physical
    • Avoid stressors where possible
    • Also important: create me-moments to combat the effects of stress

    Stress

    Stress is a subjective experience. Different people are stressed by different things. The fundamental fact remains: feeling stressed can trigger a migraine attack. There’s a connection. So to avoid migraine attacks, it’s important to find a healthy way to cope with your stress.

    Types of stress

    Stress can be emotional or physical. Feelings of being unable to cope, frustration and relationship problems can all cause emotional stress. Incorrect posture can trigger physical stress. If you sit still at work for a prolonged period in a position that puts an unequal strain on your body’s structures, you may experience physical stress.

    How do I cope with stress?

    Try to avoid your personal stressors wherever you can. But that’s not always possible, so doing things to combat the effects of stress is important too. Sticking to a routine that includes breaks and moments of relaxation, regular exercise and plenty of restful sleep is a good start.

Identifying migraine triggers

Figuring out your own migraine triggers takes a little patience and care. But it's worth it. If you know your personal migraine triggers, you can avoid them day to day and prevent a lot of attacks. 'Prevent Headache – The App' can help you there. Keeping a detailed record of your day will help you see patterns, triggers and warning signs. This makes it easy to pay special attention to those factors. A reminder feature helps you stick to your 'ideal' routine.

Discover your headache type

Migraine, tension-type headache and medication overuse headache are by far the most common types of headache. Take the Quick Headache Quiz to discover if your headache is one of those three types.

TAKE THE QUIZ

Understanding migraine

Migraine is a neurological disorder. The World Health Organization (WHO) ranks migraine as one of the most disabling disorders.

  • How migraine develops

    How migraine develops

    Menschen, die unter Migräne leiden, haben ein besonders leistungsfähiges Gehirn. Viele bedeutende Persönlichkeiten waren von Migräne betroffen, so z. B. Pablo Picasso, Richard Wagner und Marie Curie. Das Nervensystem von Migränepatienten steht ständig unter ‚Hochspannung‘. Reize werden vom Gehirn früher und schneller aufgenommen sowie rascher verarbeitet. Für diese angeborene Besonderheit sind nach heutiger Erkenntnis 44 Genvarianten verantwortlich. Das kann aber auch zu Migräneattacken führen: Bei zu schneller oder zu lang andauernder Reizverarbeitung kommt die Energieversorgung der Nerven nicht mehr mit und bricht zusammen. Schmerzauslösende Botenstoffe werden von den Nervenzellen nun ungehindert freigesetzt. Sie gelangen in die Blutbahn und lösen an den Adern der Hirnhäute eine Entzündung aus. Diese Entzündung nimmt der Betroffene als pochende und hämmernde Kopfschmerzen wahr.

    Die Migräneattacke

    Eine Migräneattacke beginnt typischerweise schon am Morgen und hält zwischen 4 und 72 Stunden an. Sie äußert sich in einem pulsierenden, pochenden und hämmernden Schmerz, der durch körperliche Aktivitäten verschlimmert wird. Die Stärke der Schmerzen ist in der Regel außerordentlich hoch. Meistens kommt noch hinzu, dass dem Betroffenen übel ist bis hin zum Erbrechen und er empfindlich auf Licht, Lärm und Gerüche reagiert. Ans Arbeiten oder auch nur an Freizeitbeschäftigungen ist dann nicht mehr zu denken. Dem Betroffenen bleibt nichts anderes übrig, als sich hinzulegen – am besten in einem abgedunkelten Raum – und auszuharren, bis die Attacke vorüber ist.

    Vor der Migräne

    Eine Migräneattacke kündigt sich oft schon 4 bis 48 Stunden vorher an. Entsprechende Vorboten (nicht Ursachen!) können sein:
    - Kreativität, Hochstimmung, Rastlosigkeit
    - Niedergeschlagenheit, Müdigkeit/Energielosigkeit, Reizbarkeit
    - Gähnen, Heißhunger (z. B. auf Schokolade), Frieren, Schwitzen

    Aura

    Bei circa 10 Prozent der Migränebetroffenen geht der eigentlichen Kopfschmerzphase eine sogenannte Aura voraus. Diese dauert normalerweise 30 bis 60 Minuten und äußert sich vor allem in Form von Sehstörungen wie etwa Zickzack-Linien, Flimmern und Flackern, verschwommenen Umrissen oder blinden (dunklen) Flecken. Folgende weitere Symptome können ebenfalls auftreten:
    - Missempfindungen (z. B. Kribbeln, das sich von den Fingerspitzen bis hoch zur Schulter ausbreitet)
    - Lähmungen, Koordinationsstörungen (z. B. Schwindel, Gangunsicherheit)
    - Störungen von Sprache oder Bewusstsein

    Nach der Migräne

    Auch nach einer Migräneattacke sind Betroffene noch bis zu 2 Tage erschöpft und reizempfindlich.

Features of a migraine attack

Duration
  • 4–72 hours
Accompanying symptoms
  • Nausea and/or vomiting
  • Sensitivity to light, noise and smells
Headache properties
  • One-sided, throbbing pain
  • Moderate to severe pain
  • Significantly interferes with everyday activities
  • Physical activity makes it worse
    (walking or climbing stairs, for instance)

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