Triggers and Risk Factors of Migraine

Nigraine is a moderate or severe pulsating skull clenching pain experienced on one side of the head. It is usually accompanied by nausea, vomiting, and sensitivity to light rays. People suffering from migraine often have the irresistible urge to stay in a dark and cool room. Migraine is said to be chronic when it occurs more than twice a week.  Chronic migraine is also described as having 15 headache days in a month with at least eight of those having migraine features. People with chronic migraine commonly have several non-migraine headaches for the rest of the month.

Why do people develop chronic migraines? The primary causes of chronic migraines (or migraines in general) remain unclear. However, there are a few theories postulating the genesis of migraines. These include family history/genetic predisposition, imbalances in brain chemicals like serotonin, changes to the brain structure, and how it interacts with specific nerves connected to the head.

Not all migraine-like headaches are migraines. Some vascular malformation conditions or brain injuries produce secondary headaches that resemble migraine.

Some people have higher chances of developing chronic migraines than others. The risk factors that predispose someone to migraine may either be modifiable or non-modifiable factors. Family history is the most common risk factor which you cannot change. Earlier reports have shown that you have about a 50-75% chance of developing migraine if one or both of your parents has chronic migraines.

Similarly, your age plays a vital role in determining the severity of migraine. The condition can start at any age, but it is often worst when you are in your 30s. As you age further, the frequency & severity of migraines lessen.

Another important risk factor is gender. Women are three times more likely to develop migraines than men. This is attributable to hormonal variation in women. In children (before puberty), headache is more prevalent among boys than girls. But as soon as females begin to experience the influence of hormones (specifically, estrogen), the paradigm shifts towards more headaches in women than in men. Estrogen regulates the female reproductive system, and it also happens to control chemicals in the brain that impact the sensation of pain. Fluctuations in estrogen level affect pain sensation and contribute to the pain sensation in migraine. These hormonal fluctuations often occur during menopause (and perimenopause), premenstrual period, when breastfeeding, and if someone is on contraceptives.

Certain medical conditions may increase your likelihood of experiencing migraine. The American Migraine Foundation lists depression, anxiety, obesity, and snoring among a number of conditions associated with a greater risk of having migraine episodes that can lead to chronic migraines.

Although the cause of migraines isn’t totally clear, a number of lifestyle and environmental triggers of migraine have been identified. These triggers must be avoided. Your sensitivity to triggers depends on how you were able to control the headaches by adhering to effective preventive and treatment regimens.

Disruption in sleeping patterns is the most common trigger of migraines. This is not only limited to jet lags and sleep deprivation, sleeping for too long can also trigger migraine. Similarly, sudden changes in your physical activity profile could trigger migraine. For example, if you usually maintain a sedentary lifestyle, a sudden switch to intense physical activity (like joining a marathon) could trigger migraine. Migraine pain worsens with exercise

Changes in your feeding habit could also trigger migraines. This may include skipping diet & overeating. Physical & emotional stress was also identified as a trigger of migraine. Simple eye strain due to prolonged screen time can also trigger migraine. This is a common trigger among adolescents or younger patients.

Overuse of over-the-counter pain relievers and some acute migraine medications could cause rebound headaches which trigger migraine. Other triggers of migraine include loud annoying sound (noise), strong scents, bright lights, poor posture, dehydration, overuse of caffeine, certain foods, obesity, asthma, and change in weather.

Treatment for chronic migraines may include administering preventive medications to help reduce the number of episodes per month and/or administration of acute treatments to provide interim relief. These acute medications should be used at the very first sign of migraine. While most of these acute medications are available as over-the-counter medications, it is very important that you adhere to a treatment plan designed by your physician.