How to Keep a Headache Diary: What to Log and What to Skip
A useful headache diary records five things for every attack: the date, the start time and how long it lasted, how severe it was, any other symptoms, and what medication you took. Add sleep, meals, stress and weather only if you can do it quickly. The Migraine Trust advises keeping it simple, and the American Migraine Foundation says the longer you track, the more patterns show up.
Start with five fields
The Migraine Trust's advice is that it is often best to keep it simple and record basic information. Five fields cover most of what a doctor asks about, and you can fill them in about a minute after an attack ends.
| Field | What to write |
|---|---|
| Date and day of the week | Tue 6 Oct. The weekday can expose patterns such as weekend headaches. |
| Start time and duration | Started 2:15 pm, gone by 8 pm. Note when pain rises or eases if you can. |
| Severity | Mild, moderate or severe, or 1 to 10 where 10 is the worst pain you can imagine. |
| Other symptoms | Nausea, sensitivity to light, sound or smells, dizziness, numbness, or warning signs before the pain. |
| Medication | What you took, how much and when, including whether you took a second dose. |
Add context only if it pays off
The American Migraine Foundation (AMF) lists sleep habits and diet as optional extras for a more detailed journal, along with possible triggers. The NHS lists common headache triggers and causes including stress, skipped meals, dehydration, too much alcohol, poor posture, hormonal changes such as periods, and overusing painkillers. A short context line covers it:
- Sleep: hours last night and whether it was broken.
- Food and drink: meals skipped, caffeine, alcohol, water.
- Stress and screens: a hard workday, long hours at a monitor.
- Cycle: where you are in your period, if relevant.
- Weather: a pressure drop, heat, a storm front. Pressure is hard to fill in by hand.
A diary shows what tends to happen around your headaches. It does not prove that any one thing caused one. That is a conversation for your doctor.
A sample entry
Tue 6 Oct, started 2:15 pm, ended about 8 pm. Severity 6 of 10. Throbbing on the left, light sensitivity, mild nausea. Took my usual pain reliever at 2:40 pm, no second dose. Slept 5 hours, skipped lunch, 3 coffees. Rainy, pressure falling.
That is under 50 words and holds everything a clinician asks for.
How often and how long
The AMF does not set a schedule. It says you may only update the journal on days you have a headache or other symptoms, and that you might log more often in the days or weeks after changing treatment. It also says that the longer you track, the more you get out of the journal, because patterns emerge over time. Ask your doctor which details they find useful so you do not record more than you need.
Why bother
The Migraine Trust says a diary can help a doctor make a diagnosis, help you recognise triggers and warning signs, show whether acute or preventive medication is working, and reveal patterns in your attacks. The AMF adds that it can help clinicians treat you appropriately in urgent situations such as an emergency room visit. Bring it to appointments as a printout, a photo or a CSV file.
When a headache is not a diary matter
The NHS says to call emergency services or go to the emergency department if a headache comes on suddenly and is extremely painful, or comes with a seizure, numbness or weakness in the face or body, difficulty speaking, loss of vision, drowsiness or confusion, a stiff neck with a high temperature, or follows a head injury in the last 3 months. Log it afterward. Do not log it first.
How Migraine Headache Tracker helps
The hard part of a diary is keeping it up when your head hurts. The Migraine Headache Tracker app records a headache with one tap on iPhone, Apple Watch or a Home Screen widget, which fixes the start time. It then fills in the context itself: Apple Health data such as sleep and heart rate variability, plus local weather, barometric pressure, air quality and pollen at the moment you log. You can optionally add a severity (slight, medium or extreme) and a note, which is a good place for medication and anything the app cannot see. Your history exports as a CSV you can share with a clinician. Everything stays on your device, with no account.
Free headache log for iPhone and Apple Watch. No account needed.
Download on the App StoreFrequently asked questions
What should I write in a headache diary?
Record the date and day, start time and duration, severity, other symptoms and any medication taken, including whether you took a second dose. The Migraine Trust suggests keeping it simple with these basics.
How long should I keep a headache diary?
The American Migraine Foundation does not set a duration, but says the longer you track, the more patterns emerge. Ask your doctor how long they want to see before your appointment.
Should I log every headache or only bad ones?
The American Migraine Foundation says you may update the journal only on days you have a headache or other symptoms, and log more often after a treatment change. Logging all of them gives your doctor the clearest picture.
Can a headache diary show what triggers my headaches?
It can show what tends to happen around them, such as poor sleep or skipped meals, which the NHS lists as common triggers. It does not prove cause, so review the patterns with your doctor.
What headache symptoms mean I should get urgent help?
The NHS says to call emergency services if a headache starts suddenly and is extremely painful, or comes with a seizure, numbness or weakness, trouble speaking, vision loss, confusion, or a stiff neck with high temperature.