Migraine Trigger Tracking: How to Find Your Triggers With a Diary

By Jack Wallner · Last updated

Migraine trigger tracking means logging each attack with what happened in the hours before it, such as sleep, meals, stress, your cycle and the weather, then looking for factors that come up more often before attacks than on other days. It usually takes a few months, and triggers are personal: a 90-day diary study found most people's trigger profiles were unique.

General information, not medical advice. The app is a log only and does not diagnose, treat or prevent any condition. A log is something to bring to a doctor, not a substitute for one.

What is a migraine trigger?

A trigger is something that makes a migraine attack more likely for a particular person. It is not the underlying cause of migraine, which the NHS says is not known. The NHS lists triggers including your period, stress, tiredness, skipping meals, too much caffeine and not getting enough regular exercise. The American Migraine Foundation notes that everyone has different triggers, and the Migraine Trust says an attack is unlikely to be set off by any one thing. Usually several factors add up.

What are the most common migraine triggers?

Stress, hormonal changes, missed meals, weather and sleep problems top the list. In a study of 1,207 people with migraine, 75.9% reported at least one trigger. These are the factors they named most often:

TriggerShare who reported it
Stress79.7%
Hormonal changes (women)65.1%
Not eating57.3%
Weather53.2%
Sleep disturbance49.8%
Perfume or odour43.7%
Neck pain38.4%
Light38.1%
Alcohol37.8%
Smoke35.7%
Sleeping late32.0%
Heat30.3%
Food26.9%
Exercise22.1%

These figures are what people believe triggers their attacks, gathered by questionnaire. A diary is how you check whether the same holds for you.

What should you record to find your triggers?

The attack itself, plus what happened in the hours before it. Start with the five basics from a headache diary: date, start time and duration, severity, symptoms and medication. Then add a short line on the factors above:

Log some headache-free days too, or at least note your usual routine. A factor only stands out if it shows up more often before attacks than on ordinary days.

Is it a trigger or an early symptom of the attack?

Sometimes what looks like a trigger is the attack already starting. Many people have warning symptoms hours before the pain, in what is called the premonitory phase. The Migraine Trust gives the example of craving chocolate: you eat some, a headache follows, and you would likely have had it anyway. A study of 1,010 people with migraine found 38.9% had premonitory symptoms at least two hours before the headache. People who named bright or flickering light as a trigger were more likely to have light sensitivity in that phase, and the same pattern held for food cravings and smells. That is why it helps to note warning signs with the time they started.

How long does it take to identify migraine triggers?

Usually a few months of consistent logging. In a Cephalalgia study, 326 people kept a paper diary of 33 possible triggers and early symptoms for 90 days. That was enough to find factors linked to attacks for 87% of them, about four factors each on average. Their profiles were highly individual, and unique in 85% of those with at least one link. Your list may look nothing like the table above.

Why is it hard to pin down a trigger from a diary?

Because real life never repeats cleanly. To be sure a factor matters, you need days that differ only in that factor, and those are rare. A 2013 analysis of daily data found a median of 2.3 days a year with closely similar weather, and about 1.5 to 2 days a month with similar stress or hormone levels. Two habits help:

What should you bring to your doctor?

A short summary on top of the raw log. Include how many headache days you had each month, any days or times they cluster, the factors that came up most often before attacks, and how many days you took pain relief. That last one matters because the NHS lists taking too many painkillers as a common cause of headaches. The Migraine Trust says a diary can help a doctor make a diagnosis and judge whether treatment is working. Your doctor decides what the patterns mean.

How does Migraine Headache Tracker Log help with trigger tracking?

It fills in much of the context so you only have to tap. Migraine Headache Tracker Log saves a headache with one tap on iPhone, Apple Watch or a Home Screen widget, which fixes the start time. It then attaches Apple Health data such as sleep, heart rate variability and steps when you allow it, plus local weather, barometric pressure and its trend, air quality and pollen. You can add a severity and a note for things the app cannot see, such as meals, stress or medication. The Patterns view describes what tends to show up in your own entries, like the time of day or the pressure trend most of your headaches share. It describes your log. It does not tell you what caused a headache. Your history exports as a CSV with 80+ columns to share with a clinician.

Free headache log for iPhone and Apple Watch. One tap adds sleep, weather and pressure. No account needed.

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Frequently asked questions

What are the most common migraine triggers?

In a study of 1,207 people with migraine, the triggers reported most often were stress (79.7%), hormonal changes in women (65.1%), not eating (57.3%), weather (53.2%) and sleep disturbance (49.8%). The NHS also lists tiredness, too much caffeine and not getting enough regular exercise.

How long does it take to identify migraine triggers?

Usually a few months. In one study, 90 days of diaries were enough to find factors linked to attacks for 87% of 326 people with migraine. Shorter logs tend to be too noisy to trust.

Can a food craving be a sign of a migraine rather than a trigger?

Yes. Craving certain foods can be a premonitory symptom, an early sign that an attack has already begun. The Migraine Trust uses chocolate as the example: you crave it, eat it, get a headache, and would likely have had the headache anyway.

Can one trigger cause a migraine on its own?

Usually not. The Migraine Trust says an attack is unlikely to be triggered by any one thing and normally follows a range of factors, which is why a diary that records several factors at once is more useful than tracking one.

Is there an app that tracks migraine triggers automatically?

Migraine Headache Tracker Log is a free headache log for iPhone and Apple Watch that records sleep, weather, barometric pressure, air quality and pollen when you tap to log a headache. It describes patterns in your own entries but does not tell you what caused a headache. A paper diary works too.

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