In the UK, The Migraine Trust has estimated that approximately 190k people a day suffer with a migraine attack. 25 million work or school days are believed to be lost a year and it is estimated that every three in a hundred GP consultations are related to migraines. Migraines are estimated to affect more than 14 % of the world’s population. It is more common than diabetes and asthma.

The Causes

What causes an actual migraine is unknown but it is becoming widely accepted that there is a link to a gene which it is believed makes migraine sufferers more sensitive to attacks. It was hypothesized, in the past, that it was due to blood vessel spasms. However, it is now believed to be more complex and related to abnormal brain activity which interferes with nerve signals which affects the chemicals in the brain. 

Common symptoms include throbbing headaches, sensitivity to light and noise, nausea and vomiting and lethargy. There are many other triggers which contribute to a migraine and these include dietary, physical, emotional, stress and environmental to name a few.

Migraines and stress are strongly connected. Anxiety, excitement and any form of tension can lead to a migraine attack. It is reported that some migraine attacks start when the stress reduces e.g. a weekend after busy week. Other possible causes are too much caffeine, particular foods, dehydration, skipping meals, eating high sugary foods or poor or very bright lighting.


Most people will respond to oral medication and some people prefer sublingual medications (under the tongue) as the absorption is reported to up to 10 times faster-acting than oral medications. Metoclopramide and anti-emetics can help to combat nausea and gastric stasis by helping to get the gut moving again. This can be of benefit to patients if they can see a GP promptly and have an intra-muscular injection.

If patients have persistent symptoms, GPs may try prophylactic medications to prevent acute attacks although this means taking daily medications long term.

There are a few true migraine specialists and most GPs will refer if the symptoms are difficult to manage, there is no regular pattern or they want to rule out other causes such as a tumour.


1) Sleep

Try to go to bed and get up at the same time each day, as sleeping during the correct phase of your circadian cycle is important. Understand your sleep needs, including both the timing and the duration of sleep (most adults need 8 hours a night). Do try and spend some time outdoors or in natural light during the daytime, as this helps your body clock accuracy. Sleeping environment needs to be peaceful which includes sufficient darkness and quiet, comfortable bedding and no mobiles, tablets, computers etc. around you.

2) Stress

Try to reduce your stress with exercise, having fun, and counselling if you need more help. Focus on getting your work / life balance right. 

3) Exercise

Moderate exercise has been shown by research to help reduce frequency and attacks. Recent studies have shown that exercise changes the levels of a wide range of body chemicals. Exercise stimulates your body to release natural pain-controlling chemicals called endorphins and natural anti-depressant chemicals called enkephalins. A well-planned exercise program could help you to reduce your drug intake to prevent migraines.

If exercise triggers an attack it maybe that you may have started exercising suddenly with no prior planning which means that your body has a sudden demand for oxygen. Eat properly before exercising so that your blood sugar level doesn’t fall quickly and make sure you are well hydrated before and during exercising.

4) Caffeine

You should restrict your intake to having no more than 4/5 cups of tea or coffee a day. Some people find that suddenly stopping caffeine altogether can also be a trigger factor. If you suspect this, you may wish to cut down on caffeine more gradually. Caffeine can be found in many products including chocolate and some over the counter painkillers.

5) Skipping meals/ dehydration

Low consumption of food is probably one of the most important dietary triggers. You may find that regularly eating balanced meals can help to control your attacks. Mild dehydration can also trigger migraine. It is recommended that you should drink at least 8 glasses of water per day, as well as other drinks you may have. Fizzy drinks can contain the sweetener aspartame which should be avoided as these may trigger migraines for some people.