To say that weather has become headache-inducing feels like an extreme understatement. The forecast has gone from something we casually referenced when choosing a coat or planning a beach day to a chronic source of anxiety. Wildfires, flash floods, record-breaking hurricanes, tornado watches—all now seem like weekly events. It's no surprise that studies are beginning to link climate-change worry to not only head pain but other psycho-physical symptoms.
For many people living with migraine, though, even ordinary weather patterns have always seemed closely linked to how they feel—and in a way that’s more than just psychological. “Migraine is a genetic neurological disease that can be affected by environmental factors, and in various studies, about 45 to 70 percent of patients report weather as a trigger for their migraine attacks,” explains Juliana VanderPluym, M.D., headache medicine specialist and assistant professor of neurology at the Mayo Clinic in Phoenix.
In some respects, weather could be considered the perfect storm of migraine triggers. That’s because we’re not just talking about dramatic events that impact everyone’s daily routines—like blazing-hot temperatures and severe thunderstorms—but layer upon layer of interconnected environmental systems. “Weather includes not just temperature and precipitation but meteorological factors like wind velocity and direction, barometric pressure and humidity,” VanderPluym says. “Plus, there are the effects that weather has on other environmental factors, such as air quality due to pollen or pollutants, and what it does to our personal habits—our activities, our hydration, etc.”
One of the most-cited culprits when it comes to weather-related headaches is a sudden drop in barometric pressure—the measure of air pressure in the atmosphere—that happens as a storm hits. (“A low-pressure system is moving in,” as a meteorologist would say.) That’s because our nasal and sinus cavities are filled with air, and a change in barometric pressure creates a difference in pressure between the outside air and the air in your sinuses. A familiar scenario where you can feel this happening in a more obvious way: Your ears pop as a plane takes off and the outside air pressure decreases rapidly.
It’s possible that other weather changes could bring on migraine pain, too. One 2009 study published in the journal Neurology found that higher temperatures increased the number of patients who went to the emergency room for severe head pain treatment. Similarly, an earlier study published in the same journal showed that strong wind prompted migraines in some people. Even calm and cloudless days aren’t in the clear when it comes to possible ties to migraine symptoms, since some studies have linked strong sunlight or prolonged sun exposure to migraine attacks. However, it’s possible that the sun could actually be a symptom, rather than a trigger. “One of the symptoms of migraine is sensitivity to light, or photophobia, so it may be that a migraine attack is already developing and making the sunlight appear strong,” VanderPluym says. It’s also possible that the real culprit on hot, sunny days is dehydration, a major trigger of both migraine and plain old headaches.
If any of these weather-related potential migraine triggers ring true for you, there are a few things you can do. If bright sunlight seems to bring on symptoms, shield your eyes with a brimmed hat and sunglasses with polarized lenses, which reduce glare. If a severe-storm watch is declared for your area and you’re sure this means a migraine attack is also on the horizon, shore up your defenses by focusing on self-care via things like diet, sleep, and moderate exercise. “When people are under increased stress, including when worrying about a [migraine] coming on, this may itself become a trigger,” VanderPluym says. “Talk to your doctor, because there are effective strategies to address this anticipatory anxiety, such as biofeedback or cognitive behavioral therapy.” It’s important to avoid turning to other triggers during stressful weather events, too. The reason you always get a migraine during a blizzard could be that you turn to chocolate and red wine for comfort while house-bound.
You should also ask your doctor whether you could time taking an anti-inflammatory medication in anticipation of certain weather conditions you’ve found problematic in the past. “We can’t control the weather, but your healthcare provider can design an effective acute and preventive treatment strategy to boost your migraine threshold, so that no matter the weather, your threshold is high enough that migraine attacks won’t occur,” VanderPluym advises. It’s also smart to keep a migraine journal where you can note symptom patterns, adding any weather observations that might play in. Some people use weather apps to predict migraine-adjacent meteorological events so they can proactively medicate, but it can be tough to stay on top of. “Tracking weather is hard because there are just so many variables to think about,” VanderPluym says. What’s more helpful to track: any non-headache symptoms you experience before migraine pain starts, like fatigue, neck soreness, yawning, or irritability. This may indicate that you have a migraine prodrome, or pre-headache phase. “Some studies have found that using your migraine rescue/acute medicine during the prodrome may help prevent the headache from occurring,” VanderPluym says. Now, if only we had a similar pill that could prevent that next crazy weather event.
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