Your Migraine Forecast: How to Predict Migraine Attacks

If you experience frequent migraines, you may start to worry or feel paranoid that a migraine could strike at any moment. You might worry about how migraines will impact your career, social life, or family. The good news is that — over time — you may get better at predicting a migraine attack.

When you can predict an oncoming migraine, you might be able to avoid it and keep the migraine from disrupting your life. “The benefit of recognizing a migraine attack early is that you're able to take an acute treatment early,” says Sylvia Mohen, MD, Neurologist in New York City. “You'll have better results treating the migraine the earlier you take medication for it.”

To predict a migraine, you need to be aware of the typical migraine timeline: the prodrome, aura, the headache, and the postdrome.

The prodrome phase

“There's a wide array of physical symptoms that can indicate that your migraine is coming. You may feel very fatigued,” says Dr. Mohen. “You may feel cognitively foggy or out of it.”

These symptoms fall in the category of the “preheadache” phase, which is formally called the prodrome phase. Not everyone who gets migraines experiences this phase. For those who do, it may last a few hours to a few days before the actual headache.

The prodrome phase includes the following possible symptoms:

• Irritability

• Depression

• Increased urination

• Fatigue and yawning

• Sensitivity to light and sound

• Cravings

• Trouble concentrating

• Nausea

The aura

“Some people have the auras, which are scary if you've never had one before, but once you come to recognize it, it can be a good indication that your migraine is about to come,” says Dr. Mohen.

Only about a third of people with migraines actually have aura, according to the American Migraine Foundation. An aura lasts between five to 60 minutes, and it can cause the following symptoms:

• Visual disturbances, such as flashing, blind spots, or moving lights and patterns

• Temporary blurriness or loss of vision

• Fantasmias, or hallucinations of smell

• Numbness and tingling in the body

The headache and postdrome phase

And finally, the actual headache may begin. It goes without saying, but migraine symptoms include a throbbing, burning headache, as well as nausea, insomnia, mood changes, and sensitivity to lights, smells, and sounds. (Check out how these people with migraines describe their own symptoms.)

However, the migraine attack may not stop there. About 80 percent of people who get migraines experience a “migraine hangover” known as the postdrome phase.

What to do when migraine signs start

When you first notice signs of a migraine, take your acute migraine medication. This may include over-the-counter pain relievers, or a prescribed treatment like triptans. Learn more about treating migraine.

In addition to medication, making lifestyle changes may help disrupt the migraine timeline. For example, avoid triggers like bright lights, lack of sleep, dehydration, low blood sugar, or certain foods. Keeping a headache diary can help you pinpoint these triggers overtime so you can successfully prevent or lessen the severity of migraines.

“Minimizing these triggers can be important, but sometimes knowing that you're going to be in a situation that's going to provoke a headache can give you a heads-up that maybe it's time to do something or take something to turn that headache off as soon as it starts,” says Dr. Mohen.