Stress as a migraine trigger

Stress is an important migraine trigger.^{[Kajal et al., 2017]} Several different patterns of stress leading to a migraine attack have been described in the literature:^{[Spierings et al., 2014; Spierings et al., 1997]}

• stress in the afternoon, leading to a headache in the evening or during the night
• stress extending into the evening, leading to the patient waking up the next morning feeling tired and developing a headache during that morning
• stress extending into the evening, and having an arousing effect, whereby the person still feels stressed the next morning and develops a headache during the following evening.

References:
Kajal M, Malik M, Kumari R. Correlation of stress with migraine – a review. Int J Cur Res Rev 2017; 9 (12): 23–26.

Spierings ELH, Donoghue S, Mian A, Wöber C. Sufficiency and necessity in migraine: how do we figure out if triggers are absolute or partial and, if partial, additive or potentiating? Curr Pain Headache Rep 2014; 18 (10): 455.

Spierings ELH, Sorbi M, Maassen GH, Honkoop PC. Psychophysical precedents of migraine in relation to the time of onset of the headache: the migraine time line. Headache 1997; 37 (4): 217–220.

Other references used on slide:
Lipton RB, Buse DC, Hall CB, et al. Reduction in perceived stress as a migraine trigger: testing the “let-down headache” hypothesis. Neurology 2014; 82 (16): 1395–1401.

Migraine Trust website. https://www.migrainetrust.org/about-migraine/trigger-factors/common-triggers/. Accessed July 2020.