How to Track Migraine Triggers: A Complete Guide

You've probably heard that keeping a migraine diary helps identify triggers. But there's a lot of conflicting advice out there, and the science is more nuanced than most articles let on. Here's what actually works, based on research and what neurologists recommend.

First, an uncomfortable truth about triggers

Trigger factors are reported by up to 75.9% of migraine patients. But here's what most articles won't tell you: individual triggers often fail to provoke migraine attacks in controlled experimental settings. A 2022 review in the journal Cephalalgia noted that scientific evidence for many commonly cited triggers is actually quite poor.

This doesn't mean triggers aren't real. It means they're more complicated than "eat chocolate, get migraine."

What research increasingly supports is the threshold theory: you have a certain level of tolerance that, when exceeded, results in an attack. One trigger alone might not be enough. But multiple triggers stacking up can overwhelm your nervous system.

Think of it this way: if you're well-rested, hydrated, and stress-free, your threshold is high. A glass of wine might be fine. But if you're sleep-deprived and stressed? That same glass of wine can push you over the edge. Your susceptibility is cumulative.

The chocolate myth (and why it matters for tracking)

Chocolate is one of the most commonly cited migraine triggers. But a 2020 review in the journal Nutrients looked at 25 studies and found something interesting: there isn't solid evidence that chocolate triggers migraines for most people.

Studies that gave some people chocolate and others a placebo found no difference in migraine frequency.

So why do so many people believe chocolate is their trigger?

The answer lies in the prodrome phase. This is the first stage of a migraine attack, starting hours or even a day before the headache hits. Common prodrome symptoms include fatigue, mood changes, neck stiffness, and crucially: food cravings.

Here's what happens: you start craving chocolate during your prodrome (your brain is already beginning the attack). You eat the chocolate. Hours later, the headache arrives. You blame the chocolate. But the migraine was already in motion before you took a bite.

This is why tracking how you track matters. If you only log what you ate before an attack, you might be recording symptoms of the prodrome, not actual triggers. The American Migraine Foundation specifically warns about this mistaken identity problem.

What the research says actually triggers migraines

A study of 378 patients found the most commonly reported triggers were:

• Psychological stress - 83% of patients (and other research confirms stress has the highest awareness level at 93.4%)
• Sleep problems - 63% of patients
• Nutritional factors - 39% of patients (though which foods vary dramatically by individual)

Weather changes, particularly barometric pressure drops, are estimated to be involved in about 20% of migraine episodes. One study found that pressure between 1003-1007 hPa (6-10 hPa below standard) was most likely to trigger attacks.

But here's the key finding that should shape how you track: research published in Cephalalgia found that 85% of patients with identified triggers had completely unique, individual trigger profiles. For those with three or more triggers, 96% had profiles that didn't match anyone else.

Your triggers are yours. Generic lists can point you in a direction, but only your own data will reveal your pattern.

How to actually track (without driving yourself crazy)

The biggest mistake people make is trying to track everything. You download an app, and suddenly you're logging 50 variables. Within two weeks, you've abandoned it.

The Migraine Trust puts it simply: keep your diary as simple as possible. The goal is consistency over comprehensiveness.

The minimum viable migraine log

For each attack, record:

• When it started and ended (duration matters more than people realize)
• Severity - use a consistent scale. Decide what "severe" means to you and stick with that definition
• 2-3 potential triggers from the past 24 hours - stress level, sleep quality, anything notable

That's it to start. You can add more detail later if needed.

Track the prodrome too

This is what separates useful tracking from noise. Note subtle early symptoms like:

• Neck stiffness
• Unusual fatigue
• Excessive yawning
• Food cravings
• Brain fog or difficulty concentrating
• Mood changes

These can start a full day before the headache. If you notice these consistently before attacks, you're not identifying triggers - you're catching the migraine early.

Don't forget migraine-free days

This is counterintuitive but important. If you only track attack days, you can't see what's different about good days. Did you sleep well? Was stress lower? Was the weather stable?

Even a quick "no migraine today, slept 7 hours, low stress" gives you comparison data.

How long before you see patterns?

Most neurologists recommend at least 2-3 months of consistent tracking. The National Headache Foundation emphasizes that patterns take time to emerge, especially since you need enough attacks across different conditions to draw real conclusions.

Apps like Migraine Insight (used by doctors at Mayo Clinic and Johns Hopkins) suggest you need about 30 days of data before their pattern detection becomes reliable.

What to do with your data

After a few months, look for:

• Day-of-week patterns - weekend migraines are common (the "let-down" effect after work stress)
• Time-of-day clustering - do attacks tend to start in the morning? Afternoon?
• Trigger combinations - remember the threshold theory. Maybe alcohol alone is fine, but alcohol + poor sleep isn't
• Weather correlations - this requires an app that logs conditions automatically, since you won't remember barometric pressure

Dr. Amaal Starling, a neurologist at Mayo Clinic, notes that "detailed information is necessary to make a diagnosis and create an effective treatment plan." Bring your data to appointments. A few months of tracking is worth more than years of vague recollections.

A note on confirmation bias

If you believe red wine triggers your migraines, you'll remember the times it did and forget the times it didn't. This is human nature, not a character flaw.

The fix is to let data speak. Don't track "wine gave me a migraine." Track "drank wine at 7pm" on one line and "migraine started at 2am" separately. Then look at the patterns across many entries. How often did wine appear before attacks versus before migraine-free days?

You might be surprised. Or you might confirm what you suspected. Either way, you'll know.

The bottom line

Migraine tracking works, but only if you can sustain it. Start simple. Be consistent. Track both attacks and non-attacks. Watch for prodrome symptoms that might be masquerading as triggers. Give it at least 2-3 months.

And remember: your trigger profile is probably unique. The goal isn't to match a checklist from the internet. It's to understand what your body is telling you.