Migraine Aftereffects

Migraines have multiple phases. In the final phase, known as the resolution phase, aftereffects of the migraine attack may occur. This article explores what these aftereffects are, how long they last, and what you can do about them.

Reading time: 7 minutes

Last updated: October 2, 2024

Migraines are episodic conditions with distinct phases. The final phase, referred to as the resolution phase or “migraine hangover,” is often overlooked, even though it can significantly impact those affected.

The Phases of a Migraine Attack

A migraine without aura has three phases, while a migraine with aura involves four phases:

The Prodromal (Premonitory) Phase: This phase may include early signs such as excessive yawning, mood swings, or food cravings.

The Migraine Aura (only in migraines with aura): Symptoms may include visual or speech disturbances, dizziness, or perceptual distortions like Alice in Wonderland Syndrome.

The Pain Phase: Characterized by unilateral, moderate to severe headaches, described as throbbing, pounding, or stabbing, often worsened by movement. Additional symptoms may include nausea, vomiting, and heightened sensitivity to light, sound, or smell.

The Resolution (Postdromal) Phase: Pain subsides, but symptoms such as fatigue, irritability, or even bursts of energy may arise. This phase is referred to as migraine aftereffects or the “migraine hangover.”

Good to Know: In medical terminology, the three main phases are called preictal, ictal, and postictal, derived from the Latin word ictus (meaning “stroke” or “attack”). The term interictal describes the symptom-free period between attacks. The precise transitions between phases remain unclear and are still under study.

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What Triggers a Migraine?

The causes of migraines, including the onset of the prodromal phase, vary greatly among individuals. One potential trigger is blood sugar fluctuations. Blood sugar imbalances can lead to energy deficits in the brain, increase the release of neuropeptides like CGRP, and promote inflammation—all of which may trigger migraines.

A low-glycemic, personalized diet that stabilizes blood sugar can help reduce the frequency and intensity of migraines. The Ebby app uses this approach to prevent migraines by providing personalized dietary recommendations based on your blood sugar responses. The app, prescribed by healthcare providers, is covered by health insurance and involves no side effects or risks.

The Resolution Phase: The Phase of Aftereffects

In this phase, the migraine attack typically subsides, and pain diminishes. Recent studies suggest a potential link between symptoms in the prodromal and resolution phases. Participants who experienced diverse symptoms in the prodromal phase were more likely to have aftereffects during the resolution phase.

Interestingly, the likelihood of resolution phase symptoms decreases with a higher frequency of migraine days per month, though the reasons for this remain unclear.

What Are Migraine Aftereffects?

Aftereffects vary by individual. Many people feel drained and liken the experience to a hangover, while others report feeling revitalized. Common symptoms include:

Fatigue and tiredness (e.g., increased need for sleep and rest)
Sensitivity to pain
Loss of appetite
Difficulty concentrating
Irritability
Muscle soreness
Feelings of euphoria or liveliness
Increased energy

How Long Do Migraine Aftereffects Last?

By definition, the resolution phase lasts up to 24 hours. However, the duration can vary, ranging from a few hours to several days.

What Can I Do About Migraine Aftereffects?

Standard migraine medications for acute attacks are generally ineffective during the resolution phase and may even worsen symptoms if overused. To avoid medication overuse headaches, limit acute medication use to what is strictly necessary.

Current recommendations to alleviate symptoms in the resolution phase include:

Plenty of rest and sleep
Stress reduction through relaxation techniques (e.g., meditation)
Staying hydrated and eating balanced, low-glycemic meals
Light physical activity (e.g., stretching, walking, or yoga)
Avoiding bright lights and loud noises (helpful for those with hypersensitivity)
Exploring remedies that work for you, such as caffeine, heat or cooling packs, or migraine masks

Listen to your body and prioritize recovery to prevent further migraine attacks.

Conclusion

Migraine symptoms aren’t limited to the headache phase—they can also occur in the surrounding phases. In the resolution phase, commonly referred to as the “migraine hangover,” symptoms like fatigue, pain sensitivity, concentration difficulties, or irritability may persist. However, some individuals experience increased energy and joy during this phase.

It’s essential to care for your body during this time, ensuring adequate rest, hydration, and low-glycemic nutrition. The Ebby app can help by offering personalized dietary recommendations based on your blood sugar responses, reducing migraine days without sacrificing enjoyment.

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About the Author

Miriam Jansen

Miriam had to give up her job due to chronic migraines - and became a migraine expert during this time. The migraine helped her to make a radical change in her life: She now lives as a digital nomad in her bus and works as a copywriter & as a shepherdess on an alp.