The Migraine Diary

A migraine diary is an essential tool for both those living with migraines and their healthcare providers. It assists in diagnosing and managing migraine attacks, offering valuable insights into the condition.

Reading time: 9 minutes

Last updated: April 19, 2024

Migraine is a lifelong condition affecting over one billion people globally. Each case is highly individual, meaning your triggers, symptoms, and effective treatments may differ greatly from others.

Given its complexity, self-monitoring can be critical for managing migraines. Recognizing triggers, evaluating remedies, and identifying patterns can pave the way for more effective therapy. A migraine or headache diary makes this possible.

What’s Recorded in a Migraine Diary?

Typically, the following details are documented:

Date and time of the episode
Pain intensity
Symptoms before, during, and after the attack
Potential triggers (e.g., menstrual cycle, sleep, stress, diet)
Acute and preventive medications taken
Other measures used to address the episode

Why Keep a Migraine Diary?

Track Your Condition

A migraine diary allows you to monitor the progression of your condition, including frequency, intensity, and triggers. For instance, sinCephalea provides a user-friendly overview of migraine patterns, as seen in Figure 1.

Aid in Diagnosis

By documenting pain days, intensity, and symptoms, healthcare providers can better identify the type of headache and make accurate diagnoses.

Identify Triggers

Recording daily habits, foods, hydration, sleep, hormonal changes, and stress levels helps uncover potential triggers, enabling effective trigger management. For example, sinCephalea can highlight how menstrual cycles align with migraine episodes (Figure 2).

Recognize Patterns

Over time, you may notice patterns, such as migraines occurring after specific triggers like low blood sugar or weekend caffeine changes. Recognizing these can guide better management strategies.

Optimize Treatment

Keeping track of medications and interventions enables adjustments to treatment plans with your doctor. SinCephalea visualizes medication use and effectiveness, helping identify the most impactful measures (Figure 3).

Prevent Medication Overuse Headache (MOH)

Tracking medication intake helps you adhere to the “10/20 Rule,” avoiding overuse that can lead to MOH.

The “10/20 rule” helps to avoid a so-called medication-overuse headache (MÜK). This states that pain medication and specific migraine medication such as triptans should be taken long-term on a maximum of 10 out of 30 days per month. No painkillers should be used on the other 20 days, as otherwise an ME can occur.

It is not the number of medications taken that counts, but the days on which medication is taken. So if you take pain medication twice in one day, this counts as one day of use. The rule is: it’s better to treat properly once than just a little. This is because hesitating to take medication can lead to a recurring headache, which can result in you having to take medication again the following day.

Improve Communication with Healthcare Providers

With sinCephalea, you can generate a comprehensive PDF report for your doctor, summarizing key metrics such as:

Number of migraine and headache days
Average pain intensity
Acute medication use and effectiveness
A detailed calendar view of attacks and related events

Better Quality of Life

Keeping a migraine diary can help you to better understand your migraine condition and its impact on your life and to adapt your life accordingly with the help of behavioral changes. For example, if you realize that your job is constantly pushing you to your limits and provoking migraine attacks, you should talk to your employer or reorient yourself in order to lead a life with fewer migraine attacks in the long term. Tip: It’s best to use the comment function in the Ebby migraine app for such observations!

Migraine Relief through Personalized Nutrition

Medication Free
Side Effect Free
Based on Science

The Role of Ebby in Migraine Management

With the migraine app Ebby, we want to help you better understand your own illness, recognize migraine triggers and support both diagnostics and migraine therapy by providing a PDF report for you to easily share with treating physicians. You can therefore document and monitor the following parameters in the app’s headache diary:

Start and end of the headache attack (migraine duration)
Headache type
Headache intensity
Absence from work: yes or no
Comment function for additional information such as measures taken

You can also enter and monitor the influence of the following parameters on your migraine:

Medication taken and its effectiveness
Menstruation
Sleep
State of health
Exercise
Drinking
Eating

As you may know, both hormones (recent changes) and changes in sleep (sleep-wake rhythm) can trigger a migraine attack. Your state of health, such as prolonged stress or not drinking enough, can also trigger an attack. It is therefore important to note and observe all these parameters.

Conclusion

A migraine diary is invaluable for acute and long-term management. Whether tracking symptoms or identifying effective interventions, a personalized approach—including non-pharmacological methods like blood sugar stabilization—can greatly enhance your migraine care strategy.

Sources

Chen, X. & Luo, Y. Digital Therapeutics in Migraine Management: A Novel Treatment Option in the COVID-19 Era. JPR Volume 16, 111–117 (2023).
Siva, Z. O. et al. Determinants of glucose metabolism and the role of NPY in the progression of insulin resistance in chronic migraine. Cephalalgia 38, 1773–1781 (2018).
Yilmaz, N. et al. Impaired oxidative balance and association of blood glucose, insulin and HOMA-IR index in migraine. Biochem Med 145–151 (2011) doi:10.11613/BM.2011.023.
Bernecker, C. et al. Oxidative stress is associated with migraine and migraine‐related metabolic risk in females. Euro J of Neurology 18, 1233–1239 (2011).
Gruber, H.-J. et al. Hyperinsulinaemia in migraineurs is associated with nitric oxide stress. Cephalalgia 30, 593–598 (2010).
On behalf of the School of Advanced Studies of the European Headache Federation (EHF-SAS) et al. Association of diet and headache. J Headache Pain 20, 106 (2019).
Evcili, G. Early and Long Period Follow-up Results of Low-Glycemic Index Diet for Migraine Prophylaxis. Agri (2018) doi:10.5505/agri.2017.62443.
Lelleck, V. V. et al. A Digital Therapeutic Allowing a Personalized Low-Glycemic Nutrition for the Prophylaxis of Migraine: Real World Data from Two Prospective Studies. Nutrients 14, 2927 (2022).
https://www.dmkg.de/files/Kopfschmerzkalender_PDF/Kopfschmerzkalender_DEUTSCH_18.3.2021.pdf

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.