Migraine Duration: How Long Does a Migraine Last?

The duration of individual migraine attacks, as well as the overall course of the condition, can vary greatly from person to person. However, there are established definitions and interesting facts about migraine duration.

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Last updated: February 6, 2024

How Long Does a Migraine Attack Last, and How Can You Shorten It?

The duration of a migraine attack varies from person to person. Typically, an untreated attack lasts between 4 and 72 hours, with an average duration of around 24 hours. However, some attacks may be shorter or longer.

It is not entirely understood why migraine attacks often subside after 72 hours (three days). Researchers suspect the body has a self-regulating mechanism. Since migraine attacks are triggered by a series of neurological and biochemical changes in the brain, these changes can’t be sustained indefinitely, and the body eventually returns to a normal state.

Various treatment approaches can help reduce the duration of a migraine attack. Medications such as pain relievers, triptans, and anti-nausea drugs (antiemetics) can alleviate symptoms and, ideally, shorten the attack. Non-medication strategies like resting in a dark, quiet room and applying cold packs can also provide relief. However, treatment effectiveness varies—what works for one attack may not work for another.

It’s important for non-migraine sufferers to understand that taking a pill doesn’t instantly restore full functionality. While medications help, about 90% of migraine sufferers experience moderate to severe pain, three-quarters are unable to work properly during an attack, and one-third require bed rest, even with medication.

In rare cases, migraines can last a week or longer. These extended attacks are known as status migrainosus.

Status Migrainosus: A Special Form of Migraine

When a migraine attack lasts longer than 72 hours, it is classified as status migrainosus. These prolonged attacks are particularly difficult to treat, as standard migraine medications often become ineffective.

According to the German Neurology Society (DGN) guidelines, treatment for status migrainosus includes a single dose of corticosteroids, such as prednisone or dexamethasone, administered either intravenously or orally. Early intervention is crucial, as enduring such a prolonged attack can be physically and mentally exhausting.

How to Cope When a Migraine Attack Lasts for Days

Severe, long-lasting migraine attacks can take a significant toll on mental health. In our article “What Helps During a Migraine Attack? Natural Remedies at a Glance,” you’ll find helpful tips on managing acute migraines, including:

Accepting the situation and your current limitations
Practicing relaxation techniques
Distracting yourself when possible
Prioritizing self-care without guilt

Give your body what it needs without feeling bad about it—whether that’s a cold soda, a bag of nuts, greasy pizza, a hot shower, an ice pack on your head, or binge-watching your favorite series. The most important thing? Let go of guilt and obligations, and accept that you can’t change your condition in that moment. This can significantly reduce stress and pressure.

Migraine Relief through Personalized Nutrition

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The 4 Phases of a Migraine Attack and Their Duration

Migraine duration varies from person to person and depends on the length of each phase of the attack. A typical migraine follows different phases:

Classic migraines with aura have four phases.
Migraines without aura have three phases.

Phase 1: The Prodrome (Early Warning Phase)

Hours or even days before the attack, many sufferers experience early warning signs, such as:

Frequent yawning
Mood swings
Neck stiffness
Sensitivity to light
Food cravings

About 30% of migraine sufferers report experiencing these symptoms, which can last up to a day. Head pain usually begins within hoursof these warning signs.

Phase 2: The Aura (For Some, But Not All)

People with migraine with aura may experience visual and sensory disturbances before the headache starts, including:

Flashing lights, zigzag lines, or shimmering spots

Dizziness, speech difficulties, or numbness

Distorted perceptions (e.g., Alice in Wonderland Syndrome)

Aura symptoms typically last 20–30 minutes and fade before the headache begins. In some cases, aura occurs without a headache at all.

Phase 3: The Headache Phase

The actual migraine headache is moderate to severe, often one-sided, and has a throbbing, pulsating, or stabbing quality. It typically lasts 4 to 72 hours and may be accompanied by:

Nausea and vomiting

Sensitivity to light, sound, or smells

Worsening pain with movement

Phase 4: The Recovery Phase

As the migraine subsides, fatigue and exhaustion set in. Some people feel euphoric and refreshed, while others need more rest. Brain fog, irritability, muscle pain, and food cravings may persist for hours or even days.

The Migraine Cycle

A migraine cycle consists of all the phases mentioned above, followed by a pain-free period. The length of this pain-free interval varies and can be extended with proper migraine prevention strategies.

A key insight: Migraines are more likely to be triggered just before an attack than in other phases. For example, you may drink red wine one day without issue but experience a migraine from the same drink another time. This is due to where you are in your migraine cycle—a crucial factor in managing triggers.

The Tipping Point Theory: Why Does Our Brain “Tip” Into a Migraine Attack?

The Tipping Point Theory, also known as the Threshold Model, suggests that migraine sufferers have a lower neurological threshold for triggers such as:

Blood sugar fluctuations
Stress
Certain foods
Hormonal changes
Lack of sleep

When these triggers exceed an individual’s threshold, a migraine attack is triggered. Stabilizing blood sugar levels has been shown to reduce migraine frequency and intensity.

How Can You Extend Your Pain-Free Phase?

You can reduce migraine frequency by:

Identifying and managing your personal migraine triggers

Practicing relaxation techniques and moderate exercise
Following a low-glycemic diet to stabilize blood sugar levels

Ebby helps personalize your diet using continuous glucose monitoring (CGM).

How Long Does a Person Suffer From Migraines in Their Lifetime?

There is no universal answer—some people experience migraines only occasionally, while others suffer from frequent, lifelong attacks. While migraines are considered incurable, they can become less frequent and severe over time.

Conclusion

Migraine attacks typically last 4–72 hours, but the duration of the overall condition varies greatly. By implementing personalized dietary adjustments, identifying triggers, and using preventative strategies, you can extend pain-free phases and reduce migraine frequency.

Sources

Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition: Cephalalgia (2018) doi:10.1177/0333102417738202.
Lipton, R. B. et al. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology 68, 343–349 (2007).
Diener, H.-C., Förderreuther, S. & Kropp, P. Therapie der Migräneattacke und Prophylaxe der Migräne: Entwicklungsstufe: S1. AWMF 030057 (2022).
Kelman, L. The Premonitory Symptoms (Prodrome): A Tertiary Care Study of 893 Migraineurs. Headache J. Head Face Pain 44, 865–872 (2004).
Grossinger, R. Migraine Auras: When the Visual World Fails. (North Atlantic Books, 2013).
Levin, M. Classification and Diagnosis of Primary Headache Disorders. Semin. Neurol. 42, 406–417 (2022).
Peng, K.-P. & May, A. Redefining migraine phases – a suggestion based on clinical, physiological, and functional imaging evidence. Cephalalgia Int. J. Headache 40, 866–870 (2020).
Lüdtke, K., Szikszay, T. & Jülke, M. Auswirkungen des Migränezyklus auf tägliche stattfindende manuelle Untersuchungen der Halswirbelsäule bei einer Migränikerin: eine Einzelfallstudie. MSK – Muskuloskelettale Physiother.25, 191–196 (2021).
Schulte, L. H. & May, A. The migraine generator revisited: continuous scanning of the migraine cycle over 30 days and three spontaneous attacks. Brain J. Neurol. 139, 1987–1993 (2016).
Dahlem, M. A. Was bedeutet ein Migränegehirn kippt? Graue Substanzhttps://scilogs.spektrum.de/graue-substanz/was-bedeutet-ein-migraenegehirn-kippt/ (2015).
Bongiovanni, D. et al. Effectiveness of ketogenic diet in treatment of patients with refractory chronic migraine. Neurol. Sci. Off. J. Ital. Neurol. Soc. Ital. Soc. Clin. Neurophysiol. 42, 3865–3870 (2021).
Evcili, G., Utku, U., Öğün, M. N. & Özdemir, G. Early and long period follow-up results of low glycemic index diet for migraine prophylaxis. Agri Agri Algoloji Derneginin Yayin Organidir J. Turk. Soc. Algol. 30, 8–11 (2018).
Razeghi Jahromi, S. et al. Association of diet and headache. J. Headache Pain20, 106 (2019).

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.