Migraine Trigger Tracker Score

Migraines are complex neurological events that rarely have a single cause. Most people with migraine can name triggers: in Kelman’s 2007 study of 1,207 patients, three in four could. The usual way to think about it is a “migraine threshold”. When enough triggers combine, the threshold is crossed and a migraine occurs.

Common Migraine Triggers

Triggers vary by individual. In Kelman’s patients the most reported were stress (80%), hormonal changes in women (65%), not eating (57%), weather (53%) and disturbed sleep (50%), with smells, light and alcohol each named by around 40%.

• Sleep disruption: Too little or too much sleep is one of the most consistent triggers. Irregular sleep schedules disrupt circadian rhythms and lower your threshold.
• Stress: Both acute stress and the “let-down” period after stress (e.g., weekends after a hard week) are common triggers.
• Dehydration: Widely reported, though the evidence is thinner than for the others. A Dutch trial (Spigt, 2012) gave headache sufferers an extra 1.5 litres of water a day; they felt better, but their headache days barely changed.
• Skipped meals: Going too long without eating is a well-documented trigger.
• Hormonal changes: Many women experience migraines around menstruation, ovulation, or during hormonal medication changes.
• Weather and pressure changes: Barometric pressure drops and high humidity are reported triggers by many sufferers.
• Caffeine: Both too much caffeine and caffeine withdrawal can trigger migraines.
• Bright lights and strong smells: Sensory overexposure is both a trigger and a symptom.
• Alcohol: Red wine is the classic one. Why is unsettled: histamine, tyramine and the plant compounds in red grape skins have all been blamed, while sulfites probably are not, because white wine usually carries more of them. The delay can be long enough to be misleading: a glass at dinner may not produce anything until the following morning.

Some “triggers” are early symptoms

A migraine often starts hours before the headache, with yawning, cravings, neck stiffness and sensitivity to light. So the chocolate you craved, or the glare that suddenly bothered you, may have been the attack beginning rather than its cause. Studies that brought on migraines in the lab found exactly this. It is the main reason a diary beats a list: a real trigger shows up before attacks again and again, an early symptom shows up only on the days that were going to happen anyway.

The Threshold Model

No single trigger reliably causes a migraine every time. Instead, triggers accumulate. A person may tolerate poor sleep alone, but if they also skip a meal and are stressed, the combination crosses their threshold. The weights in this calculator are its own, a way of seeing what is stacked up today rather than a validated prediction.

Two numbers that matter more than any trigger

Painkiller days. Taking headache medicine too often causes headaches of its own. The international headache classification (ICHD-3) calls it medication-overuse headache once simple painkillers such as ibuprofen or paracetamol are taken on 15 or more days a month, or triptans, combination painkillers or opioids on 10 or more, for over three months.

Migraine days. The American Headache Society’s 2021 consensus says preventive treatment should be offered, or at least considered, from about four migraine days a month, and sooner when the attacks are disabling. Many people with eight a month have never been told there is anything to prevent them.

Using This Tool

Rate your exposure to common triggers over the past 24 hours. The calculator scores each factor and gives you an overall risk level. Use it regularly to identify your personal patterns. Keeping a trigger diary is one of the most effective tools for migraine management.