Tracking Triggers: How to Keep a Migraine Diary That Actually Helps

Keep it to six fields

Long templates get abandoned. A single line per day is enough for patterns to appear over a couple of months.

• 01Date and whether an attack occurred
• 02Start time and rough duration
• 03Severity out of ten
• 04Sleep: hours, and how broken it was
• 05Meals, caffeine and water, roughly
• 06Anything unusual: travel, weather change, cycle day, deadline, alcohol

Track for eight to twelve weeks

Shorter than eight weeks and you cannot separate coincidence from pattern, particularly where hormonal cycles or weather are involved. Consistency matters more than detail, so record on clear days too. Days without attacks are the comparison group.

Read the days before, not just the day itself

Premonitory symptoms often begin a day or two ahead, which means the real signal may sit in the previous entry: a short night, a skipped lunch, an unusually intense afternoon. Look at 24 to 48 hours before onset rather than the morning of.

Beware the false trigger

Chocolate and cheese cravings can be part of the premonitory phase rather than a cause of it, so what feels like a trigger is sometimes an early symptom. Test one variable at a time, over several weeks, before removing anything from your life permanently.

Bring it to your appointment

Summarise before you go: attacks per month, average severity, acute medication days per month, and the two or three factors that recur. Medication overuse headache is a real risk when acute painkillers are used regularly, and an accurate count is the single most useful number you can hand over.