• Category: Wellness, work environment

Migraine Triggers and Management

Migraine Triggers and Management

November 13, 2025
Written By Dana Koroluk, Guest Writer

Introduction

Headache disorders, including migraine, are the third leading cause of disability worldwide. In Canada, it is estimated that migraine is prevalent in 8.4% to 10.2% of Canadians. Migraines significantly impact individual participation in the workplace through both missed workdays and reduced productivity due to migraine symptoms. As well, migraine predominantly affects women with peak occurrence during prime working years [1].

Migraine is a neurovascular disorder characterized by headache, aura (sensory disturbances such as tinnitus, visual changes or loss) and sensitivity to normal sensory inputs including light, sound, odour and movement [2]. Patients often describe early symptoms such as neck stiffness, dizziness, yawning or drowsiness when they feel a migraine coming on. Those who suffer from migraines can usually identify common triggers, which can be grouped into five major categories [3]:

  • Emotional stress
  • Menstruation
  • Temperature and environmental changes
  • Sleep disturbance
  • Food and alcohol

The Chicken or the Egg?

It is also reported that sensory input can be triggering for migraines. However, In studies focused on triggers, migraines could not be reliably induced by sensory stimuli such as intense lights, loud noises or offensive odours [4]. In addition, individuals may be more sensitive to light in between migraine attacks. Even visually impaired individuals can experience sensitivity to light during a migraine [5,6]. This suggests the relationship between migraine triggers and onset may be more complex than simple ‘cause and effect’. This raises an important question: Do triggers cause migraines or are they simply early symptoms of a migraine that has already begun?

Neurophysiological studies indicate that brain activity changes hours before headache onset, particularly in the frontal cortex, which is key for executive function, attention, decision-making and problem-solving [7,8,9]. These early changes prime the brain to be more reactive to ordinary sensory stimuli and correlates to early symptoms such as sensitivity to odors, lights or noises [6].

Reframing Prevention: from Avoidance to Balance

There is little evidence to suggest that avoidance of potential migraine triggers reduces the likelihood of migraine attacks. In fact, focusing on triggers may actually increase pain intensity and reduce quality of life [3]. Migraine management is shifting away from strict trigger avoidance towards lifestyle regulation and resilience. These recommendations include [6]:

  • Optimizing Sleep Hygiene: Maintain consistent sleep schedules and avoid sleep deprivation.
  • Nutrition and Hydration: Opt for regularly scheduled, balanced meals instead of fasting or skipping meals. It is not recommended to eliminate entire food groups considered to be migraine triggers. Also ensure adequate fluid intake and hydration.
  • Hormonal Regulation: For menstrual migraines, estrogen withdrawal (e.g. late luteal phase) and prostaglandin changes may be involved. Talk to your doctor about management strategies focused on regulation of these hormones.
  • Stress Management: Relaxation training, biofeedback, Cognitive-Behavioural Therapy, mindfulness and coping-skills education can reduce attack frequency and intensity.
  • Workplace Posture: Evaluate your workstation setup and maintain proper posture to reduce head and neck strain, as prolonged neck flexion or hyperextension can lead to head and neck pain. See other blog posts for ways to optimize your workstation or talk with your supervisor to see if an ergonomic assessment is right for you.
  • Environmental Modifications: Consider using sunglasses, anti-glare filters, hats, fluorescent light filters or lower overhead lights as needed. Implement sound-dampening materials, noise-cancelling headphones or ear plugs to manage noise.

Beyond Lifestyle

While optimizing lifestyle and environment may lead to reduced migraine frequency and intensity, once a migraine mounts, it may require further treatment to reduce the severity and duration. Besides management with medications, alternative therapies have proven to be helpful. Acupuncture and transcutaneous electrical nerve stimulation (TENS) have demonstrated benefits in reducing migraine frequency and improving quality of life [10,11].

Light therapy, paradoxically, may also play a therapeutic role in migraine treatment. Despite light sensitivity being a defining symptom of migraine, this is usually isolated to blue and red lights as the culprits [9]. Emerging evidence in support of light therapy has indicated that green light is associated with headache symptom relief, and may also be associated with improved sleep quality and reduced anxiety [12]. While this research is in early phase and practical application is limited, narrow-band wavelength green light sources and sunglasses are being developed as a hopeful solution for migraine symptoms [13].

Key Takeaways

Migraines reflect a complex interaction of brain hypersensitivity, and physiological changes resulting in sensitivity to environmental inputs. Rather than steering clear of triggers, effective symptom management comes from regular routine and balance including: restorative sleep, stress management and optimizing your environment.

References

  1. Graves, E. B., Gerber, B. R., Berrigan, P. S., Shaw, E., Cowling, T. M., Ladouceur, M. P., & Bougie, J. K. (2022). Epidemiology and treatment utilization for Canadian patients with migraine: a literature review. The Journal of international medical research, 50(9), 3000605221126380. https://doi.org/10.1177/03000605221126380
  2. Ropper A, Samuels M, Klein J. Adams and Victor’s Principles of Neurology, 10th edition. McGraw Hill Education: Medical, 2014.
  3. DynaMed. (2025). Migraine prophylaxis in adults. EBSCO Information Services. https://www-dynamed-com.login.ezproxy.library.ualberta.ca/management/migraine-prophylaxis-in-adults
  4. Sand T, White LR, Hagen K, Stovner LJ. Visual evoked potential and spatial frequency in migraine: a longitudinal study. Acta Neurol Scand 2009; 120:33–37.
  5. Tiévant, C. (2023). Des innovations « anti-migraine » parmi Les Filtres Thérapeutiques. Revue Francophone d’Orthoptie, 16(3), 109–115. https://doi.org/10.1016/j.rfo.2023.07.013
  6. Martinelli, D., Pocora, M. M., De Icco, R., Putortì, A., & Tassorelli, C. (2022). Triggers of migraine: where do we stand?. Current opinion in neurology, 35(3), 360–366. https://doi-org.login.ezproxy.library.ualberta.ca/10.1097/WCO.0000000000001065
  7. Noseda R, Bernstein CA, Nir RR, et al. Migraine photophobia originating in cone-driven retinal pathways. Brain 2016; 139:1971–1986.
  8. Ambrosini A, De Noordhout AM, Sandor PS, Schoenen J. Electrophysiological studies in migraine: a comprehensive review of their interest and limitations. Cephalalgia 2003; 23(Suppl 1):13–31.
  9. Artemenko AR, Filatova E, Vorobyeva YD, et al. Migraine and light: a narrative review. Headache J Head Face Pain 2022; 62:4–10.
  10. Tao, H., Wang, T., Dong, X., Guo, Q., Xu, H., & Wan, Q. (2018). Effectiveness of transcutaneous electrical nerve stimulation for the treatment of migraine: A meta-analysis of randomized controlled trials. The Journal of Headache and Pain, 19(1), 42. https://doi-org.login.ezproxy.library.ualberta.ca/10.1186/s10194-018-0868-9
  11. Cui, F. (2024). A meta-analysis of acupuncture’s improvement of mood disorders, pain and quality of life in migraine patients. Alternative Therapies in Health and Medicine, 30(11), 304–311.
  12. Lipton, R. B., Melo-Carrillo, A., Severs, M., Reed, M., Ashina, S., Houle, T., & Burstein, R. (2023). Narrow band Green Light Effects on headache, photophobia, sleep, and anxiety among migraine patients: An open-label study conducted online using daily headache diary. Frontiers in Neurology, 14. https://doi.org/10.3389/fneur.2023.1282236
  13. Hou, T. W., Yang, C. C., Lai, T. H., Wu, Y. H., & Yang, C. P. (2024). Light therapy in chronic migraine. Current Pain and Headache Reports, 28(7), 621–626. https://doi.org/10.1007/s11916-024-01258-y

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