Is It Really Worth Keeping a Headache Diary?
Maybe your doctor suggested it. Maybe you saw people in an online migraine group talking about it. And you’ve started to wonder: Should I keep a headache diary too?
We say yes! Journaling your headaches can reveal things you never knew about your migraine patterns and triggers. Here’s a simple guide to get you started.
What Is a Headache Diary?
Simply put, it’s a record that tracks the frequency, duration and intensity of migraine attacks (or other headaches) over time. Keeping an accurate headache diary can help you and your healthcare provider understand which treatments work best for you and which may be losing their effectiveness. It can also help you identify your migraine triggers and avoid them in the future.
For some people, a migraine diary can even be a welcome daily reminder to keep healthy migraine habits, such as exercise (that you can tolerate) and keeping a regular sleep schedule.
Of course, it’s not for everyone. When your migraine pain is so bad that you can barely move, taking notes may be too much to ask. But you don’t have to keep a migraine journal forever! Usually, a few months is enough time to identify patterns and show your healthcare provider what’s working and what’s not.
What Should a Headache Diary Include?
That’s really up to you. For some people, it’s as simple as marking every day they have a headache, along with the intensity. Others include headache factors such as:
- Location of pain
- Preventive treatments
- Abortive treatments
- Response to treatments
- Length of migraine
And external/environmental factors, such as:
- Time of day
- Weather conditions
- Activities and foods/drinks consumed prior to the attack
- Menstrual cycle
- Sleep schedule
- Other possible migraine triggers
Don’t feel compelled to include everything on this list. If you already know that hot weather is a migraine trigger, or if a visual aura always precedes a migraine attack, there’s probably no need to record those details.
Instead, think like a scientist: What do you want to learn about your migraine patterns? What hypothesis are you testing? If you’re trying to gauge whether a new treatment or habit is having a positive effect, then keep the rest of your routine the same for a while. This can be especially helpful if you’re trying an elimination diet for migraine. As you add foods back to your diet one at a time, journaling can identify which ones cause problems.
For accuracy, it’s best to record your journal entries in real time. If you wait until the attack has passed, you may forget exact times and details.
What Format Should a Headache Diary Take?
These journals can be visually appealing, believe it or not! Many bullet-journal fans create lavishly illustrated versions — like this one that features the Pokémon Psyduck, a character that suffers from splitting headaches. This example uses a clever system of color-coding, numbers and cross-hatching to record an entire year of migraines on one page.
If you’re not the type to create an elaborate journal, here’s a simple, printable version from the National Headache Foundation. You can jot down a few notes on each attack in a regular notebook, too — but later, you may have to compile all the data into one spreadsheet or document for your healthcare provider to review.
You can also try a migraine-tracking app. Apps make it easy, because your phone’s always with you. You may be able to personalize the interface to record only the data that’s most relevant to you, or auto-suggest your most common triggers and treatments. One study followed 62 people as they used an app to record their migraine attacks, and concluded that “smartphone headache diary application is an effective tool to assess migraine trigger factors.”[i]
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[i] Park JW, Chu MK, Kim JM, Park SG, Cho SJ. Analysis of Trigger Factors in Episodic Migraineurs Using a Smartphone Headache Diary Applications. PLoS One. 2016;11(2):e0149577. Published 2016 Feb 22. doi:10.1371/journal.pone.0149577