Identify and Avoid Triggers:
- Common triggers: stress, lack of sleep, certain foods (e.g., aged cheese, chocolate, alcohol), sensory stimuli (bright lights, strong odors).
- Rationale: Migraineurs often have heightened sensitivity to these factors, which can precipitate attacks.
- Lifestyle Modifications:
- Regular sleep schedule (7–9 hours/night).
- Consistent meal times; avoid skipping meals.
- Hydration (2–3 L/day of water).
- Rationale: Disruptions in circadian rhythms and dehydration are known migraine triggers.
- Stress Management:
- Relaxation techniques (biofeedback, meditation, yoga).
- Cognitive-behavioral therapy (CBT) for stress coping.
- Rationale: Stress is a major trigger; CBT is evidence-based for migraine prevention (Level A evidence per AHS guidelines).
- Hormonal Considerations (for women):
- Estrogen fluctuations (menstrual cycle, hormonal contraceptives) can trigger migraines.
- Rationale: Hormonal changes are a well-documented trigger; consider non-hormonal contraception if migraines worsen.
- Sensory Stimuli Avoidance:
- Limit exposure to bright lights, loud noises, strong odors.
- Rationale: Sensory hypersensitivity is common in migraineurs; reducing stimuli can prevent attacks.
- Regular Exercise:
- Aerobic exercise (e.g., walking, swimming) 3–4x/week.
- Rationale: Exercise improves vascular health and reduces stress, but avoid overexertion (a potential trigger).
- Non-Pharmacologic Adjuncts:
- Caffeine (100–200 mg/day) may help, but avoid excess (can trigger rebound headaches).
- Rationale: Caffeine has mild analgesic effects but can worsen headaches if overused.
Key Reference: AHS/ANM guidelines emphasize non-pharmacologic strategies as first-line management for episodic migraine.