Migraines: Simple steps to head off the pain

Medicine is a proven way to treat and prevent migraines. But medicine is only part of the story. It's also important to take good care of yourself and know how to cope with migraine pain when it hits.

Lifestyle choices that support good health overall may lower the number of migraines you have as well as ease migraine pain.

To manage migraines most effectively, try the following healthy-lifestyle steps, along with taking your medicines.

When you notice a migraine starting, take a break. If stepping away from what you're doing isn't possible, try to keep your surroundings as quiet and calm as you can.

• Turn down the lights and noise. Light and sound can make migraine pain worse. Relax in a dark, quiet space if it's available. If not, lessen the light and sound around you. Rest if you can.
• Try temperature therapy. Apply hot or cold packs to your head or neck. Ice packs have a numbing effect that may ease pain. Hot packs, heating pads, and warm showers or baths relax tense muscles.

• Sip a caffeinated drink. In small amounts, caffeine may relieve the pain of a migraine as it starts. Caffeine also may boost the effect of acetaminophen (Tylenol, others) or aspirin in easing pain. If you avoid caffeine for personal or health reasons, talk with your healthcare professional about other options.

  Also, be careful with caffeine. Drinking too much of it too often can lead to withdrawal headaches later. Having caffeine too late in the day can make it hard to sleep at night. That could make migraines worse.

Getting enough sleep is important. A poor night's sleep can trigger migraines. Migraines also may keep you from falling asleep. Or the pain may wake you up at night.

Use these tips to help you sleep better.

• Aim for regular sleep hours. As much as your schedule allows, try to go to bed and get up around the same time every day, even on weekends. If you nap during the day, keep it short. Naps longer than 20 to 30 minutes can make it harder to sleep at night.

• Relax at the end of the day. You likely will sleep better if you take time to relax before you go to bed. Listen to soothing music, soak in a warm bath or read a favorite book. Intense exercise, heavy meals, caffeine, nicotine and alcohol make it harder to get to sleep.

• Create a peaceful sleep space. If possible, save your sleep space for rest and intimacy. Try to avoid watching television or using a computer in bed. If your sleeping area has a door, closing it at night can help. Try using a fan or other soothing sounds to muffle outside noise.
• Don't try to force sleep. The harder you try to sleep, the more awake you'll likely feel. If you can't fall asleep, read or do another quiet activity until you become drowsy.
• Check your medicine. Medicine that contains caffeine or another stimulant, including some medicine to treat migraines, can make it hard to get to sleep.

What and when you eat can have an effect on migraines. Follow these guidelines:

• Be consistent. Eat at about the same time every day.
• Don't skip meals. The risk of migraines goes up when you don't eat.
• Drink water. Drinking plenty of water or other healthy fluids throughout the day may help lower the risk of a migraine.
• Keep a food journal. Keep track of the foods you eat and when you have migraines. That can help you find foods that could be causing migraines.
• Eat healthy foods. Diets rich in fruits, vegetables and foods with higher levels of omega-3 fatty acids, such fish and shellfish, can lower the severity and frequency of headaches.
• Avoid foods that trigger migraines. If you think a certain food is causing migraines, don't eat it for a while to see what happens. Foods that are known to lead to migraines in some people include aged cheese, chocolate, caffeine, alcohol and processed meats, such as salami, hot dogs and bologna.

During physical activity, the body releases chemicals that block pain signals to the brain. These chemicals also help lower anxiety and depression. Both of those conditions can make migraines worse.

Obesity also raises the risk of chronic headaches. Staying at a healthy weight through exercise and diet may help manage migraines.

There are many ways to be active. Pick an exercise you enjoy. Walking, swimming and biking are popular choices. Water aerobics and recumbent biking can be good options for people with mobility issues. Talk with your healthcare professional before you start a new exercise routine. Ease into exercise slowly. Very vigorous exercise may lead to a migraine.

Stress raises the risk of a migraine. Completely avoiding daily stress isn't realistic. But managing it well may reduce migraines. The following steps can help.

• Simplify your life. Try not to fill all your time with activities and chores. Leave some time in your day for relaxation, if possible.
• Manage your time wisely. Be realistic about what you can get done, both at work and at home. Ask for help when you need it. Break down large projects into smaller, more manageable steps.
• Take a break. If you feel overwhelmed, a few slow stretches or a quick walk may renew your energy.
• Try to stay positive. For example, if you find yourself thinking, "This can't be done," switch gears. Think instead, "This will be tough. But I can make it work."
• Enjoy yourself. Find time to do something you enjoy for at least 15 minutes every day. It could be playing a game, having coffee with a friend or engaging in a hobby. Doing something you enjoy is a natural way to lower stress.
• Relax. Deep breathing from your diaphragm can help you relax. Focus on inhaling and exhaling slowly and deeply for at least 10 minutes every day. It may help to relax your muscles one group at a time. When you're done, sit quietly for a minute or two.

Keeping a headache diary may help you see what triggers your migraines. Note when a migraine started, what you were doing at the time, how long it lasted and what, if anything, provided relief.

Until recently, avoiding migraine triggers was considered the best advice. But certain triggers cannot be avoided. And some research now suggests that completely avoiding triggers might raise a person's sensitivity to potential triggers.

A more useful approach could be slow exposure to migraine triggers and learning to cope with those triggers by using behavioral management techniques. That may include identifying and challenging negative thoughts, relaxation training, and stress reduction. Talk with your healthcare professional to see if this approach could be helpful for you.

Living with migraines can be a daily challenge. But making healthy lifestyle choices often helps. Ask family and friends for support as you make healthy changes.

If you're feeling anxious or depressed, consider joining a support group or finding a therapist. Ask a member of your healthcare team to help you connect with support groups and other resources in your community or online.