With three days until Thanksgiving there's no denying it: the holiday season is upon us. But while many of us are looking forward to celebrating the season with loved ones, an estimated 30 million Americans suffering from migraine are cringing at the thought of holiday crowds, travel delays, stress and other triggers that can result in headache pain.
In an effort to better understand how to manage headache disorders during the holidays, I turned to Robert Cowan, MD, director of the new Stanford Headache Clinic. Below Cowan discusses why headaches and migraines can be more common during the holidays and tips for preventing the pain.
During the holidays, some people may find that their headaches and migraines occur more frequently. Why?
For some people, the holidays are a perfect storm of triggers: stress, changes in sleep pattern, travel, special foods, special events and the list goes on. Of course, not every migraine sufferer has the same triggers but some of the most common ones tend to show up at the holidays. To make matters worse, we have less control over our lives during the holidays. Plans are hard to change, house guests occupy our time and all around us are smells, noise and lights. All this makes it hard to retreat from the environment to that cool, quiet, dark place where a migraine can cool off.
Some patients have reported thatcertain foods can trigger their headache disorders. What tips can you offer about how eating habits that can reduce the frequency of headaches or migraines?
Actually, I hate those lists of foods to avoid. There really are no "universal" triggers. Foods in particular are over-hyped. Sure, some people have headaches triggered by one food or another but it is not a good idea to generalize. If something tends to trigger your headaches, and it is not particularly important to you, then avoid it. If it is important to you, you can take measures to minimize its impact. As far as tips, the best strategy is to stay consistent in your eating behaviors. Be consistent with meal times, food portions and ratios of carbohydrates to proteins to fats. All tricky to pull off during the holidays. Skipping lunch and overeating the big dinner is the norm, which is a bad idea.
Previous research has shown that too much or too little sleep can induce migraines. What role do our sleep habits play in provoking or preventing headaches and migraines?
Many of us lose our normal sleep pattern during the holidays. We don't have to get up for work, we stay up late with friends we drink, we get less or more exercise and we nap. All these things alter our sleep pattern and it is the sleep pattern that our bodies rely on to set cortisol and other hormonal cycles. It is this disruption of the body's normal hormonal cycles that can trigger headaches.
Increased stress seems inevitable during the holiday season and, as you mentioned, this can also bring on headaches and migraines. What stress management tactics can help in averting headaches and migraines?
I guess stress comes as close as anything to a universal trigger. It is the rare migraine sufferer that is immune to stress. Whether it is leaving work undone because of family obligations, dinner with relatives you are not fond of or spending money you don't have for gifts, there are ample opportunities for stress during the holidays. Psychologists tell us to reserve time for yourself, set boundaries, maintain exercise and sleep strategies and pay attention to how you are feeling. It is a good strategy to take regular breaks during the day, just as you would (or should) when at work.
Holiday travel, which disrupts our sleep schedule, nutrition habits and raises our stress level, can trigger headaches and migraines. And past studies have shown that many experience headaches when flying on airplanes. Do you have any suggestions for how to make holiday travel a little less painful?
There are a few things that can help with holiday travel. First, and perhaps most obvious, give yourself plenty of time. Everything takes longer during the holidays and tempers are often short. So go with the flow. If you are traveling across time zones, advance or retard your sleep pattern over several days before you leave. The idea is to be on your normal schedule in the new time zone if you are going to be there a while. If it is a short run, try to stay on your base time zone schedule. Sometimes this can mean forcing sleep on the plane or upon landing. Or, conversely staying awake during the flight and after landing. It is also useful to take your headache medicine as a preventive before getting on the plane. Making sure to hydrate, abstain from alcohol and eat on your schedule can also help.