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Headache Diary: How Tracking Your Symptoms Can Improve Treatment

When a headache strikes, it might seem like it comes out of nowhere. Whether the pain starts suddenly or you feel it building up, it can be tough to figure out why. 

While you can’t always figure out what’s causing your headaches, a lot of times things like tension, dehydration, lack of sleep or other health conditions can trigger them. And keeping a headache diary can help you get to the bottom of the causes. 

By knowing what’s behind your headaches, you can take steps to help keep them from happening as often. And you may be able to make them less severe.

Joshua Tobin, MD, a neurologist with Banner Brain and Spine, explained more about how to use a headache diary to track the factors that could be impacting your headaches.

What is a headache diary? 

A headache diary is a tool you can use to track your headaches and the factors that might be causing or influencing them. In it, you log when headaches happen, how severe they are and what happened before and around the time of the headache.

By keeping a diary, you have a record of information related to your headaches you can share with your health care provider. You and your provider can use this information to develop and modify a targeted treatment plan. 

As you track information like stress, diet and sleep in your diary, you can start to spot circumstances, behaviors or factors that could be influencing your headaches. By recording and analyzing your experiences, you’ll be more attuned to your body and able to communicate with your provider. And it can feel empowering to gain more control over your headaches and your health.

A headache diary can help reduce the impact of headaches on your daily activities, work, well-being and quality of life. Depending on what you learn, it could be life changing.

How to set up a headache diary

To start, you’ll want to decide whether a digital or paper format is best for you. You may like the tangible aspect of a paper version and feel that seeing it will remind you to make your entries. Or you may prefer a digital tool or app that’s always with you and can help analyze your data.

Whichever format you choose, here’s what you may want to track:

  • Date and time of each headache episode
  • How severe your headache is — mild, moderate or severe
  • Where you notice the pain — for example: on one side of the head, the temples or all over
  • How long the headache lasts
  • Possible triggers, such as foods, stress, sleep changes, dehydration, changes in the weather, altitude changes or other factors
  • Medications and how well they worked

A headache diary entry might look like this:

  • Date and time: December 3, 2023, 8:30 p.m.
  • Severity: Moderate
  • Location of pain: Right temple
  • Duration: Approximately two hours
  • Potential triggers: Stress at work, skipped lunch
  • Medication: None

Be sure to track the most common triggers. Dr. Tobin said they are:

  • Stress
  • Nonrestorative sleep
  • Barometric pressure changes
  • Daily temperature changes
  • Dehydration
  • Neck pain
  • Missed meals

Spotting patterns and trends

When you document these details, over time you may notice patterns that could be causing or worsening your headaches. You can share your diary with your provider to get the benefit of their expertise in analyzing your information.

For example, you may notice:

  • Frequent headaches on or after days with high stress levels at work
  • More severe headaches in the evening
  • Headaches following a poor night's sleep
  • Headaches after eating certain foods

“Each person’s triggers are unique. For one person, missed meals may be a trigger but not alcohol. Without this knowledge you might avoid both and needlessly avoid all alcohol, or you might avoid neither, resulting in more migraines,” Dr. Tobin said.

The goal of keeping a headache diary is to improve your treatment and minimize your headaches. Detailed records about your headaches can help your provider adjust your medications, recommend lifestyle changes or suggest alternative therapies. The diary helps you and your provider create a treatment plan designed just for you.

Even if you can’t avoid triggers, knowing what they are can be valuable. “For example, some people develop a headache every time they fly or every time they drive to a higher altitude. Rather than never flying or driving, they may want to take their migraine medication around the same time they are exposed to the trigger rather than waiting for the actual headache to start,” Dr. Tobin said.

How to use a headache diary

To get the most benefit from your headache diary or headache journal, it’s important to be consistent. Taking a few minutes every day to maintain your diary can give you a lot of information.

You may want to have a specific entry time each day. Making it part of your routine can help you remember to update it. You may also want to use a phone reminder or alarm, so you don’t forget.

Be honest and detailed about your entries. Factors like your stress levels, sleep quality and food and drink choices can impact your headaches, so keeping detailed, accurate records is important. 

“Keeping this diary for about three months allows you to look for patterns. For example, you might notice that migraines tend to start one to two days after missing a meal,” Dr. Tobin said. 

If this is the case, you can avoid missing meals, make no other changes, and wait another three months. “Fewer migraines during these three months will confirm that missed meals are a trigger,” he said.

Share your diary with your provider and communicate openly about what your headaches are like and how you think triggers could be influencing them. Your provider can also help tease out whether a trigger is actually part of the prodrome (symptoms many people with migraines have before the actual head pain starts).

“For example, food cravings like an urge for chocolate is a prodrome symptom in some people,” Dr. Tobin said. “This craving leads people to eat chocolate which is then followed by a migraine, so they think the chocolate caused the migraine.”

One thing to keep in mind: Food allergens are a known trigger. So if you think certain foods are causing your headaches, you may want to talk to your provider about food allergen testing instead of using the trial-and-error method of documenting changes in your diet.

Headache diary options

If you prefer a paper headache diary, you can use any blank notebook or journal or use this printable version from the National Headache Foundation. 

You may prefer using an app instead. Most apps are customizable, can remind you to make your entries, and can graph your data so it’s easier to see patterns. They might also work with other health and wellness apps you use, giving you a bigger picture of your overall health. And if you usually have your phone with you, apps like Migraine Monitor or Migraine Buddy are easy to access. 

For more insight into triggers and other information, check out the American Migraine Foundation’s articles and the HeadWise blog

The bottom line

Factors like your stress, sleep, diet and even the weather can impact how often you have headaches and their severity. By keeping a headache diary, you can uncover these triggers and work with your provider to take steps to reduce them.

Banner Health’s experts can help you evaluate the information in your headache diary and create a tailored treatment plan. Reach out to connect with a provider.

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