Although auras are thought to be the hallmark sign of an impending migraine, the majority of people who get migraines don’t actually experience them, says Mia Minen, MD, MPH, a neurologist and the director of headache services at NYU Langone Health in New York City. But it’s not just aura that can precede the onset of headache in someone who has migraine. About 10 to 20 percent of people may also experience a prodrome — a premonitory symptom — up to 48 hours before their headache kicks in, according to a study in Therapeutic Advances in Chronic Disease. “Recent neuroimaging fMRI studies have demonstrated that there are changes in the brain up to 24 hours before the onset of pain,” Dr. Minen says. “Prodromal symptoms have been documented in both adolescents and adults.” The premonitory phrase can last for a few hours or a few days, according to the MRF, and some of these early symptoms — like fatigue and mood changes — can be subtle and easy to overlook. That’s why some experts recommend keeping a headache diary. By logging your dietary intake and lifestyle habits, you may be able to spot potential triggers and avoid a migraine in the future. Here are a few migraine warning signs to look out for:
1. You have food cravings
“Eating abnormally may be part of the prodrome of the migraine,” says Noah Rosen, MD, director of the Northwell Health Headache Center in Great Neck, New York. “While you may blame that chocolate bar you ate at your 11 a.m. break for causing your headache, it may have been part of the prodrome that led you to eat it in the first place.” (Cocoa may be protective of migraine, he notes.)
2. You’re yawning excessively
This is likely due to changes in the activity of neurotransmitter dopamine in the brain, Dr. Minen says. “Recent neuroimaging fMRI studies have shown that this is due to the nerve fibers extending down from the brain to the cervical spine — the neck region,” she says. “These fibers then loop back up toward the brain. So while people may feel that their pain is muscular, it actually stems from the changes in the brain related to migraine.”
4. You’re excessively sleepy during the daytime
Feeling drowsy during the day could be one sign of an impending migraine attack. For example, a study published in April 2016 in The Journal of Headache and Pain found that nearly 20 percent of people with migraines reported experiencing excessive daytime sleepiness compared with about 13 percent of those who don’t have migraines. (It’s worth noting that daytime fatigue is a symptom of other conditions, too, including sleep disorders.)
5. You have to urinate frequently
Some people feel a need to urinate frequently during the premonitory phase of the migraine, according to the American Headache Society; this urge can also be accompanied by pelvic pain, says the Association of Migraine Disorders. After the migraine attack, which can last for hours or up to three days, comes what’s called the postdrome, or the “migraine hangover.” The MRF estimates that approximately 80 percent of people can experience fatigue, body aches, dizziness, and sensitivity to sound — and the organization points out that these symptoms can be just as debilitating as those of a migraine itself. By recognizing your symptoms early on, there’s a chance that you can ward off some of the pain associated with a migraine attack, either by taking medication or making adjustments to your everyday routine.
