Do you see an uptick in headaches clinically in the fall, particularly in Colorado, where we can go from a barometer-plummeting 80-degree high one day to sub-40 degrees the next?
Yes. It’s interesting. I originally trained on the East Coast, and I would occasionally hear patients mention symptoms associated with changes in the weather. However, after moving here, I noticed such complaints became almost a daily occurrence. Whenever there are significant storms, fluctuations in barometric pressure, and sudden temperature swings, there is an uptick of these reports, and those weather changes happen commonly in this region.
Can you explain a little bit more about the barometric pressure relationship?
Research shows that drops in barometric pressure are most often associated with migraines and cluster headaches. In general, rapid shifts in weather and atmospheric conditions lower a person’s threshold for developing headaches.
Some studies suggest that decreases in atmospheric pressure may activate the neurons involved in the pain response. Those same pressure fluctuations can also affect the middle ear and other pressure-sensing structures within the brain, which can trigger headache symptoms.
Did you know? Research suggests between 30% and 50% of people with migraines identify some type of weather change as a trigger, making it the most commonly reported migraine source. Read more in The Conversation.
We set our clocks back an hour this weekend (Nov. 2 ). Are headaches linked with daylight saving time?
There are well-documented medical consequences that come with the time change. We know that shifting the clock can increase the frequency and severity of headaches by disrupting the circadian rhythm and causing sleep disturbances. Those changes in sleep patterns and light exposure can trigger migraines or make existing headache disorders worse.
It also has broader effects on mood and mental health. The transition, especially in the fall, can contribute to seasonal affective disorder and increase the risk of depression. Because depression and headache disorders are so often comorbid, one can easily amplify the other.
Some reports suggest low vitamin D levels due to darker days and less time outdoors trigger headaches. Can you explain?
Vitamin D is involved in a range of neurologic processes. It helps protect nerve cells, modulates inflammation, and even influences mood, pain and cognition. There are links between low vitamin D and conditions like multiple sclerosis, depression and migraine. For my patients with headache disorders, I recommend their vitamin D level to be at least 30.
What about stress from things like going back to school and preparing for the holiday season?
Yes, stress is one of the most common triggers that people report with headaches and migraines. There is a noticeable increase in emergency room department visits for headaches both at the fall start and even the return to school in January after break.
There's another type of headache disorder called new daily persistent headaches where all of a sudden someone develops a continuous, unrelenting headache. This type of headache is associated with increased stress from school, changes in sleep and different daily routines in the fall.
Did you know? New daily persistent headache is a rare disorder that can last months and most commonly affects women and youth, especially between ages 10 and 18.
Allergy season has reportedly been extending into fall with climate change, and some things like ragweed are high in the fall. Can that be part of it?
Yes, there’s a well-established association between histamine and headaches. In fact, antihistamine medications are sometimes used to help treat headaches, particularly in children. People with seasonal allergies often experience more tension-type headaches, and there’s a higher prevalence of chronic migraine in individuals with allergic conditions.
Mast cell activation and the release of histamine with allergies can act on your blood vessels and your nerves in your brain, which then can set off that inflammatory cascade. Allergies can also directly activate that trigeminal nerve (the largest cranial nerve that reaches down each side of the face, branching in toward the eye, nose and jaw), which can then trigger pain too.
Can fall’s fierce winds play a role?
There have been some reports suggesting that wind can trigger headaches. A few smaller studies have shown a small association between windy conditions and headaches, although this can be challenging to study since windy days often coincide with other weather changes, such as storms or shifts in barometric pressure.
There is also a condition, trigeminal neuralgia, a facial pain disorder that typically affects someone's lower jaw. That one is classically affected by wind exposure. In fact, it is one of the most common and well-recognized triggers that patients describe.
Did you know? People with seasonal allergies often experience more tension-type headaches, and there’s a higher prevalence of chronic migraine in individuals with allergic conditions.
What can people prone to weather-related headaches do?
While the weather itself is beyond your control, you can still put yourself in the best position to minimize its impact. If you know a major storm is approaching, prioritize a good night’s sleep, regular exercise, nutritious meals, and adequate hydration (at least 64 ounces of water a day). For some patients, I recommend taking a preventive dose of medications before the weather change. You can also wear hats, sunglasses and special earplugs designed to minimize barometric pressure changes.
Did we miss anything, or is there anything you would like to add?
Dryness, like we experience here in Colorado, hasn’t been well studied, but rapid changes in humidity and high humidity are thought to increase the susceptibility of migraine, as can bright light and intense sunlight.
That said, weather is just one part of the headache puzzle. There are many people who will go through fall and extreme temperature changes without developing headaches. I often explain it by saying that everyone has a “fuse” for developing a headache, and some people's fuse is simply shorter. For them, those weather changes may be enough to set off that fuse.
