A study out of Spain, published last month, set out to investigate what factors seemed to set off migraine attacks in patients, especially those with high disability. The three most common "precipitating factors" are show below (in order from top to bottom):
- Hormonal factors (75.2%)
- Stress (70.9%)
- Factors related to sleep disorders (68.4%)
The researchers from the Medical Center of Asturias pointed out that it’s very important to focus on these factors during migraine treatment. In other words, if we try to treat the disease without treating the things that are setting off the attacks, we might be starting from the wrong angle. Or at least ignoring the key.
But there are some problems with reports like these. First, these are factors that patients feel are triggers – but it’s often more complicated than that. Migraine attacks often start long before patients are aware. For example, stress could actually be a result of early migraine symptoms.
Secondly, precipitating factors are really a whole lot more complicated. Just because these are the three most commonly reported, doesn’t mean that’s all there is (and we know there’s a lot more!). Migraine is often triggered by a set of things together, often things we’re not even aware of.
Many times, migraine attacks come apparently for no reason at all.
So if this is a reminder that we need to investigate what triggers (not what causes, what triggers) a migraine attack, then I wholeheartedly agree. But let’s be careful that we don’t use this as another excuse to say "It’s just stress" or "It’s just hormones". It probably isn’t that simple.
Be a part of our own online poll, featuring a wide variety of trigger categories. As I write it’s currently on the right sidebar at Headache and Migraine News.
See the study abstract: Precipitating factors of migraine attacks in patients attended in neurology services.