Smells and Migraine: Getting Worse?

Sensitivity to odours is osmophobia. Yes, this can refer to a fear of smells, but the hypersensitivity to smells related to migraine applies as well.

A study published in the Journal of Headache and Pain last month provides some interesting insights into common sensitivities and also a possible progression of the symptom.

The researchers, in this case, recognized that many “migraine symptoms” are not only present during an attack, but also before, after, or between attacks – or all the time. This is important to understand for people who still think that migraine only affects you when you have a “migraine headache”.

The biggest offenders probably won’t surprise you. The easy winner was “sweet perfumes”. But next to that, the odours of various foods, cigarette smoke, and exhaust fumes were common offenders. All of these sometimes covered all categories above in the sense of when they were a problem, some being bothersome all the time, and all for some people were considered triggers.

Also not surprising was that if a smell bothered you before an attack, it was likely to bother you during an attack. If it bothered you during an attack, chances were better that it would bother you all the time.

Perhaps most interesting in this study were the age differences. Patients who tended to be sensitive to certain smells between attacks tended to be about 10 years older, and/or they had had migraine for 8 years longer. This may indicate that migraine sensitivity does progress. Would the osmophobia be less if migraine had been treated properly in the early years? This study didn’t address the question, but it seems possible.

Some good news is that people with a high sensitivity to odours did not necessarily seem to be more disabled in general. In other words, although obviously this is a part of the migraine disability, it doesn’t seem like it is necessarily a sign that your migraine is getting more severe. A possible exception were those who became especially sensitive just before a migraine attack.

It may also be encouraging to know that the researchers found that patients were not nearly as likely to have an attack triggered by a certain odour as was believed from an earlier study. It could be that certain smells become more intense and annoying at certain times, such as right before an attack. But that does not necessarily mean that the perfume or whatever is actually triggering an attack.

For more on the study, check out Interictal osmophobia is associated with longer migraine disease duration.