Vacations bring changes to your daily routine, stress levels, and environment. These changes can have different effects on people with migraine. Some find relief from their migraine attacks, while others might have more attacks or even experience them for the first time.

How Migraine Changes Before, During, and After Vacation

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Migraine symptoms can fluctuate at various stages of your vacation due to changes in stress levels, routine, and environment. Here's a closer look at how migraine can change before, during, and after your trip:

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Before Vacation

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The process of organizing travel details, packing, and ensuring everything is in order before leaving can be stressful. This stress can trigger migraine attacks.

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Trying to wrap up work projects or making sure home responsibilities are managed while you're away can add to the stress, potentially leading to migraine attacks.

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The excitement or anxiety about the upcoming trip can also play a role. While positive anticipation can sometimes be a good stress, it can still impact those with migraine.

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During vacation

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Initial stress and adjustment

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The act of traveling, whether by car, plane, or other means, can be stressful. Factors like delays, long hours in transit, and dealing with luggage can contribute to migraine attacks.

New environments mean exposure to different weather, altitudes, and allergens. These changes can trigger migraine attacks as your body adjusts.

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Vacations often mean a break from your usual schedule. Changes in meal times, sleep patterns, and daily activities can trigger migraine attacks. The migraine brain prefers consistency, so these changes can be challenging.

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Relaxation phase

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Once you settle into your vacation routine, the reduction in daily stressors can lead to fewer migraine attacks. Enjoying leisurely activities, spending time in nature, and having more time to rest can positively impact migraine.

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Being mindful of hydration, especially in warm climates, can help reduce the frequency and intensity of migraine attacks.

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Engaging in activities that promote relaxation, such as massages, yoga, or gentle exercise, can help manage migraine symptoms.

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Potential triggers

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Trying new foods and drinks can be a trigger for some people. Be mindful of known dietary triggers.

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Changes in sleep routines, including different bedtimes or poor-quality sleep in a new environment, can trigger migraine attacks.

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Overexerting yourself with activities like hiking or sightseeing can be a trigger. It's important to pace yourself and include rest periods.

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After vacation

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Coming back to your daily routine can be a source of stress. The transition from vacation mode back to work and home responsibilities can trigger migraine attacks.

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The need to catch up on work or home tasks that accumulated during your absence can add to stress levels.

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Feeling down after the end of a vacation, often called post-vacation blues, can also impact migraine. The letdown effect of returning to everyday stressors can trigger attacks.

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Cortisol, the brain, and the letdown effect

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Cortisol is a hormone produced by the adrenal glands in response to stress. It plays a vital role in various bodily functions, including regulating metabolism, reducing inflammation, and controlling the sleep-wake cycle. Cortisol levels typically rise in response to stress and decrease when the body relaxes.

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Cortisol affects how the body perceives pain. In people with migraine, cortisol levels can influence the frequency and severity of attacks. Chronic stress leads to consistently high cortisol levels, leading to a heightened state of alertness and a lower pain threshold. When cortisol levels drop suddenly, the body's ability to manage pain decreases, potentially triggering a migraine attack. This hormonal fluctuation can disrupt the balance of other hormones and neurotransmitters in the brain, further contributing to migraine onset.

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The letdown effect occurs when the body transitions from a high-stress state to a relaxed state. It’s common to experience this effect after completing a major project, finishing exams, or, notably, at the beginning of a vacation.

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Why migraine may improve on vacation

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Various factors contribute to this improvement, offering a much-needed break and potentially reducing the frequency and severity of migraine attacks.

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Breaking the routine

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• Mental stimulation: Exploring new places and engaging in different activities can provide mental stimulation and distraction from chronic pain.
• Reduced monotony: The change in scenery and routine can help break the cycle of daily stressors that often contribute to migraine attacks.
• Escape from work: Being away from work-related stress, deadlines, and responsibilities can significantly lower stress levels.
• Family and household stress: Taking a break from daily household chores and family responsibilities can also help reduce stress.

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Relaxation and rest

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• Leisure activities: Engaging in leisure activities like reading, swimming, or sightseeing can promote relaxation and reduce stress.
• Spending time in nature: Being in natural settings, such as beaches, mountains, or parks, can have a calming effect and reduce migraine triggers.
• Better sleep quality: Vacations often allow for better sleep due to fewer disruptions and a more relaxed schedule.
• Regular sleep patterns: Without the pressure of early mornings and late nights, you can maintain a more consistent sleep pattern, which is beneficial for managing migraine.

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Increased hydration

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• Drinking more water: Many people pay more attention to their hydration levels while on vacation, especially in warm climates where drinking water is crucial.
• Avoiding dehydration triggers: Staying hydrated helps prevent dehydration, a common trigger for migraine attacks.
• Access to fresh foods: Vacation destinations often provide access to fresh, wholesome foods that may be less processed and healthier.
• Regular meals: With a more relaxed schedule, you can eat regular, balanced meals, avoiding the blood sugar spikes and drops that can trigger migraine attacks.

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Reduction of environmental triggers

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• Allergens and pollutants: Being away from everyday allergens, pollutants, or specific lighting conditions that trigger migraines can be beneficial.
• Controlled environment: Choosing accommodations with good air quality and lighting control can help reduce exposure to common migraine triggers.
• Warm weather: Some people find that warm, stable climates help reduce the frequency of their migraine attacks.
• Consistent barometric pressure: Destinations with stable weather conditions and less fluctuation in barometric pressure can be beneficial for people with migraine.

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Activities that promote well-being

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• Gentle exercise: Activities such as walking, swimming, or yoga can help improve overall well-being and reduce migraine frequency.
• Outdoor activities: Spending time outdoors can be refreshing and reduce stress levels.
• Massages and spa treatments: Many vacation destinations offer massages and spa treatments that can help alleviate tension and promote relaxation.
• Mindfulness and meditation: Practicing mindfulness or meditation can help manage stress and improve mental health, reducing migraine triggers.

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Psychological benefits

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• Change of pace: A break from the usual routine can provide mental refreshment and reduce the mental fatigue associated with chronic migraine.
• Positive mood: Enjoying new experiences and spending quality time with loved ones can boost your mood and reduce the likelihood of migraine attacks.
• Lower cortisol levels: The reduction in stress and the opportunity to relax can lower cortisol levels, which helps in reducing the frequency of migraine attacks.
• Improved mental health: Better mental health and reduced anxiety can lead to fewer migraine triggers.

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Should I take my meds if I’m feeling better on vacation?

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YES.

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It’s essential to continue taking your medications even if you feel better on vacation.

Migraine is a chronic condition, and skipping doses can reduce the effectiveness of preventive treatments, potentially leading to more severe or frequent attacks.

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Always have your medications with you to manage any unexpected migraine attacks.

Stopping daily medications suddenly can be harmful, possibly triggering withdrawal symptoms or exacerbating your condition.

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Even in a relaxed vacation environment, unforeseen triggers can arise, so maintaining your medication regimen ensures consistent management of your migraine disease and helps prevent disruptions in your treatment plan.

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Should I consider moving to a vacation spot if my migraine improves there?

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While migraine attacks may temporarily improve on vacation, the underlying life stressors don't disappear when you return home.

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The relief you experience on vacation is often due to a temporary stress reduction, and sometimes due to environmental changes or barometric pressure.

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While it’s tempting to consider moving after a trip, your IRL stressors will remain. So it’s better to incorporate some of those healthy, restful habits from your trip once you’ve returned to your home routine.

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Vacationing with migraine: Your pre-trip checklist

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Planning ahead is key to enjoying a migraine-free vacation. Here's your checklist to keep those attacks at bay:

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Before you go:

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• Talk to your doctor: Discuss your travel plans and get personalized advice on managing your migraines while away from home.
• Pack your migraine toolkit: Prepare a kit with essentials like medications, pain relievers, ice packs, earplugs, eye masks, and any calming aromatherapy or relaxation tools.
• Research your destination: Be aware of potential migraine triggers specific to your destination, such as high altitudes, weather patterns, or local cuisine.
• Schedule downtime: Don't overpack your itinerary. Plan for relaxaton and rest to avoid overexertion and stress.

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During your trip:

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• Maintain consistency: Stick to your regular sleep schedule and meal times as much as possible, even while enjoying vacation activities.
• Stay hydrated: Drink plenty of water throughout the day, especially during flights or in warmer climates. Dehydration can be a major trigger for migraines.
• Eat balanced meals: Opt for regular, nutritious meals with plenty of fruits and vegetables. Limit processed foods, alcohol, and caffeine, which can trigger migraines.
• Protect yourself from the sun: Wear sunglasses, hats, and sunscreen to avoid sun-triggered migraines.
• Listen to your body: Don't push yourself too hard. Rest when you need to and be mindful of your body's signals.
• Take your medications: Don't skip your preventive medications, even if you're feeling good. Bring extra medication in case of delays or unexpected events.
• Consider neuromodulation: If you use neuromodulation devices like Cefaly, pack them and use them as part of your migraine prevention strategy.
• Be COVID-prepared: Take precautions to protect yourself from illness, as infections can both trigger and exacerbate migraine attacks. Recurrent COVID infections may increase the risk of developing long COVID.

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Practical tips to manage migraine at home

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Managing migraine effectively often involves making thoughtful lifestyle changes and adopting habits that can reduce triggers and improve overall well-being. Here are some practical tips that can help:

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• Carve out time for enjoyable activities like reading, gardening, or painting.
• Practice mindfulness, yoga, or deep-breathing exercises.
• Say "no" to avoid overcommitment and reduce stress.
• Prioritize self-care and manage workload effectively.
• Spend quality time with supportive friends and family.
• Join a migraine support group.
• Stick to regular sleep and meal times.
• Plan a structured daily routine with balanced activities.
• Avoid overexertion and include regular breaks.
• Use time management tools to stay organized.
• Eat balanced meals and stay hydrated.
• Engage in regular, moderate exercise.
• Ensure good sleep hygiene.
• Try cognitive behavioral therapy (CBT) for coping strategies.
• Use biofeedback to control physiological functions.
• Follow your healthcare provider’s advice.

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Traveling with migraine? Check out our blog post Travel Tips When You Have Chronic Migraine.

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Your Neura provider and care coach can help you prepare for travel and manage potential migraine pattern changes during your vacation. Book a video visit today!

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