According to the American Migraine Foundation, approximately 39 million men, women, and children in the United States suffer from migraine, a serious ongoing neurological disease. Migraine attacks are characterized by head pain along with other symptoms that vary from person to person, including “sensitivity to light or sound, nausea, and vomiting. Some individuals experience visual disturbances (auras) that may present as zigzag lines or flashing lights either before or during a migraine,” according to the National Institute of Neurological Disorders and Stroke.
Yet, despite the high number of sufferers, and the fact that migraine attacks interfere with education, career, or social activities for more than 90 percent of those affected, per the AMF, it’s still a disease with no cure that’s often misunderstood and too often undiagnosed.
So what do you need to know about migraine attacks? SheKnows spoke to Dr. Brynna Connor, Healthcare Ambassador at NorthWestPharmacy.com to help you understand why some migraine attacks occur, why they may last longer than a day, and what solutions are available, both at your doctor’s office and at home.
How Long Do Migraine Attacks Last?
Migraine attacks will often occur in four stages, each of which has its own length. The prodrome stage can warn you that a migraine is coming within the next day or so and is characterized by symptoms like nausea, sensitivity to light, and irritability. This phase can last anywhere from a few hours to a few days. The second phase is the aura phase, which is only experienced by 20 percent of migraine sufferers, according to AMF. This phase is shorter, lasting only a few minutes to an hour.
The third phase is the one we typically think of when we think migraine: it’s the headache stage, which can last between 4 and 72 hours, depending on the severity of the attack and how quickly treatment is administered, according to Dr. Connor.
The final phase, the postdrome, or migraine hangover, can occur within a day or two after the headache phase has passed.
Why Do Migraines Last More Than A Day?
Migraines that last longer than a day, particularly those that persist for several days or more, are often called status migrainosus, explains Dr. Connor. “These prolonged attacks can occur for multiple reasons, including Inadequate or delayed treatment [or] medication overuse (overuse of pain medications such as triptans, NSAIDs, or acetaminophen) [which] can lead to ‘medication overuse headache’ (MOH), which can prolong a migraine. Co-existing conditions, such as chronic migraines or hemicrania continua, can also lead to longer-lasting symptoms.”
She notes also that migraines that persist for longer periods of time may also be due to a specific person’s triggers. “Some people may have more sensitive nervous systems, making them prone to prolonged migraine episodes when triggered by environmental factors, stress, or hormonal changes.”
What To Know About Triggers For Migraines That Last Longer Than A Day
A “migraine trigger” is an environmental or internal event that may result in a person having a migraine attack.
Hormonal changes, especially in women, are a common trigger associated with migraines. “When estrogen levels drop or spike, blood vessels in the brain can constrict, sending pain signals to the nerves, which may trigger a migraine. Additionally, lower estrogen levels can increase the sensitivity of nerves in the scalp and face, making them more prone to pain,” says Dr. Connor.
Certain foods and beverages can also be migraine triggers. Dr. Connor notes that the most “frequently mentioned culprits” include caffeinated drinks, chocolates, aged cheeses, and processed meats. Likewise, even if the specific foods themselves are not a trigger — the timing of meals or drinks may be. Low blood sugar levels that result from skipping meals or dehydration that results from not drinking enough can also trigger a migraine attack.
Changes in routine, changes in sleep patterns (getting too much or too little sleep), altering caffeine intake, and sensory inputs — bright lights, strong smells, loud noises — can all trigger migraine heads, as can some medications, specifically immunosuppressive drugs.
Finally, no discussion of migraine triggers would be complete without discussing stress. “Stress is one of the most prevalent migraine triggers,” according to Dr. Connor, who notes that during times of stress (emotional and/or physical), the brain releases chemicals that can result in a migraine.
How To Prevent Migraines
For those who suffer from migraine, especially migraines that disrupt their lives for days at a time, preventing migraines before they start is top of mind. Even reducing the frequency, severity, and possibly the duration of attacks can be life-changing.
There are a number of options for preventative migraine medications, according to Dr. Connor. These include blood pressure-lowering medications, antidepressants, antiseizure medications, and a newer class of migraine medications that help block pain pathways in your brain. Botox can also be used to prevent and treat chronic migraine.
The AMF also notes that migraine prevention may require a combination of strategies, medication along with certain natural supplements, vitamins, or minerals, and lifestyle changes.
When it comes to lifestyle changes, Dr. Connor urges people who suffer from migraine attacks to keep a regular sleep schedule, which can help regulate the nervous system, and to engage in stress management techniques like yoga, mindfulness meditation, and relaxation exercises, which can reduce stress.
She also encourages people to eat balanced meals, stay hydrated, and avoid known triggers whenever possible. Also, movement. Her advice: “Exercise regularly to help promote overall brain health.”
Ultimately, finding what works will be specific to each person and each situation.
How To Treat Migraine Attacks & Long-Lasting Migraines
Migraine attacks can be treated in a variety of ways, and treatment often works best when started at the first sign of a migraine.
For migraine sufferers, pain relief is paramount, and there are both prescription and home remedies folks can try.
Some of the home treatments Dr. Connor suggests include over-the-counter pain relievers, such as ibuprofen, aspirin, naproxen (Aleve), acetaminophen, or a combination over-the-counter like Excedrin Migraine (which is a combination of aspirin, caffeine, and acetaminophen), resting in a place free of too many stimuli, applying a cool compress to the forehead or back of the neck, or performing a scalp massage. For those who are able, meditation, and yoga may also be helpful.
Along with home remedies, there are some medical solutions folks can try, which include a variety of prescription drugs taken as pills, shots, or nasal sprays. These prescription drugs can alleviate pain, although many come with side effects.
For particularly long migraines, those that persist for more than 72 hours, hospitalization and potential intravenous (IV) treatment may be required. The treatments Dr. Connor highlights in those situations include IV fluids and anti-nausea medications, IV steroids, IV triptans or anti-migraine medications for rapid relief, IV Ketorolac (IV NSAID) for pain management, or occipital nerve block, which is a targeted injection of anesthetics or steroids near the occipital nerve that can sometimes help break the cycle of a prolonged migraine.
Migraines can impact careers, relationships, and mental health, especially migraines that disrupt your life for more than a day. If over-the-counter medications don’t bring relief, or if the migraine attacks are too frequent, migraine sufferers should talk to their doctor to determine the best course of treatment.
The important thing to remember is that relief is possible, and support is available.
Before you go, check out our favorite beverages that help you stay hydrated:
This article was originally published on sheknows.com.