“Let-Down” Headaches

It has been proposed that reductions in stress and improvement of mood can be used to predict the onset of headaches in people with migraines. The phenomenon of relaxation after stress increasing the likelihood of headache in migraineurs is called “let-down” headache. A recent study set out to test how reliably relaxation and mood improvement predicted headache in migraineurs. For the study 20 headache clinic patients with migraine who reported awareness of impending migraines were asked to record data daily using a handheld device. The participants were asked to report whenever they anticipated a headache as well as their headache status at random times throughout the day. The participants also reported their mood at two times during each day, rating their feelings of happy, sad, relaxed, nervous, lively, and bored on a 0 – 100 scale. When the data from the study was analyzed, it was found that lower levels of stress in one day were associated with increased likelihood of headache attack within 12 hours. Improvement in the mood categories of happy and relaxed from day to day were also significantly associated with increased odds of headache occurrence within 24 hours of the improvement. It was found that decreases in stress were not associated with increased odds of attack. The study concluded that “let-down” headaches were a real phenomenon which could reliably used to predict headache. Reduction in perceived stress or improvements in feelings of happiness or relaxation were associated with statistically significant odds of headache within 24 hours. The authors of the study also concluded that focusing on mood and stress may improve headache prediction and provide targets for headache prevention in the future.