Harvard Study Links Daily Surprises to Increased Migraine Risk

Researchers from Harvard Medical School have uncovered a significant relationship between daily life variability and the likelihood of migraine attacks. Their findings, published in the journal JAMA Network Open, indicate that higher levels of “trigger surprisal” can lead to increased headache activity within the following 12 to 24 hours. This study highlights the importance of understanding daily experiences in managing migraines.

The research focused on a cohort of 109 adults, all diagnosed under the International Classification of Headache Disorders, 3rd Edition criteria. Participants, ranging from ages 18 to 65, reported experiencing between four to 14 headache days each month. The study aimed to explore how deviations from a person’s typical daily routine could influence migraine occurrences.

Participants logged their daily experiences through twice-daily electronic diaries over a span of up to 28 days. Morning entries captured information on sleep quality, bedtime routines, and mood, while evening entries delved into food and drink consumption, environmental exposures, and stress levels. This comprehensive approach allowed researchers to calculate individual “surprisal scores,” reflecting the atypical nature of each participant’s day.

The results revealed a clear connection between unexpected daily experiences and the likelihood of migraine attacks. Specifically, the analysis indicated that an increase in surprisal scores corresponded with an 86% increase in the odds of a migraine within 12 hours, escalating to a 115% increase over 24 hours. Significantly, the study found that individuals who typically experienced unusual days were less affected by further deviations in routine, indicating varying sensitivity to changes among participants.

Understanding the implications of these findings is crucial for migraine sufferers. Traditional strategies often focus on identifying specific triggers, such as certain foods or stressors. However, the concept of surprisal offers a new perspective, emphasizing the overall perception of a day rather than pinpointing isolated factors. The researchers suggest that incorporating surprisal metrics into self-management strategies could enhance migraine forecasting and prevention.

While the study provides valuable insights, it is essential to note certain limitations. The initial target sample size was set at 200, but pandemic-related disruptions reduced it to 109. This smaller cohort limited the ability to analyze specific subgroups, such as age or headache types, which could have provided deeper insights into migraine triggers.

The researchers conclude that adopting routines that minimize daily unpredictability may help reduce the risk of migraine attacks. Instead of solely avoiding identified triggers, fostering stability in daily life could be a beneficial approach for individuals prone to migraines.

As the understanding of migraine triggers continues to evolve, the findings from this study signal a shift toward a more nuanced approach to management. This research underscores the importance of daily experiences and their impact on health, paving the way for potential innovations in migraine risk assessment and self-management tools.

For further insights, refer to the original study by Dana P. Turner and colleagues, titled “Information-Theoretic Trigger Surprisal and Future Headache Activity,” published in 2025.