Migraine on the beach: holiday headaches explained

Congratulations, you made it through another digital semester of online lectures, studying alone on your laptop, the final push to pass your exams. Semester break is here and you so deserve it. As the tension drains away, you should be feeling great, right? Time at last to get away from it all, clear your head and just enjoy. Migraine on vacation seems to make no sense. When you leave your daily hassles behind, how can a migraine catch up with you? The reality for some people is that vacation makes their migraine worse. The timing could hardly be less appropriate. When you want to unwind, a headache is the last thing you need.

Is migraine a manifestation of ‘leisure sickness’?

Leisure sickness is when your body lets you down just when you were about to do all those things you were looking forward to for so long. According to the findings of a Dutch study at Tilburg University in 1128 men and 765 women aged 16 to 87, about three percent of the population in our part of the world experience regular bouts of leisure sickness, a condition that tends to strike busy adults on vacation or weekends. Subjects in the study who regularly fall ill during their free time reported symptoms including fatigue, immunodeficiency and aching limbs. The most common complaint was an increased frequency of migraine attacks. The study found that a tendency to get sick during rest and recreation periods has nothing to do with your gender or whether you live alone or with a large extended family. In fact, the main determinant is an inability to let go and switch off in your free time, the authors (Prof Adrian Vingerhoets et al) conclude.

Why would a migraine kick in after the pressure is off?

Abundant evidence from headache research shows that heavy stress can trigger migraine attacks. (Our blog article explaining the connection is here) So how does that square with the “leisure sickness” theory, according to which attacks increase when the pressure eases, i.e. on weekends and vacation? It may seem paradoxical, but it makes sense on closer inspection. The point is not that the leisure-time period associated with worse migraine is stress-free, it’s that it comes after a period of very high stress. In a US study from 2014, stress levels in subjects with migraine didn't impact migraine occurrence, but a sharp fall-off in perceived stress did – evidence of what the researchers call a "let-down headache."

Stress and post-stress

Findings of a 2016 German study suggest that the severity of post-stress symptoms is closely associated with the intensity of perceived exhaustion. Looking at these results combined with the Dutch study, it seems clear that it’s not the lack of stress at weekends or on vacation that might give you a migraine during your time off. It turns out that the migraine happens when too much pressure has been building up for too long. When that pressure-packed period ends suddenly, it can be too much for your body to cope with at that moment, and/or you have a hard time letting go of your workday stress in your time off.

What can I do?

The latest research gives a few pointers on how to help prevent migraine attacks on weekends and vacation.

Winding down: de-stressing and decompressing

External stressors are not always under your control. Important exams are coming up at the end of the semester and there’s nothing you can do about it. And you can’t just switch off the pressures you face in other areas of your life, be it your part-time job, circle of friends, or family. But you can learn to stop the strain from getting to you in the first place, and you can teach yourself ways to de-stress properly. A German study from 2020 showed that two factors are crucial to bounce back from major pressure at work. One is to stop letting work issues dominate your thoughts. The other is a positive overall attitude to the work you do.

Say goodbye to your working day

To achieve the latter, the authors of the study suggest you wrap up your working day by recalling good things that happened at work that day and by anticipating more such events in the future. For your final act after a long day’s studying, think back on nice things that happened. Jot down a few lines on a piece of paper indicating what excited, interested or motivated you most that day and what you look forward to doing next time you study. It could be a sense of achievement you got from studying hard. Or something a professor said that inspired you. Or you had a lightbulb moment that made you see things differently. Or you were just plain thankful for being able to study? Try this ritual for two weeks and see if it makes a difference. Who knows, you might want to make it permanent. Brief reflection in this way will lift you to a positive frame of mind about your university life and help you draw a clear line of separation between work and your evening, weekend or vacation – which brings us neatly to the second crucial factor: decompressing.

Learn to let go of your stress

In the same study, subjects who stopped thinking about work after their moment of reflection and became engrossed in a favorite pastime were able to de-stress much more effectively than subjects who did not. If there's something that helps you clear your head and easily fits into your routine, go for it! Make it a regular part of your life, no matter how stressful your day has been. Carve out half an hour most days to exercise, listen to music, or enjoy the outdoors and see what a difference it makes to your stress management capabilities. Not just on weekdays, either. If you practice your evening de-stress faithfully, you’ll find it easier to leave the stresses and strains of university life behind you when vacation time rolls around. Jacobson's Progressive Muscle Relaxation is a classic relaxation technique you might like to try. We’ve come up with a version that’s easy to work into your everyday routine – you never know, it might be the perfect ritual to help you shed your workday stress. A guide to the exercise is also provided in the app so you can do it wherever you happen to be, even on vacation.

Going on vacation? Take your rituals along with you

If you invest time every day to practice letting go of your stress, shifting to vacation mode will be much smoother. For migraineurs, regularity in your day is essential for an enjoyable start to your vacation. If you've read the migraine information on the website, you'll know that maintaining a regular routine is fundamental. Going to bed and getting up at about the same time every day, eating and drinking regularly to maintain stable energy levels, and regular breaks for mindful relaxation are the cornerstones of migraine prevention.

Keep up your headache prevention routine, even on vacation

Think about it for a while. What makes vacation different from real life? It’s not just the change in workload and general stress levels. A lot of the processes that affect ‘basic body care’ shift as well. If you are a person who gets migraines, you may have managed by now to follow some of the lifestyle rules that prevent migraine attacks. But maybe you haven't gotten around to it yet, or are still finding it difficult – whatever the case may be, vacation is the right time to remind yourself that keeping to a routine is very important for migraine prevention. It seems unfair – you were so looking forward to being able to sleep in for a change and would rather relax than having to plan ahead to the next meal or rustle up that obligatory glass of water. But up against the fact that these basic precautions can help make your vacation a pain-free experience, it’s a no-brainer.

Take the pain out of migraine prevention – set up reminders for yourself

Having to keep all this in mind sounds like a real drag. But don’t worry – our app is there to remember it all for you and help you stick to a healthy routine on your days off. Use it to keep your sleep schedule on track or remind you to eat and drink regularly. Set it up to give you reminder notifications throughout the day so that you don't have to remember everything all by yourself and can enjoy some carefree hours. A gentle reminder that it’s time for a water or snack or relaxation exercise will leave you free to focus on having fun. The ultimate tip: if you feel like sleeping longer but don’t want to wake up with a migraine, don’t forget to have a bedtime snack. A snack before going to bed is a great way to prevent migraine in general, and it’s even more important if you plan to sleep late. And when you wake up refreshed the next morning, have breakfast right away. On vacation or at home, your super-active brain needs a stable supply of energy.