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Migraine “Let-Down” Headache: What It Is & How to Prevent

Under: Migraine

Picture this: You made it through a grueling week at work and sailed through it migraine-free. But when you wake up Saturday morning, WHAM! A migraine hits.

Sound familiar? If it does, then you’ve just had what’s known as a “let-down” migraine.

Whether it happens the day after final exams or the first day of your honeymoon, let-down migraines are a confusing experience. After all, stress is the most common migraine trigger. So why do migraines happen when stress finally dies down?

If you’re curious to find out, read on. In this article, we’ll explore what let-down migraines are, why they happen, and what you can do to prevent them.

What is a Migraine “Let Down” Headache?

Stress is a migraine trigger for roughly 80% of people.1 However, research suggests that drastic drops in stress can be an even bigger trigger for migraine episodes.

One study published in Neurology found that sudden reductions in stress from one day to the next often trigger migraine attacks.2 This phenomenon is known as the “let down” effect.

In the study, migraine episodes increased nearly fivefold in the six hours following a decline in stress.2 Meaning, that you are more susceptible to migraines once stress finally lifts.

Since this often happens on the weekends, let-down migraines are often called “weekend migraines.” This can make Friday “happy hour” a not-so-happy occasion.

In the study, stress levels were not significantly linked with the onset of a migraine attack.1 However, fluctuations in perceived stress were.

What Causes Let-Down Migraine Attacks?

It’s not entirely clear. However, researchers suggest the stress hormone cortisol may be to blame.2

Periods of intense stress trigger your body’s “fight or flight” response. This ramps up cortisol production. While cortisol is often seen as the bad guy, it has anti-inflammatory effects that help numb pain.

let-down headache

When stress dies down, cortisol drops. And as cortisol dips, so do its pain-reducing effects.

Plus, living with migraine is stressful in and of itself. Going about your day worrying when the next attack will hit is enough to stress anyone out. Chronic pain from migraine attacks is a form of physical stress too. Add it all up, and the relief that follows an attack can take cortisol levels on a roller coaster ride, creating a vicious cycle.

Not to mention that in periods of stress, self-care often goes out the window. You may skip meals, skimp on sleep, forget to drink water, or skip workouts. This is bad news, as dehydration, missed meals, lack of sleep, and sedentary lifestyles can all lead to migraines. Meaning, each self-care activity you neglect increases the likelihood of a future attack.

In addition, people often engage in unhealthy behaviors to deal with stress, which can set the stage for migraine. You may drink more alcohol or rely on caffeine and convenience junk foods just to get through the day. This too, can make a migraine episode more likely.

How to Prevent Let-Down Migraines

In our modern world, it’s impossible to avoid stress altogether. That said, you have more power than you think. Prioritizing a healthy lifestyle is key. That way, you can keep your cortisol levels more balanced to prevent huge stress crashes.

Here are a few ways to reduce let-down migraines:

1 – Build awareness

Since extreme fluctuations in stress can trigger let-down migraines, step one is to become more aware of stress. Make an effort to relax during times of stress, not just after them. 

According to the study co-author Dawn Buse, PhD, director of behavioral science at Montefiore Headache Center, “It is important for people to be aware of rising stress levels and attempt to relax during periods of stress rather than allowing a major build-up to occur. This could include exercising or attending a yoga class or may be as simple as taking a walk or focusing on one’s breath for a few minutes.”3

If you feel out of touch with your stress levels, journaling is an excellent way to build awareness. When you sense your stress levels rise, that’s your cue to slow down and carve out time to relax.

2 – Maintain healthy lifestyle habits

Keeping a healthy lifestyle, while important for everyone, is essential for people with migraine. That’s because many migraine triggers can be avoided by maintaining healthy habits.

Here are a few healthy habits to help prevent let-down migraines:

  • Prioritize sleep. Lack of sleep or too much sleep can trigger migraine attacks. So do your best to stick to a consistent sleep schedule. (And for more sleep habits to avoid migraines, click here.)
  • Stay hydrated. Dehydration is another common migraine trigger. To prevent this, keep a water bottle handy wherever you go. Aim for 2 liters a day (or more if you’re active).
  • Don’t skip meals. Skipping meals is a migraine trigger for 57% of migraineurs.1 So avoid skipping meals and keep snacks on hand so you never get hungry.
  • Exercise regularly. Exercise does double duty. It relieves stress and reduces the chance of future migraine attacks.4
  • Manage stress. Yoga, meditation, deep breathing, and spending time in nature can all help melt away stress. Talking to a supportive friend or therapist about your worries can also help prevent a stress build-up.

3 – Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) builds awareness of your thoughts, feelings, and behaviors, and how they’re connected.5 This can help you recognize and reframe unhelpful thoughts that lead to stress loops. A therapist may also guide you through relaxation exercises to help you learn to handle stress better.


4 – Nutritional Support (Foundational and Targeted)

Research shows people with migraine are often deficient in certain nutrients like magnesium.6 Correcting these deficiencies is shown to be beneficial to migraine sufferers. Other beneficial supplements include vitamin B2 (riboflavin), feverfew, and CoQ10.7 Having the right nutritional support can make a big difference when taken consistently.

For more migraine prevention tips, check out this article.

Remember, let-down migraines are due to extreme fluctuations in stress. While you can’t avoid stress altogether, you can do things to prevent stress from building up. The more consistent you are with healthy lifestyle habits, the less likely major stress crashes, and let- down migraines will be.