Should I track my migraine triggers?

Test one specific suspect for a set stretch rather than logging everything forever. Food cravings and other early symptoms can show up hours before the pain starts, so a broad trigger log often blames something that was already part of the attack.

How do I log an attack when I can barely look at my phone?

Log the start time and nothing else, then fill in severity, symptoms and medication once you can. Start time and return-to-baseline time matter most. The rest can wait a few hours.

How long should I keep a headache diary before my appointment?

Three months lines up with the window used for the chronic migraine definition and the MIDAS disability score. Don't hold off on care to finish the diary, though. Bring whatever you have.

Is a 0 to 10 pain scale better than none, mild, moderate, severe?

Either works if you use it the same way every time. The four-point scale is what migraine treatment trials typically use, and it's quicker to answer in the middle of an attack.

Why track how long the after-phase lasts?

Fatigue, brain fog and residual light sensitivity after the pain ends are lost function. A log that only records headache hours undercounts the disability your treatment is supposed to reduce.

What to actually track for migraine (and what's just noise)

Article · 3 min read

What to track for migraine: six things, and what to skip.

The short list a headache specialist actually uses, a track-this, skip-that table, and how to log the hours after the pain ends.

What should you track for migraine?

For migraine, track six things: when each attack started and when you felt like yourself again, peak severity on a simple scale, the symptoms that came with it (nausea, light or sound sensitivity, aura), every acute medication dose and whether it worked within two hours, the days it cost you, and your cycle if you menstruate. Skip the meal-by-meal food log, hand-entered weather and hourly pain scores. They drain energy you don't have and rarely change a treatment decision.

The list isn't arbitrary. It maps almost line for line onto ICHD-3, the International Classification of Headache Disorders that clinicians use to diagnose migraine, and onto the outcomes migraine treatment trials measure. So when you log what your clinician already uses, your diary becomes evidence they can act on in a short appointment.

Everything else is optional. Most of it, anyway.

The track-this, skip-that list

Each row below is sorted by one test: does a clinician use this to diagnose, choose a treatment or judge whether one is working? If yes, track it. If it only makes the log longer, skip it.

Food is the row people argue with. Diary studies of the premonitory phase, the hours before pain, list food cravings among the early symptoms of the attack itself. That means a daily food log can end up blaming the chocolate for an attack that was already underway. Test one specific suspect for a set stretch if you want. Then stop.

Sorted by clinical use: ICHD-3 (International Headache Society, 2018), standard migraine trial endpoints, and the MIDAS disability questionnaire.
What to log	Track or skip	Why it matters clinically
Attack start, and the time you felt back to baseline	Track	Gives true attack length, including the after-phase. ICHD-3 uses duration as a core migraine criterion.
Peak severity: none, mild, moderate, severe	Track	The four-point scale used in migraine treatment trials, so it compares cleanly visit to visit.
Hourly pain scores	Skip	Hard to log mid-attack. Peak severity plus duration carry the useful information.
Nausea, light sensitivity, sound sensitivity, aura	Track	ICHD-3 diagnostic features. Aura status also shapes some treatment choices, including hormonal contraception.
Acute medication: name, dose, time, relief at 2 hours	Track	Pain freedom at 2 hours is the standard acute-treatment trial endpoint.
Days with any acute medication	Track	ICHD-3 medication-overuse thresholds are counted in days per month.
Missed or half-functional days	Track	Feeds MIDAS, a three-month disability score many clinicians use.
Menstrual cycle, if you menstruate	Track	ICHD-3 menstrual migraine criteria look at attacks from day -2 to day +3 of menstruation in at least 2 of 3 cycles.
After-phase symptoms and how long they last	Track	Fatigue, brain fog, neck stiffness and residual light sensitivity are function lost after the pain ends.
Rough sleep hours and timing	Track lightly	Sleep changes are a commonly reported trigger. A rough number is enough.
Every meal and snack, every day	Skip (unless testing one suspect)	Premonitory cravings can make food look like a trigger when it's an early symptom.
Weather and barometric pressure, entered by hand	Skip	If you suspect weather, compare your attack dates against weather history later. Daily manual entry adds effort, not precision.

Pain ending and the attack ending are two different timestamps

Most migraine logs record a headache like a light switch. On, then off. But the attack has phases, and the one after the pain is both common and long enough to matter. In a 2016 electronic diary study published in Neurology, Giffin and colleagues found that 81% of patients reported at least one non-headache symptom after the headache resolved, with tiredness the most common.

So log the end of the attack as the moment you're back to baseline. And rate the after-phase as dimensions on a scale (fatigue, brain fog, residual light sensitivity, neck stiffness) instead of ticking boxes. A 0 to 3 rating once or twice a day is plenty.

Why bother with the extra field? Because the disability your neurologist is trying to reduce includes the day you spent rereading the same email four times, and a binary log files that day as headache-free.

81%

of patients in an electronic diary study reported at least one non-headache symptom after the headache resolvedGiffin et al., Neurology 2016

4 to 72 h

headache-phase duration of an untreated or unsuccessfully treated migraine attack in the diagnostic criteriaICHD-3, 2018

What to put in front of your neurologist

Clinicians read migraine by the month. The numbers that come up in a visit are monthly headache days, monthly migraine days, days with acute medication, and disability over the last three months. Those four decide whether you meet the chronic migraine definition, whether medication overuse is a concern, and whether a preventive is doing its job. Preventive trials, including the CGRP antibody studies, commonly report the share of patients who cut their monthly migraine days by half.

The same counts tend to show up on prior authorization paperwork for CGRP preventives, alongside which preventives you've already tried. A three-month export with those totals at the top and the raw attack log underneath answers most of the questions before anyone asks them.

15+

headache days a month, for more than 3 months, defines chronic migraineICHD-3, 2018

of those days must have migraine features for the chronic migraine diagnosisICHD-3, 2018

10+

days a month of triptan or combination-analgesic use meets the medication-overuse threshold (15+ for simple analgesics)ICHD-3, 2018

3 months

the look-back window of the MIDAS disability questionnaireMIDAS questionnaire

Logging the hours after the pain, too

We built Postdrome around a continuous symptom timeline because so many trackers close the entry the moment the headache stops. An attack stays open while you rate how the fatigue, fog and light sensitivity are trending, and it closes when you mark yourself back to baseline. Aura Mode is there for the stretch when a bright, busy screen is the last thing you can handle.

Your data stays on your device. It also exports, so the three-month view above is something you hand over instead of rebuilding from memory in the waiting room. Pricing is a one-time lifetime purchase, stated up front.

When to call a clinician instead of logging

A diary is for patterns. Some headaches need a clinician now, and none of these should wait for next month's export.

Don't log these and wait

Get emergency care for a sudden, explosive headache that peaks within about a minute, a headache with fever and a stiff neck, or weakness, numbness, confusion or speech trouble that doesn't resolve. Book a prompt appointment for a new headache pattern after age 50, aura lasting longer than an hour, a clear change in your usual attacks, headaches that began after a head injury, or acute-medication days that keep climbing.

Start a three-month log your neurologist can actually read. Get Postdrome.

Postdrome is built around a continuous symptom timeline, so the after-phase gets rated on a scale (fatigue, fog, light sensitivity) until you mark yourself back to baseline, which is the part of the attack most logs drop. Aura Mode keeps logging usable on bad days, data stays on your device and exports when you need it for a visit, and pricing is a one-time lifetime purchase.

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