Study Links Daily Surprises to Increased Migraine Risk

Researchers at Harvard Medical School have identified a significant relationship between unexpected daily experiences and the likelihood of migraine attacks. Their study, published in JAMA Network Open, reveals that higher scores of “trigger surprisal” are correlated with increased odds of experiencing a migraine within the following 12 to 24 hours. The findings suggest that individuals’ daily unpredictability may play a crucial role in headache management.

The cohort study involved 109 adults diagnosed with migraines based on the International Classification of Headache Disorders, 3rd Edition criteria. Participants were aged between 18 and 65 and reported experiencing between four and 14 headache days each month. Over a span of up to 28 days, they completed electronic diaries twice daily, detailing various behavioral, emotional, and environmental factors potentially affecting their migraine occurrences.

Each participant’s diary entries were analyzed to determine the “surprisal” of their daily experiences—essentially measuring how atypical or surprising a given day felt compared to their usual routine. The research demonstrated that when individuals experienced a day markedly different from their norm, their risk of a migraine attack increased significantly. Specifically, the study found that if a person had a typical day prior, a surprising day raised their risk of a headache attack by 86% within 12 hours and 115% within 24 hours.

Understanding the Impact of Daily Variability

The concept of surprisal goes beyond traditional migraine triggers, which often include specific foods, environmental changes, or stressors. Instead, it emphasizes the overall unpredictability of daily life. The analysis revealed that individuals exhibit varying sensitivity to these daily surprises; while some may be highly susceptible to deviations in routine, others showed little to no correlation between unusual days and migraine incidents.

The implications of this research are significant for migraine management. Providing individuals with tools to recognize and quantify their daily experiences may facilitate better self-management strategies. Rather than merely avoiding specific known triggers, individuals could benefit from maintaining a steadier routine and managing emotional responses to daily changes. The study’s authors propose that integrating surprisal scores into mobile applications could help users predict their migraine risk in real time, enhancing their ability to prepare for potential attacks.

Despite the promising findings, the study faced limitations. The original target for participant recruitment was 200, but the final cohort was reduced due to pandemic-related challenges. This smaller sample size restricts the ability to explore specific subgroups or other variables that may influence headache activity, such as medication use.

In summary, the research conducted by Harvard Medical School highlights a novel approach to understanding migraine triggers by focusing on daily unpredictability. The notion that surprise experiences may heighten migraine risk offers a new avenue for individuals seeking to manage their condition more effectively. As the scientific community continues to explore this relationship, the potential for innovative self-management tools becomes increasingly tangible.

For further details, refer to the study by Dana P. Turner et al., titled “Information-Theoretic Trigger Surprisal and Future Headache Activity,” published in JAMA Network Open in 2025.