back to basics


Back to Basics with Migraine Management

Dr Katy Munro explains how learning about the basics of migraine management can help limit and reduce the number of migraine attacks.

Migraine and Cluster Headaches- What’s the Difference?

Max’s Story: Childhood Migraine

Are you worried about your child going back to school while suffering from migraine? Watch Max’s story on his experience with migraine and how he learnt how to manage them.





Back to Basics with Migraine Management

By Dr. Katy Munro

People who come and see us at the National Migraine Centre have often tried many different treatments and strategies to manage these troublesome and debilitating headache attacks. One of the main things we do here is to go back to basics in understanding what is going on and how you can help yourself to limit and reduce the number and frequency of migraine attacks.

Eating and Sleeping  Regularly

We talk to our patients about the daily routine of waking, eating and bedtimes. Lots of people tell us that they commonly wake up with the headache already present.

As a migraine sufferer, you have inherited a tendency for your brain to be more irritable and sensitive to changes –this tendency is present even when you don’t have a headache. For example, you may be the one who always wants the music turned down or doesn’t like the glaring of sunshine or headlights.  If too many things add together to irritate your brain, a migraine may result.

One of the most irritating things for your brain is not having a steady supply of fuel! Missing meals, exercising without eating, and having a long night’s sleep and then no breakfast are all potent triggers for a migraine to develop.

We always recommend that you try to eat something within an hour of waking up. Then it’s important to eat every 3-4 hours during the day. The final time is just before bed when a snack of slow release food can keep you going through the night and prevent that wake up head pain.

Try and keep to the same bedtime and wake times or at the least the same number of hours of sleep too. Short nights or having a lie-in can also irritate your brain! Keeping hydrated is important too.

What foods should I eat?

There are no absolute rules but we usually say try to avoid intensely sugary, sweet foods and fast release carbohydrates like white bread and white rice. Protein and fat give slower release energy. So snacks or meals containing nuts, seeds, eggs, meat, dairy products, avocados and berries are preferable to those containing high concentrations of sugar e.g. sweets, cakes, biscuits and too much dried fruit. Obviously avoid any foods which always trigger your headaches although this true food trigger problem is less common than many people think.

Other Changes

Anything that changes in your body can irritate the brain so fluctuations in stress, excitement and hormones are all powerful irritants. Be aware that the changes happen over the 24 hours before you become aware of the migraine. By beginning to realise what adds together to trigger your headaches, you can then start to plan forward. For example, if you are getting up in the middle of the night to catch a plane to go on holiday, you will definitely need to eat regularly and keep well hydrated to minimise the chances of a holiday headache.

Treat early, treat hard

The other concept to think about is the way that migraine develops over an attack. I like to think of it as a rolling snowball gathering size. As the migraine rolls on and gathers momentum, it becomes much harder to treat effectively and get rid of the pain completely. Many people are rightly concerned about over-using pain relieving medication (See our leaflet about Medication Overuse Headache on the website). Unfortunately by delaying taking painkillers too long, you are more likely to get a migraine that has settled in for the duration! Hitting it again the next day and the day after results in a drip, drip, drip of pain killers that can lead to medication overuse headache.

It is better to take repeated doses of your pain killers, preferably with an anti-nausea tablet to enhance their absorption, on Day One of your migraine attack. Treat it fast with high doses (talk to us or your GP for advice about which medications and doses are safe and right for you) and then take them again if it hasn’t been fully “squashed”. This strategy can shorten your attacks and the fewer you have the calmer your brain gets!

Come for a consultation for a personalised plan of how you can best manage your particular migraine.

Migraine and Cluster Headaches- What’s the difference?

By Dr. Katy Munro

Many people who suffer with migraine get several days of headache in a row and wonder if they are having clusters of headaches. It is confusing because actually cluster headache is a different type of headache condition. There are some similarities between migraine and cluster headache but there are also some significant differences. It is important to distinguish between them because there are some treatments which work more effectively for cluster headaches than for migraine.

So what is Cluster Headache?

  • Agony: Sometimes called ‘suicidal headaches’ because of the excruciating intensity of the pain, they are always on one side of the head (usually on the same side) and very often behind the eye.
  • Sudden: They begin very suddenly with the pain rapidly reaching distressingly high levels in a matter of minutes.
  • Short: The attack often is quite short in duration lasting 15 minutes to an hour and a half (though they may last as long as 3 hours).
  • Repeated attacks: Often they occur several times in a day. This pattern may repeat every day for a number of weeks or months. The attacks eventually settle and go and there is then some time without pain. This relief may last a variable amount of time before the headaches recur.
  • Agitation: The pain in cluster headache is so sudden and agonising that it often makes sufferers want to bang their heads, stride about or rock. It causes great agitation. This is one of the differences from migraine attacks where the migraineur is often very sensitive to movement and is helped by keeping as still as possible.
  • Time & Seasons: Another typical feature is the relationship to the time of day or the seasons. Cluster headaches often start at the same time each day or repeatedly wake sufferers at the same time each night. They may also recur at the same time of year. This pattern is not seen so typically in migraine headache. Cluster headache is more common in Autumn and Spring.
  • Autonomic features: Both migraine and cluster headaches can involve the part of the nervous system called the autonomic nervous system. When this is affected, sufferers notice watering from the eye, sweating of the face and a blocked or runny nose on the affected side. Sometimes drooping and swelling of the eyelid occurs and the size of the pupil may be smaller than usual. The eye may look red too.
  • Triggers: In both migraine and cluster headache it may not be possible to identify why they start. In some cluster headache sufferers though there may be some obvious triggers especially during a bout. Alcohol is a common one. Being hot after exercising, being in a stuffy room or having a hot bath can also start an attack. Many sufferers of both migraine and cluster headaches are also very sensitive to strong smells like perfume, solvents, petrol etc.

How common are Cluster Headaches?

1 in 1000 people get cluster headaches and, of these, about 10% are chronic with headache-free periods lasting less than a month. Sometimes another family member may also suffer from cluster headaches –in about 1 in 20 cases there is a positive family history. Migraine is much more common and also often runs in families.

For more information about cluster headache and migraine please take a look at our factsheets.

Max’s story: Childhood Migraine


Max tells his experience of childhood migraine and how after coming to the National Migraine Centre he finally learnt how to control his migraines.

Watch Max’s story on childhood migraine.

If your child sufferers from migraine and you are worried about them going back to school please have a look at our factsheets on children and migraine and advice to schools:

Children and Migraine

Advice to Schools

Book an appointment at the National Migraine Centre today and take control of your migraine! Call us on 020 7251 3322.



Looking to change mobile phone providers?

Are you looking to change your mobile phone provider, but aren’t sure who to choose? The People’s Operator (TPO) are a mobile company that has set out to make a difference by raising money for charities.  By choosing them as your mobile network provider you can raise money for the National Migraine Centre at no cost to you. 10% of what you spend will go directly to our Centre.  TPO uses the EE network, which is the UK’s biggest 3G network, so you will have complete coverage and also be raising money to help others suffering from migraine.  For more information go to The People’s Operator’s website.  When you sign up you are given the opportunity to search for the charity you wish to benefit (you can use our Charity number as the easiest way to find us, 1115935).

Extreme sports enthusiast?

Are you an older individual who still likes to participate in extreme sports like bungee jumping, surfing or sky diving? Then get in touch!  Remember a Charity are looking for people with an extreme story they wish to share which will be photographed, filmed and printed in national, regional and broadcast media.

Remember A Charity is also looking for case studies to feature in national newspapers explaining why they are willing to leave a gift in their Will.  So if you have ever thought about leaving a gift in your Will for the National Migraine Centre then do get in touch via email at or by phone on 020 7251 3322.

Thank You!


A big thank you to Lauren Shirazi who ran the Morrisons Great Newham 10k and raised £160 for the National Migraine Centre.

 Support Our Team

Charlotte Burr, our Communications & Operations Manager, will be running the Royal Parks Half Marathon on Sunday 11th October for the Centre.   Visit her Virgin Money Giving page and help us to carry on helping others like you.

Raise money for us at no extra cost to you

Thank you to our supporters who this quarter raised £87.84 by shopping on Easyfundraising.

By shopping online, purchasing insurance or travel you can raise funds for us at no cost to you and with one simple click.  Simply go to (you will need to register), select the shop that you wish to make a purchase from, for example ‘John Lewis’, and start shopping.  The price of the product you wish to buy is exactly the same, but by going through Easyfundraising you will be given a cash reward from the store you made the purchase at, which can then be turned into a donation for our Centre.

If you aren’t already make sure you shop at, to raise funds for us and help others like you. Popular stores include:

easyfundraising shops