• Tracking your migraine attacks can help aid diagnosis, identify migraine triggers, and help you get the best treatment possible.
• You can use a paper migraine tracker, a calendar, an app, or another format that's comfortable for you to track your migraine attacks.
• When tracking your migraine attacks, you should add as much detail as possible, including where you were when it happened, what symptoms you experienced, how long it lasted, and more.

A migraine diary is an incident log of every migraine attack you experience. In a migraine diary, you record the details of your migraine as you are experiencing an attack, or directly afterward. Keeping track of your migraine attacks can help aid diagnosis, identify migraine triggers, and help you get the best treatment possible.

What Does a Migraine Diary Record?

A migraine diary can help you and your health care team gain better insight into managing your migraine attacks. In short, this diary records all aspects of your migraine attacks, from symptoms and duration to potential triggers. Think about this process as data collection. The objective is to understand the complexities of your symptoms through observation.

As one myMigraineTeam member described, a migraine diary can include many different features of your attacks. They recommended gathering details by asking yourself detailed questions about the attacks: “When they start and if they stop. How bad was the pain? Where is the pain located? What were you doing before it started? Are you having any sensations? Do you feel nauseous? Things like that.”

Here are some pieces of data that you can focus on as you start your migraine diary:

Setting

To start an entry in your diary, it’s a good idea to write down the circumstances of your attack. Essentially, you are answering the where and the when of your migraine. Things to include are the date and day of the week, the time of day, and the location where you were when the attack occurred.

As you begin to log your attacks, you may be able to find patterns that exist at the beginning of each migraine. Maybe you tend to have attacks at night or in the morning, or perhaps your migraine symptoms tend to correlate with your menstrual cycle. By discussing these patterns with your doctor, you may start to uncover potential migraine triggers.

Duration and Severity of the Attack

Once you’ve identified the setting of your migraine, you can then quantify the attack. This step includes writing down how long the attack lasted, as well as rating the pain on a scale from 1 to 10 (where 10 is the worst pain you can imagine).

These numerical pieces of information allow your doctor to further understand your particular migraine attacks and identify the best actions to take in treating them.

Medication

It is also helpful to write down the current medications that are helping you manage your migraine symptoms. This addition may open up a conversation with your doctor about your overall treatment plan. As one MyMigraineTeam member suggested, “keep notes about what you take and the time you take it. Your doctor will want to know.”

Description of Symptoms

When a migraine occurs, it can come with a host of symptoms ranging in severity and duration. What’s more, the symptoms of migraine vary from person to person. Though there are some common threads between cases (including severe head pain, nausea, throbbing pain, and sensory overload), it may be difficult to understand the entire scope of your migraine attacks.

It can be useful to write down as much as you can about the symptoms you experience during your attacks. This may involve identifying the different stages of migraine you experience. As one MyMigraineTeam member advised, “the best thing you can do is keep a journal of what you experience in the four stages of your migraine.”

The Mayo Clinic describes the different stages of migraine as follows. Keep in mind that you may not experience every stage of migraine.

Stage 1: Prodrome

The prodrome is a warning sign that you may feel even days before the start of a migraine attack. Be on the lookout for any irregular sensations, such as constipation, mood swings, food cravings, and more. Take careful note of how you feel before an attack — this may help you identify an attack before it arrives.

Stage 2: Aura

An aura can manifest as various forms of sensory disturbances, either right before or during a migraine attack. Though this only occurs in 10 percent to 30 percent of cases, people have reported experiencing symptoms including visual distortions, difficulty speaking, and uncontrollable movements.

Stage 3: Attack

The migraine attack (sometimes referred to as the migraine headache) is the typical understanding of a migraine. In a period lasting between four and 72 hours, you may experience throbbing head pain, oversensitivity to sound/light (phono-/photosensitivity), and nausea, among other symptoms.

Stage 4: Post-Drome

Once the pain of a migraine attack has diminished, it is common to feel exhausted, or even confused for up to a day afterward. It’s also possible to experience quick bursts of head pain with sudden head movements.

How Can a Migraine Diary Help?

A migraine diary is an extremely useful tool for managing your health. The records you keep can help you receive an accurate diagnosis, identify triggers, and track the effectiveness of your treatments, as well as providing other benefits.

Diagnosis

A doctor will take a detailed medical history when making a migraine diagnosis. They will ask questions about the severity of your symptoms, frequency, and other details. Bringing your migraine diary can help you answer your doctor’s questions.

Triggers

The information you compile in your migraine diary may also help you identify certain migraine triggers. Over the course of keeping a migraine diary, you may find that stress, your menstrual cycle, or weather changes trigger a migraine. With this knowledge, you may be able to take steps to avoid triggers or better manage them. Other important things to log in your diary include any food or drinks that may have been consumed before the headache started. In addition, try to estimate your sleep times from the night before.

Treatments

Tracking your migraine attacks can help your doctor understand your symptoms, your triggers, and how you’re responding to treatments. Your doctor can use your migraine diary to make a treatment plan geared to your needs and to tweak that treatment plan if it’s not working.

Your migraine diary can also be useful for obtaining insurance approval for certain migraine treatments. Before approving coverage for some newer migraine treatments, insurance companies may require that you prove that other — usually less expensive — treatments were not effective. In addition, some medications are only approved if you have a certain number of migraine attacks each month. The information you’ve logged in your migraine diary can help make the case to your insurance company for covering a specific drug.

Disability Benefits

Keeping a migraine diary can also help you in the event that your migraine attacks become so severe or frequent that you are unable to work. If you choose to apply for Social Security Disability Insurance, you will be required to provide written documentation of the ways migraine prevents you from working. You can use the information from your diary to help fulfil the reporting requirements from the Social Security Administration.

Tips for Keeping a Migraine Diary

It is important to stay consistent with your journal. You may feel discouraged as you continue your log, but consider your entries as stepping stones. All of your entries are helping you and your neurologist better understand your migraine symptoms and how best to treat them.

The form your migraine diary takes is entirely up to you. You can use a written template, like the one provided by The Migraine Trust, or consider using a mobile or computer application.

MyMigraineTeam members report taking both approaches. One wrote that “MigraineBuddy is a great app for tracking and charting your migraines, and gives bariatric pressure alerts.” Other popular migraine tracking apps include Migraine Monitor and N-1 Headache. One MyMigraineTeam member added that they use an app “but also keep a separate daily diary.” Some people find a calendar a convenient way to record their headaches.

There are benefits and drawbacks to keeping a digital or paper diary. Some benefits of using an app include the convenience of using your smartphone, the reports migraine apps generate, and a digital record of your symptoms. However, not everyone has a smartphone or is comfortable using smartphone apps.

One of the main benefits of using a paper diary is the ability to be creative and include any information you’d like. You can write about your day, journal your emotions, or even draw pictures in addition to the migraine information you're logging. Downsides include the possibility of not having it with you when you experience symptoms, or losing it.

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Have you tried keeping a migraine diary? Share your experience in the comments below, or start a conversation by posting on MyMigraineTeam.