If you’re experiencing exhaustion alongside migraine attacks, you’re not alone. In fact, fatigue is one of the most common symptoms of migraine, and it can have a significant impact on quality of life.

“Can migraine cause fatigue?” one MyMigraineTeam member asked. Another said, “I get extremely fatigued once the headache and vomiting are over.”

“I’m sooo tired of it all,” admitted one member. “It’s a draining effect on my so-called life.”

According to one 2023 study, nearly 70 percent of people with migraine also endure migraine-related fatigue. Everyone feels tired from time to time, but fatigue is different. It goes beyond normal tiredness, leaving you exhausted or drained no matter how much rest you get. Luckily, there are some ways you and your healthcare provider can work together to manage this fatigue while living with migraine.

Premigraine and Postmigraine Fatigue

You probably experience several stages of a migraine, and fatigue generally occurs in the prodrome, or preheadache, phase. It’s also common during postdrome, or the end of the headache phase. Postmigraine fatigue is often referred to as the “migraine hangover.”

For many members of MyMigraineTeam, the hours and days after a migraine are often just as debilitating as the headache itself. One member shared that they experience “confusion, poor articulation, fatigue, weakness, nausea, trouble focusing, and back pain” after a migraine attack. Another wrote that they feel “dizziness, lightheadedness, feeling out of it, weakness, and anxiety.” As one member summed it up: “The after-effects can be as painful (or difficult) as the migraine itself! I call it the ‘hangover without the fun’ phase.”

Nearly 70 percent of people with migraine also endure migraine-related fatigue, one study found.

Conversely, feeling overtired can actually trigger migraine attacks in some members. As one shared, “When I get very fatigued, it can lead to a migraine. So, I just try to rest often.” Another member who experiences extreme fatigue wrote, “I wake up and go to bed with migraine attacks.”

Can Chronic Migraine Cause Sleepiness?

According to the American Migraine Foundation, those who experience chronic migraine (defined as 15 or more days of painful headaches per month) also tend to have twice the rate of insomnia — and worse fatigue — when compared to those with less frequent headaches. A bad night’s rest can make you sleepy the following day. “Got a crushing headache today just like the last 60 or so days. It’s wearing me out,” one member shared. “I’m just so exhausted from my 15-day migraine at this point,” another lamented.

A study also found that people with migraine have a 1.5 times higher chance of developing chronic fatigue syndrome (CFS), or fatigue that doesn’t improve with sleep and lasts over six months.

Coping With Migraine Exhaustion and Fatigue

Managing migraine-related fatigue can involve several different approaches and treatment options, from managing your migraine medications to making healthy lifestyle changes. As always, talk to a healthcare professional if you experience new or worsening fatigue. They can determine the cause of your exhaustion and work with you to find the best way to manage it.

1. Manage Your Medications

Many prescription and over-the-counter medications, including many popular pain relievers, can contribute to or cause fatigue and drowsiness. “It doesn’t help that the vast majority of meds we take for this condition list tiredness as a side effect,” one member noted. Another agreed: “The pain makes you tired, and so do the painkillers.”

If you believe your migraine treatment may be causing fatigue or tiredness, talk to your doctor. They will be able to determine the right medications and dosages for managing migraine pain while minimizing side effects like fatigue. They may also suggest switching treatments if your current therapy isn’t working.

In addition to talking with your doctor, you may want to avoid certain activities that demand alertness and intense focus, such as driving, until you understand how your medication affects you. In some cases, medication-related fatigue lessens over time as the body adjusts to the drug. However, if excessive drowsiness or chronic fatigue continues or impairs your day-to-day functions, ask a healthcare professional for medical advice as soon as possible.

2. Get Plenty of Rest

People with migraine often have trouble getting a good night’s sleep. Disrupted sleep patterns, decreased sleep quality, sleep disorders, and migraine attacks themselves can all contribute to feeling exhausted and fatigued. Migraine attacks can even strike in the mornings, making it challenging to get out of bed.

Migraine can be physically draining, leaving your body in need of a good, long rest. When this happens, you must focus on giving your body the care it needs. Once you feel a migraine attack coming on, take a step back and place yourself in a calm, restful environment. This can include turning off the lights and lying down (or sleeping, if you’re able to) so your body has a chance to unwind and you don’t risk aggravating your migraine further.

“When I get very fatigued, it can lead to a migraine. So, I just try to rest often.”

— A MyMigraineTeam member

The traditional approach for surviving a migraine — “dropping out” for a few hours or a day — also works for before or after migraine exhaustion. As one member wrote, “I just lie down in a cool, dark, quiet room, stay hydrated, and sleep.”

Maintaining good sleep hygiene is crucial. Try to set a consistent sleep schedule and develop a calming routine before bed to improve sleep quality and potentially reduce the frequency of migraine attacks. A bedtime routine could include reading a book, listening to gentle music, or taking a warm bath. Avoid stimulating activities before bed, including intense exercise, heavy meals, and smoking.

3. Exercise When You Can

Although it may be the last thing on your mind when you’re exhausted, exercise can play an important role in managing migraine fatigue. As one member shared, “Going to the dance studio for group class and a lesson with my husband helped.”

During exercise, your body releases certain chemicals that block pain signals to your brain, including endorphins, which are hormones that are released when you feel pain or stress. Not only do these chemicals ease stress, they can also help with anxiety and depression — two health conditions that can contribute to worsened migraine headaches. Staying physically active can also reduce your risk of a heavier weight — which may increase the risk of chronic headaches — and even help with insomnia.

As with any major lifestyle change, consult your doctor before beginning any new or intense exercise regimens. Exercise can be helpful, but jumping into vigorous activity too quickly or after periods of low or no activity can trigger migraine attacks or lead to injury. Ease yourself gradually into a new exercise plan.

4. Manage Your Stress

Stress can have significant detrimental impacts on your overall health, contributing to both fatigue and migraine attacks in some people. To help improve fatigue and stave off migraine attacks, try to reduce or eliminate stress wherever possible. Taking time for yourself and giving yourself breaks when needed — whether during work, school, or just day-to-day activities — can help lower your daily stress levels, as can getting adequate rest and finding time to relax and unwind after a hectic schedule.

Part of cutting back on stress can also involve adjusting your attitude by focusing on the positive and lifting yourself up instead of tearing yourself down. Try to avoid dwelling on what you can’t do or what’s still left to be done. Instead, think about how far you’ve come and how much you’ve already done, despite living with migraine.

To help improve fatigue and prevent migraine attacks, try to reduce or eliminate stress wherever possible.

“It’s hard to rest when you’re suffering pain,” one MyMigraineTeam member told another. “But I encourage you to try any means necessary to get relaxation and restoration for your weary mind and body. Long hot baths, massage, soothing music.” Another member added: “We just have to go with the flow and try not to dwell on our migraine attacks. Always thinking about them probably makes them worse.”

5. Take Your Supplements

Certain vitamin supplements may help boost energy levels in those experiencing migraine-related fatigue. These supplements, including vitamins B1, B2, B6, and B12, can have many positive health impacts, like helping the body convert carbohydrates, fats, and proteins into energy and form red blood cells. As one member said, “My doctor suggested I try a B12 supplement for fatigue. Maybe I’ll be less tired.”

Be sure to talk to your healthcare provider before taking any supplements.

6. Eat a Healthy Diet

Changing your dietary habits can benefit your overall health and may help alleviate or reduce the frequency and severity of your migraine attacks. You may want to consider:

• Eating smaller, more frequent meals throughout the day for a more consistent schedule
• Never skipping meals
• Identifying and avoiding trigger foods
• Keeping a migraine food journal to track migraine triggers and progress
• Minimizing your caffeine and alcohol intake
• Staying hydrated

While small amounts of caffeine may temporarily help reduce drowsiness or sleepiness, larger quantities or overuse can actually trigger or exacerbate headaches. Too much caffeine might also lead to caffeine withdrawal symptoms, dehydration, and sleep problems.

The American Migraine Foundation encourages frequent caffeine drinkers who experience migraine to cut their caffeine intake by 25 percent per week to reduce negative symptoms and avoid withdrawal.

Talk to your neurologist or headache specialist if you aren’t able to shake the fatigue that accompanies your migraine attacks. They can help you find solutions that should improve your quality of life.

Find Your Team

MyMigraineTeam is the social network for people with migraine and their loved ones. On MyMigraineTeam, more than 84,000 members come together to ask questions, give advice, and share their stories with others who understand life with migraine.

How do you manage migraine-related fatigue? What other strategies have you used to cope with migraine exhaustion? Share your experience in the comments below, or start a conversation by posting on your Activities page.