• Posted November 14, 2025

Surprise! Migraine Risk Linked To Disruptions In Daily Routine

Want to avoid migraines? Stick to your boring routine, a new study suggests.

Any major disruption to a person’s daily routine — called a “surprisal” event — is strongly linked to a higher risk of a migraine attack within the next 12 to 24 hours, researchers reported Nov. 11 in JAMA Network Open.

Too much food or drink, staying up late, a stressful incident, unexpected good or bad news or a severe mood swing could pose a “surprise” to the body, setting it up for a next-day migraine, researchers said.

“Incorporating measurement of surprisal into migraine forecasting tools could provide individuals with a more effective, personalized strategy for managing headache risk,” concluded the research team led by Dana Turner, an assistant professor of anesthesia, critical care and pain medicine at Harvard Medical School.

In fact, the findings support a person-centered approach to treating a migraine “that moves beyond static lists of potential causes to account for the unpredictable and context-sensitive nature of daily life.”

For the study, researchers tracked 109 people with migraine from April 2021 to December 2024. Participants kept daily diaries that marked their migraine attacks and any potential migraine triggers they encountered.

The research team created an average for each person’s migraine triggers, and then went looking for days on which a “surprise” deviation from that average took place.

In their words, they quantified “the unexpectedness of daily experiences and the subsequent occurrence of migraine attacks.”

Results showed a high surprisal event increased a patient’s risk of migraine by 56% within 12 hours and by 88% within 24 hours, after controlling for other factors and differences between people.

“The results of the present study provide evidence that the degree to which an individual’s experiences deviate from their usual patterns can be used to identify near-future migraine risk,” researchers wrote.

Dr. Noah Rosen, director of the Northwell Headache Center in Great Neck, New York, reviewed the findings.

“A lot of this is in sync with how many people and I have envisioned migraines, which is often a hypersensitization with reaction to change in stimuli," he said in a news release.

“Our bodies maintain homeostasis; that is the correct amount of food, sleep and hydration. A migraine in some ways may be an alarm system that goes off when some of that is disrupted,” Rosen added.

This might be why only 70% of people with migraines have been able to identify specific triggers, he said. They're looking for specific things, rather than a deviation from the norm.

“Surprisal would be the way that something steps away from your usual activities or requires responses different than your every day,” Rosen explained. "Sudden stressful events may include experiences such as traumatic experiences and fights. Unexpected bad news or even good news. The disruption of normal activity by other events; things that may get in the way of your normal work, school or home activities."

Researchers said future studies should look into better methods for tracking surprisal events, which might help migraine patients prepare themselves for an oncoming attack.

More information

The American Migraine Foundation has more on migraine triggers.

SOURCES: JAMA Network Open, Nov. 11, 2025; Northwell Health, news release, Nov. 11, 2025