How to keep a migraine diary: what to record and why it helps
If you see a doctor about migraines or frequent headaches, there's a good chance they'll ask you to keep a headache diary. It's one of the most useful things you can bring to an appointment. Here's what to record, how long to keep it, and how to make sense of it.
Why doctors ask for a migraine diary
- Diagnosis: the pattern of your headaches, how long they last and what comes with them help tell different types of headache apart.
- Triggers: recording sleep, meals, your period and other factors can reveal what tends to come before an attack.
- Treatment: counting headache days before and after a change is the clearest way to see whether it works.
- Painkiller use: taking painkillers on many days a month can itself cause headaches, so tracking how often you take them matters.
What to record for each headache
NHS hospital and charity diaries ask for broadly the same details:
- Date and start time, and how long it lasted.
- Severity on a 0 to 10 scale.
- Whether you think it was a migraine.
- Other symptoms: sensitivity to light or sound, nausea or vomiting, aura (visual changes, tingling or numbness before the headache).
- Medication: what you took, when, and whether it helped.
- Possible triggers: poor sleep, skipped meals, alcohol, stress, screens, weather.
- Your period, if you have one, since many people notice a link.
Mark headache-free days as well, so you can count how many headache days you have each month.
A simple template
| Date | Start | Lasted | Severity (0–10) | Symptoms | Medication and time | Possible triggers |
|---|---|---|---|---|---|---|
| Tue 14 | 07:30 | 6 hours | 7 | Light sensitivity, nausea | Ibuprofen 400 mg at 08:00 | Slept 5 hours |
| Wed 15 | – | – | 0 | None | – | – |
How long to keep it
Keep your diary for at least a month before your appointment; two or three months give a clearer picture. Bring it with you, and send it in advance if your clinic asks.
Making sense of the results
- Count headache days per month, and how many needed painkillers.
- Look for clusters: the same weekday, the same point in your cycle, after short nights.
- Be cautious about single triggers. Triggers often add up, and something that seems to cause one attack may not cause the next.
Share what you notice with your doctor rather than drawing conclusions alone.
Get urgent help if you have a sudden, very severe headache, or a headache with weakness, confusion, slurred speech, fever, a stiff neck, or after a head injury. This guide is general information, not medical advice.