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Migraines and Fatigue: 6 Tips To Feel Better

Updated on September 28, 2022
Medically reviewed by
Evelyn O. Berman, M.D.
Article written by
Megan Cawley

If you’re looking for ways to reduce the fatigue that often accompanies migraine headaches, you’re not alone. Fatigue is one of the most common symptoms of migraine and can have a significant impact on quality of life. On MyMigraineTeam, members frequently discuss coping with exhaustion alongside the other symptoms of migraine.

“I get extremely fatigued once the headache and vomiting are over,” one member wrote. Another shared, “After a migraine, I feel like I’ve been run over by a truck for two days. Then, another one starts, and it becomes a big loop.”

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

According to one study, nearly 60 percent of people with migraines also suffer from 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 health care provider can work together to manage this fatigue while living with migraine.

Pre- and Post-Migraine 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 — 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 she experiences “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.”

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 migraines.”

Coping With Migraine 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 health care professional if you experience new or worsening fatigue. They can determine the cause of your exhaustion and work with you to find the best ways of fighting it.

1. Manage Your Medications

Many prescription and over-the-counter medications can contribute to or cause fatigue and drowsiness, including many popular pain relievers. “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.”

As one member who takes erenumab-aooe (sold as Aimovig) wrote, “It’s helping the migraine but makes me sleep for 72 hours.” Another member who recently started gabapentin (sold as Neurontin and Gralise) said, “I’ve been on it just two days and already have really bad fatigue.” Others who take that same medication advised, “The fatigue will pass as your body adjusts to it,” and that taking it at bedtime can help.

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.

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 continue or impair your day-to-day functions, ask a health care 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 habits — as well as decreased sleep quality, sleep disorders, and migraine attacks themselves — can leave you feeling exhausted and fatigued.

What’s more, members who experience chronic migraines (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. “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.

Migraines can be physically taxing and can leave the 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.

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

It is important to get good-quality sleep at night. Setting a consistent sleep schedule, and performing soothing activities before bed (reading a book, listening to gentle music, taking a bath, etc.) can help ensure you get the best sleep possible and potentially reduce the frequency of your migraine attacks. Avoid strenuous activities right before bedtime (such as intense exercise, heavy eating, or smoking).

3. Exercise When You Can

Although it may feel like 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, including endorphins (hormones released when you feel pain or stress), that block pain signals to your brain. These chemicals can also help ease stress, as well as anxiety and depression — two conditions that can contribute to worsened migraine headaches. Staying physically active can also reduce your risk of obesity — 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 fatigue and even triggering migraines 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 is still left to be done. Instead, think about how far you’ve come and how much you’ve already done, despite living with migraine.

“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 migraines. Always thinking about them probably makes them worse.”

5. Take Your Supplements

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

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. These changes can include:

  • Shifting your eating habits to a more consistent basis — you may want to try eating smaller meals more frequently throughout the day
  • Ensuring you don’t skip meals
  • Avoiding triggering foods or drinks like alcohol
  • Keeping a migraine food journal to track migraine triggers and progress
  • Minimizing your caffeine and excessive alcohol intake
  • Staying hydrated

Although caffeine may temporarily help reduce drowsiness or sleepiness in small quantities, larger quantities or overuse can actually trigger or make migraine headaches worse. Excess caffeine consumption may also lead to other issues, including caffeine withdrawal, dehydration, and sleep problems.

The American Migraine Foundation encourages frequent caffeine drinkers who experience migraines 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

Are you living with migraine? Consider joining MyMigraineTeam today. Here, you can ask questions, offer support and advice, and join ongoing conversations. Before long, you’ll have a team of more than 78,000 members from around the world who understand life with migraine.

How do you manage migraine-related fatigue? Share your thoughts or tips in the comments below or by posting on MyMigraineTeam.

    All updates must be accompanied by text or a picture.
    Evelyn O. Berman, M.D. is a neurology and pediatric specialist and treats disorders of the brain in children. Review provided by VeriMed Healthcare Network. Learn more about her here.
    Megan Cawley is a writer at MyHealthTeam. She has written previously on health news and topics, including new preventative treatment programs. Learn more about her here.

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