Can chronic migraine cause fatigue?

Fatigue is a state of physical, mental, and emotional exhaustion that interferes with a person’s ability to function in their normal daily activities. It is associated with many different health conditions, including migraine.

Migraine is a neurologic disorder that causes recurring episodes of debilitating headaches and other symptoms. It can be divided into different categories, based on the frequency of episodes:

• Chronic migraine means a person experiences 15 or more headache days per month for at least 3 months, with migraine symptoms on at least 8 days.
• Episodic migraine means a person experiences fewer than 15 headache days per month.

While exact numbers are unknown, studies have consistently found that over 60 percent of people with migraine experience fatigue. Some studies have found the prevalence of fatigue to be considerably higher among people living with chronic migraine.

What does fatigue feel like?

A person experiencing fatigue may find they have a lack of energy and motivation, difficulty concentrating, forgetfulness, drowsiness when they need to be awake, and changes in mood (such as being irritable). They may also experience apathy, a lack of caring about what is happening in their life. Although tiredness is a symptom of fatigue, fatigue is more severe and persistent. Unlike feeling tired after a long day or strenuous activity, fatigue does not resolve with rest and recovery.

In some cases, fatigue is a normal response to demanding physical activities, periods of high emotional stress, or major life changes. It’s the body and mind signaling that demand is outpacing recovery. In other words, it needs fewer stressors and more rest.

In other cases, fatigue is the result of a health condition—something a person has far less control over. In addition to migraine, fatigue affects people living with anemia, sleep disorders, COVID-19, depression, infections, nutritional deficiencies, and many other conditions.

What is the link between migraine and fatigue?

Fatigue is known to occur in the hours or days leading up to a migraine attack and linger in the days following, but the relationship between migraine and fatigue is not fully understood.

Some studies suggest that migraine and fatigue (and also mood disorders) overlap in how they affect the brain, and that the relationship is bidirectional—that migraines contribute to fatigue and fatigue contributes to migraines.

Chronic fatigue syndrome

People who have migraines—and especially chronic migraine—are at an increased risk for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a medical condition where a person experiences severe fatigue, sleep problems, and symptoms that worsen with physical and mental activity, with symptoms lasting six months or longer.

ME/CFS affects many systems of the body, and headaches are a common symptom.

Work with a healthcare provider

It should also be mentioned that migraines and fatigue frequently occur alongside other health conditions., including cardiovascular disease, inflammatory disorders, depression, anxiety, and sleep disorders. In other words, these are often pieces of a larger picture of a person’s health, and the best source of information will be an evaluation by a healthcare provider.

If any of the fatigue symptoms described above sound familiar, it’s important to see a healthcare provider. Treating migraine involves steps like avoiding triggers and responding to episodes when they occur (and in the case of chronic migraine, ongoing treatment with therapies that prevent attacks). But treatment also involves addressing the ways that migraines impact your life and taking care of other aspects of your health.