What should you record in your headache diary?

If you’re living with chronic migraine or have experienced migraines with any frequency, you’ve likely heard this recommendation before—keep a headache diary.

Also known as a symptom journal or symptom tracker, a headache diary is an ongoing document where you keep track of everything related to headaches and migraines. (And while the focus here is on migraine and especially chronic migraine, symptom journals can be useful in the management of many other conditions).

One of the main goals of keeping a headache diary is identifying patterns in migraine episodes and (hopefully) identifying migraine triggers. If you know something can cause a migraine, you can take steps to avoid it, and hopefully experience fewer migraine episodes. Keeping a record of your headache days can also help your healthcare provider better understand what you need from treatment and determine if your current treatment plan is meeting your needs.

If you’re starting a headache diary, getting back to one after a break, or keeping one but want some ideas on what to include, the strategies below can help.

Getting started

When we hear the word “diary” we tend to think of a pen and paper, and many people who keep headache diaries (or symptom journals related to other conditions) do so with a notebook.

Many others prefer to keep a digital record, either with an app designed for keeping track of headaches or by using a word processing program, spreadsheet, or some other type of electronic document.

Unless your healthcare provider requests a specific format for the information you are recording, there is no right approach for everyone, and the best strategy is the one that works for you. You may need to—or want to—try several approaches for settling on one. And you can always change your approach if something isn’t working as well as you need it to.

Two questions to ask yourself

There are really only two criteria that matter when keeping a headache diary:

• Are you able to capture the information that you need to capture?
• Are you able to be consistent?

When and what to record

Keeping notes on what you did each day can be helpful—where you went, what you ate, what you did, how you slept, how you felt, anything that was out of the ordinary or stressful. Even if you didn’t experience any symptoms that day, migraines can be unpredictable, and this information may be helpful later. Daily recaps do not need to be detailed. You just need enough to serve as a reminder, something that you can refer back to later.

Documenting a migraine attack

If you experience a migraine, headache, or other symptoms, you’ll want to record as much information as possible as soon as you are feeling up to it. Here’s what to include in an entry:

• Date , time, and duration. When did the first symptoms begin? When did they end?
• Headache symptoms. Describe any headache pain or other pain you experienced. Where was the pain located? Was the pain throbbing, dull, sharp? Did it stay consistent, or did it come and go? How intense was the pain on a scale of 1 to 10?
• Other symptoms. Did you experience other symptoms, such as aura, nausea, vomiting, sensitivity to light and/or sound, or visual disturbances?
• Medication. Did you take any medication to treat the migraine? When did you take this medication? Do you feel it helped?
• Location. Where were you when the first symptoms started? What were you doing?
• Potential triggers. Are there any other triggers that you think may have caused the migraine?
• Food and drink. What did you consume in the hours before the episode?
• Sleep. How were you sleeping in the days leading up to the migraine?
• Stress. How were your stress levels in the days leading up to the migraine?
• Menstrual cycle. Noting where you are in a menstrual cycle can also be helpful. Migraine episodes have been associated with hormonal changes.

Tips to stay consistent

Like any new habit, keeping a diary can feel like work at times, and there will be days you do not want to do it. Try to set aside five minutes a day, preferably the same time each day. Here are some other strategies that can help:

• Set an alarm or reminder
• Keep your headache diary in a place where it is easy to access
• Add it to another part of your routine (for example, write an entry immediately after brushing your teeth or taking a medication)
• Keep entries small and manageable
• Find an accountability partner, such as a family member or friend
• Remind yourself of the benefits

Before you go to an appointment, take some time to review your entries and decide what you want to discuss with your healthcare provider. A headache diary can also be a good place to keep track of questions you want to ask at your next appointment.