TABLE 4.

Dietary and physiologic migraine triggers.

Migraine triggers	Recommendations
Stress (conflict at home/work, death of relative, physical pain, infection, other illness, etc.)	Exercise, start with 5 minutes, gradual 1–2 minutes/week increase, goal 20–30 minutes 3–5 times a week Practice guided meditation
Sleep (too much sleep, too little sleep, interrupted sleep, shifting sleep schedule, different sleep schedule on weekends, etc.)	Maintain the same regular sleep schedule on weekdays and weekends Use guided meditation on nightly basis before sleep Avoid looking at screens and turn lights down 1 hour prior to sleep to not suppress melatonin secretion Diagnose/treat sleep apnea
Diet (skipping meals, eating certain foods, and dehydration)	Maintain a strict eating schedule by eating on time, even if not hungry Drink ≥70 oz. of water per day, more with exercise or when outdoors in the heat Follow the migraine diet by eliminating caffeine, avoiding byproducts of food aging or fermentation (red wine, aged cheeses, yeast, etc.) which contain tyramine (also in overly ripened fruit, processed protein/meat, etc.), monosodium glutamate (MSG) (soy sauce, canned soups, pickled foods, chips, canned foods, salad dressings, etc.), and histamine‐containing foods (citrus fruit and nuts)