For some individuals, changes in altitude can directly trigger debilitating migraine attacks. This connection highlights the body’s sensitivity to shifts in its surroundings, particularly when ascending to higher elevations. A clear relationship exists between altitude and the onset or worsening of migraine symptoms for susceptible people.
How Altitude Triggers Migraines
Ascending to higher altitudes introduces physiological changes that can contribute to migraine development. A primary factor is reduced oxygen availability, known as hypoxia. This occurs because atmospheric pressure decreases at elevation, meaning less oxygen reaches the body’s tissues, including the brain. This lower oxygen level can trigger various responses.
One response is cerebral vasodilation, the widening of blood vessels in the brain. This aims to increase blood flow to compensate for reduced oxygen. Hypoxia can provoke migraine-like attacks and cause cranial arteries to dilate. While vasodilation is considered a part of migraine pathology, its exact role is still being explored.
Dehydration also plays a role in altitude-induced migraines. Higher altitude air is often drier, and increased respiration leads to faster fluid loss. Dehydration is a known migraine trigger, amplified in high-altitude environments. Maintaining adequate fluid intake is important to mitigate this risk.
Rapid changes in barometric pressure, occurring with quick ascent, can affect sensitive individuals. Fluctuations in air pressure can create imbalances within the body’s air-filled cavities, like the sinuses, and influence how the brain processes pain. These pressure shifts are recognized as potential migraine triggers.
Recognizing Altitude Migraine Symptoms
Altitude-induced migraines present with typical migraine symptoms. These include throbbing head pain, often on one side, along with nausea, vomiting, and sensitivity to light (photophobia) or sound (phonophobia). These symptoms can be intense with altitude changes.
Migraine symptoms may be more severe or occur alongside indicators of acute mountain sickness (AMS). Additional AMS symptoms include dizziness, fatigue, weakness, and shortness of breath. The AMS headache is intense and throbbing, developing within six hours to four days of arrival and potentially lasting up to five days. It often worsens with exertion, coughing, or lying flat.
Differentiating an altitude migraine from a milder altitude or tension headache is important. An altitude migraine shares features of a person’s usual migraine, but may be more severe or include increased nausea due to altitude. While a mild headache can occur at elevations around 8,500 feet, a migraine is more debilitating and includes sensory sensitivities.
Strategies for Prevention and Relief
Preventing altitude-induced migraines involves allowing the body to adjust and minimizing triggers. Gradual ascent is an effective strategy, giving the body time to acclimatize to reduced oxygen. This means ascending slowly, often not more than 1,600 feet per day above certain elevations, and incorporating rest days.
Maintaining consistent hydration is crucial, as dehydration contributes to migraine attacks at altitude. Drinking plenty of water, at least eight glasses daily, is recommended before and during time spent at higher elevations. Avoiding dehydrating substances like alcohol and excessive caffeine is also advisable upon arrival.
Other preventive measures include avoiding strenuous physical activity immediately after arriving at altitude and ensuring adequate rest. Dietary adjustments, such as a high-carbohydrate diet, and mindfulness of personal migraine triggers like bright lights or strong odors may also help.
For relief and prevention, various medications can be considered; consulting a healthcare provider is recommended. Over-the-counter pain relievers like ibuprofen or paracetamol can manage mild headaches. For those prone to migraines, prescription triptans are often effective. Prophylactic medications like acetazolamide (Diamox) are sometimes prescribed before ascent to help the body acclimate and reduce altitude sickness risk.