What lifestyle modifications should I advise to patients with frequent migraines?

Advise patients who experience frequent migraines to implement the following lifestyle modifications:

• Keep a headache diary to identify migraine frequency, triggers, and treatment effectiveness.
• Avoid known migraine triggers where possible, as trigger avoidance can reduce attack frequency.
• Manage stress through relaxation techniques or mindfulness.
• Maintain good sleep hygiene to ensure adequate and regular sleep patterns.
• Stay adequately hydrated and maintain regular meal times to prevent migraine onset.
• Engage in regular physical exercise to support overall health and potentially reduce migraine frequency.
• Maintain a healthy weight as part of overall migraine management.
• Address and optimally treat comorbidities such as sleep apnea, insomnia, depression, and anxiety, which may exacerbate migraines.
• Limit acute migraine medication use to no more than 2 days per week to avoid medication overuse headache, which can worsen migraine frequency and intensity.

These lifestyle changes, combined with education and support, can help patients take an active role in managing their migraines and improve their quality of life.

Note: Women with migraine with aura should be advised against using combined hormonal contraception due to contraindications.

For further information, patient resources such as NHS A-Z and The Migraine Trust can be recommended.

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