9个偏头痛和预防头痛的技巧

即使头痛和偏头痛的治疗选择比以往任何时候都要多headache比试图摆脱一个要容易得多。一旦头痛袭击，尤其是如果它是migraine attack, you might be out of commission for several hours or even days. Avoid your headache triggers — includingdehydration, skipped meals, and too little sleep — and you may stay pain-free.

"You're not going to be able to prevent all headaches,” saysMark Green, MD，纽约市西奈山医学院的神经病学，麻醉学和康复教授以及头痛和疼痛医学中心主任。

That’s because there are headache triggers you can control and those you can’t. Some triggers in the latter category are the weather and, if you’re female, the hormonal fluctuations that occur with menstruation andperimenopause.

The good news is you can minimize headaches and migraine attacks by managing your triggers, says Dr. Green. Even if you can't stop every headache from happening, some simple changes can help you avoid at least a few.

What Causes a Migraine Attack?

头痛和偏头痛攻击可能对很多人来说是有关的。Lauren Doyle Strauss, DO， 一个headache specialist和an assistant professor at Wake Forest Baptist Health in Winston-Salem, North Carolina. “People wonder, ‘Why am I getting a headache or migraine? What is causing such a big disturbance in my life?’”

There have been a lot of advancements in the understanding of headache and pain mechanisms in the past decade, says Dr. Strauss. “It’s really exciting, and it’s allowed for some new therapeutics to be developed, such as CGRPs (calcitonin gene-related peptide) pathway monoclonal antibodies,” she says. CGRP antibodies are new medications that are approved as a preventivemedication for migraine.

“We’re learning new things and discovering new target sites, but unfortunately, we don’t fully understand the pathophysiology or all aspects of migraine and the related symptoms,” says Strauss.

“There is a genetic component to migraine, where we see multiple family members who have the disease, and we suspect there are multiple genes related in the development of migraine or inheriting migraine,” she says.

If one or both of your parents have migraine, there is a 50 to 75 percent chance that you will have the disease, too, according to theAmerican Migraine Foundation.

Although you can’t change your genetics, you can control some of the factors that trigger a headache or migraine. Here are some expert tips on keeping headaches and migraine attacks at bay.

1.保留日记以学习您的个人偏头痛触发器

If you have frequent migraine attacks or headaches, it can be really helpful to track what you’re experiencing, says Strauss. The type of information you can track can include the following:

• All medicines you take
• What time you wake up and go to bed
• When you eat meals and snacks
• All exercise and any other physical activities you undertake
• All beverages you drink, especially beverages with caffeine or alcohol
• All foods you eat

记录您所经历的每个头痛或偏头痛攻击，一天中发生的时间以及您所做的事情resolveit. It's also a good idea to track what the weather was like and any hormonal changes you’re aware of, such as when you ovulated or began yourmenstrual period.

Write down your symptoms, says Strauss. “Where is the pain located? Are you tired or dizzy? Are you sensitive to light or sound? Do you have anupset stomachor vomiting? Keep track of those can help you understand your headaches,” she says.

After a while, you should begin to see patterns. For instance, do you notice headaches more on weekends when you sleep in? What happens on Mondays, when you have to get to work early? What happens on Friday nights when you drink wine?

This information will help doctors determine what's causing your headaches, and what you can do to prevent them. “Every day of the week gives us hints," says Green.

2. Take Acute, or Rescue, Medications as Soon as You Feel an Attack Starting

对于轻度至中度偏头痛的人，非处方药，例如acetaminophen(Tylenol),ibuprofen（motrin），或萘普生（Aleve）可以缓解偏头痛症状， 一个ccording to theAmerican Migraine Foundation.

处方药称为药物经常使用for moderate to severe migraine attacks. These medications work in a variety of ways in the brain to help relieve pain and restore function, and they’re more effective when used early in a migraine attack while the pain is still mild, according to theNational Headache Foundation.

有一类新的偏头痛药物针对不同的药物神经递质pathway than triptans do, called CGRP receptor antagonists, or gepants, for short. There are currently two approved medications in this class,Nurtec (rimegepant)和Ubrelvy (ubrogepant). Like triptans, these drugs should be taken early in a migraine attack for best results.

3.如果您经常发生偏头痛攻击，请考虑预防药物

Strauss说，许多用来帮助防止偏头痛的药物已从其他疾病中“借用”。其中包括血压药物，例如β受体阻滞剂，antidepressants，她补充说。

尽管这些药物可能会有所帮助，但仍有专门设计用于靶向和预防偏头痛的新药物，“这对我们其他药物失败的某些患者来说是令人兴奋的，”她说。

Aimovig（Erenumab）,Ajovy (fremanezumab)， 和emgality（加尔班那珠单抗）are once-monthly drugs that people inject at home to help prevent migraine. You’ll need a prescription from your doctor for any of these.

镁补充剂也可以每天作为预防服用。Nada Hindiyeh，医学博士，a headache specialist and researcher at Stanford Health Care in Palo Alto, California.

There is evidence to support using magnesium, though the mechanism of action, or the “why” behind how it improves migraine, is not totally clear, she says. “It could be stabilizing cells or decreasing hyperexcitability or neuronal firing, but that’s all theoretical at this point,” says Dr. Hindiyeh.

4. Stick to a Sleep Schedule

“I think one of the most effective tools for my migraine patients has been focusing on healthy habits, andsleep is a big part of that; that can be especially challenging right now with all the changes that the pandemic has brought into our lives,” says Strauss.

Consistency is key, says Strauss. “I recommend going to bed and getting up at around the same time every day, even on weekends, and avoiding naps if possible,” she says.

施特劳斯说，这可能很困难，因为有时睡眠是唯一可以在头痛中帮助人们的事情。“问题是，如果您白天要小睡过多，那使晚上难以入睡。尝试限制白天的睡眠，并将所有的睡眠都移至晚上，并保持同样的就寝时间。”她说。

5. Stay Hydrated by Drinking Plenty of Water Throughout the Day

HydrationStrauss说，这是其他健康习惯之一，一致性可以在偏头痛预防方面产生重大影响。“经常，人们在一天结束时意识到自己的水分还不错，然后他们试图通过喝很多东西来赶上。她说：“这通常不足以弥补您的身体需求。”

Try having at least one full glass of fluid with each meal, Strauss suggests. “That’s three glasses, and then try to have a glass when you first wake up before you eat breakfast, and then one at night with any medications you might take,” she says.

6.每天食用相同数量的咖啡因，或根本没有

有几个原因患有偏头痛的人施特劳斯说，应该谨慎食用咖啡因mild diuretic effect. “It makes you pee out water and fluid, so you may think you’re doing really well in hydration, but too much caffeine may be impacting that,” she says.

施特劳斯说，此外，患有偏头痛的人可能对咖啡因确实很敏感，这可能会影响您的睡眠质量。“没有获得优质睡眠可能是偏头痛的触发因素。”

最好是如果你能消除咖啡因,but that’s not always possible or desirable for some people, says Strauss. “I would suggest trying to not have caffeine after breakfast time. That would be a good way to limit the effects it would have on sleep and also minimize the amount of caffeine that you’re having throughout the day,” she says.

7. Get Regular Aerobic Exercise, and Try HIIT

Exercise is one of the lifestyle modifications that can make a real difference, says Hindiyeh.

“常规的aerobic exercise她说：“也可以自行作为一种预防性药物工作，也有一些研究表明瑜伽和HIIT（高强度间隔训练）也可以有所帮助。”

A study于2018年3月出版斯堪的纳维亚体育医学与科学杂志showed that high-intensity interval training was more effective at reducing the frequency of migraine attacks than moderate-intensity exercise, although moderate exercise also had a positive effect.

8. Follow a Migraine-Preventive Meal Schedule

施特劳斯说，考虑偏头痛的一种方法是，它就像您身体的“警报”一样，可以通过任何类型的变化来启动。她说，如果您跳过饭，那会触发警报。

“There’s a reason why many people say that breakfast is the most important meal of the day. If you have dinner, and then you skip breakfast because you’re busy, that means your brain hasn’t gotten any fuel in a long time,” says Strauss.

It’s a good practice for people with headaches or migraine to have breakfast, lunch, and dinner with some snacks throughout the day, she adds.

When it comes to which foods to avoid, that can vary from person to person, says Strauss. “Currently, we don’t have a lot of literature to support what some of our headache patients report to us. For example, I’m not convinced that chocolate is something that people with headaches really need to avoid,” she says.

“节制是一个好主意：不要吃或喝任何东西。避免有很多沉重的防腐剂，例如加工肉或硬奶酪。” Strauss说。

9. Make Sure Your Home and Workspace Aren’t Triggering Migraine Attacks

“We are seeing a lot of new patients who are experiencing headache for the first time because of changes thatCOVID-19has caused,” says Strauss. In addition to managing extra stress, many people are nowworking remotely from their homein a less-than-ideal, makeshift office setup.

她说，人们通常会建立工作区认为这将是暂时的，但是大流行已经持续了一年，并且可能会持续一段时间。施特劳斯说：“评估您的情况是一个好主意，包括一天中大部分时间的位置和方式。”

如果您的工作需要大量的屏幕时间，请定期休息。Strauss说：“您还可能会考虑降低屏幕的亮度或切换计算机设置，以使背景为黑色，文字为白色。”

Additional reporting byDiana Rodriguez.