Preventing summer migraine headaches

AccuWeather

Dr. Emad Estemalik, with the Cleveland Clinic, was live on the AccuWeather Network on July 21 to discuss heat, humidity and migraines.

Transcript

00:00When temperatures rise, so can your risk for a migraine.

00:04Hot weather, humidity, and even changes in barometric pressure can trigger summer migraines.

00:09Here to help with some tips is Dr. Imad Estamalik,

00:14Director of the Headache Center at the Cleveland Clinic.

00:17Thank you so much for being with us.

00:18I practiced your name, but I think it still maybe didn't come out perfect, so I apologize for that.

00:22No, you said it perfect. Good morning. Thanks for having me.

00:24Excellent.

00:25Okay, all right.

00:25Let's start out with how heat, extreme heat, and even the humidity affects the brain and can trigger migraines.

00:31So, very good question.

00:34And if we want to start by quickly just going over the prevalence of migraines,

00:37because really it comes up a lot.

00:39So roughly 20% of women have migraines, 10% of men.

00:42So you can see how prevalent really it is.

00:44And weather tends to be one of the most important factors that can affect migraine frequency,

00:50but also bring on migraines for a lot of these patients.

00:54So A, so you are correct, the barometric pressure change, if we go really from, you know,

00:58high temperatures to low or vice versa, it really acts in our sinuses.

01:03If you think about our sinuses, they're chambers of air.

01:05So anytime that barometric pressure change changes in the external environment, it creates that disequilibrium.

01:11And for those who have migraines, they know it right away, it will trigger a bad headache for them.

01:16The second being extreme weather, so really extreme heats and extreme colds is another factor that brings it on.

01:24And then the third, and that's actually very interesting, we see it with tropical storms or heavy rains, hurricanes.

01:32I remember actually doing once an interview when the hurricanes hit in California,

01:36because a lot of the media channels were noticing that they were getting a lot of phone calls from patients

01:40because of more and more migraines.

01:43So it is really those three factors that play a huge role for these patients.

01:48How big of a role does dehydration play?

01:50Is this one of the more common summer triggers?

01:54So dehydration, of course, is very common in the summer, and there are many reasons.

01:57A, you're losing a lot of fluid because of, you know, increased sweating.

02:01Second, we all tend to be outside during these hot weathers.

02:07So, again, that's another factor for dehydration.

02:11And then another thing is, and I mentioned that to a lot of my patients as well,

02:14you know, you're enjoying a barbecue, it's very hot, you consume a few alcoholic beverages,

02:18and alcohol in general can cause dehydration as well.

02:21So you add all those factors together, dehydration is big when it comes to triggering migraine as well,

02:28on top of the weather, of course.

02:29All right, so maybe many people think, okay, I'll just take some more of my migraine medication,

02:34but how can that end up backfiring?

02:35What exactly is a rebound headache?

02:38So for those who have migraines, one of the very important concepts to understand

02:43is that what we call rebound headaches or, in our terms, MOH or medication overuse headache,

02:49those pain receptors in migraine patients are a little bit different than the average population.

02:55All it takes is two to three weeks of an overconsumption,

02:59even simply over-the-counter painkillers.

03:02And they can get into that rebound, even sometimes in what we call it a status migranosis,

03:07where they have a headache that's just not subsiding.

03:10And what does it mean to overconsume some of these over-the-counter painkillers?

03:14Our number actually is no more than two to three times a week.

03:17Once patients get into that four to five or sometimes daily consumption of over-the-counters

03:21over a period of two to three weeks, they can really end up in a cycle where they're having

03:26daily headache or even transform from what we call having episodic migraine to chronic migraine.

03:31And how do we define that?

03:33When you have more than 15, 20 headache days a month, you could simply be having two to three

03:38or even sometimes one migraine.

03:39And you get into that rebound and you have a complete transformation,

03:42which puts you in a very different category of how we approach this from a preventive mechanism.

03:48We have one final brief question for you.

03:50What can people do to avoid migraines in hot weather?

03:54So, again, there are many steps you can take.

03:56We always talk about modifiable factors and non-modifiable.

04:00So things we can modify, of course, is stay hydrated.

04:04Caffeine in itself can dehydrate a little bit,

04:06but the right amount of caffeine tends to be protective.

04:10Really watching their diet during these times.

04:14Things that we tell patients about, MSG, nitric oxide,

04:17so they know exactly the food we're talking about.

04:19Sleep, not skipping meals, and again, the proper hydration is all important.

04:23When it comes to weather, of course, we all want to be outside.

04:26We all want to enjoy it.

04:28But those who have migraines, I mean, again,

04:30you can't avoid really the tropical storms or the rain.

04:33But if you notice that, you know, an extreme weather is there,

04:38and you know that tends to be a trigger for you,

04:42I don't think it's unreasonable to kind of take precaution,

04:44maybe not be outside if the temperatures are, you know, 100 or above.

04:49And again, I say that knowing how migraines can really be debilitating for a lot of patients.

04:54So, again, you take some of these approaches, I think it can really help.

04:57Dr. Imad Estamalik, director of the Headache Center at the Cleveland Clinic,

05:02thank you for all of that information and for joining us here at AccuOther Early.

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