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Among more than 2,000 migraine patients in the Netherlands, more
than a third said alcohol was a migraine trigger for them. Of the
650 patients who had stopped consuming alcohol, one in four said it
was to avoid triggering migraines. And 78 percent of patients who
did drink alcohol cited red wine as the specific drink that could
trigger an attack. Vodka was a trigger for only 8 percent.
Whether alcohol is a reliable migraine trigger - and why - are both
poorly understood, the study authors write in the European Journal
of Neurology. Alcohol seems to affect about a third of those prone
to migraines, and the amount of alcohol and time it takes to trigger
a headache vary as well, they note.
"Migraine patients frequently link the consumption of alcoholic
beverages with the triggering of their migraine attacks . . .
however, patients report that alcoholic beverages do not
consistently trigger attacks," lead study author Gerrit Onderwater
of Leiden University Medical Center in the Netherlands told Reuters
Health.
These migraines are likely triggered by alcohol mixed with several
other factors, he said.
"Identifying factors involved in the triggering of attacks may point
to compounds which could be avoided," he said in an email.
Onderwater and colleagues found that alcoholic drinks were reported
as a trigger by about 36 percent of survey participants. For a third
of these patients, the migraine started within three hours, and for
almost 90 percent, the migraine began within 10 hours. Patients
estimated that it took about two drinks to initiate an attack.
Still, among those who said red wine was a trigger for them, only 9
percent said it triggered a headache every time they drank it. Among
those who said vodka was a trigger, only 11 percent said it brought
on a headache every time.
"Migraineurs already have burdens and limitations regarding
different trigger factors. I always heard from my patients that they
were prohibited from consuming wine because they were migraine
sufferers," said Dr. Abouch Krymchantowski of the Headache Center in
Rio de Janeiro, Brazil, who wasn't involved in the study.
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Migraines may be triggered by certain types of red wine, including
those with more phenolic flavonoid components, he said. Combining
wine with other triggers such as menstruation, stress, heat, certain
foods, fasting or sleep deprivation may influence the migraine as
well.
"I frequently have attacks when I combine wine with sleep
deprivation, like a long-duration flight," he told Reuters Health by
email. "Combining with other triggers increases the chance of an
attack over savoring your favorite wine when you are relaxed and
well."
"I believe that many chronic pain conditions, including migraines,
can be significantly affected by lifestyle and behavior changes, and
alcohol consumption is one of many behaviors that can be adjusted,"
said Rachel Davis-Martin of the University of Massachusetts Medical
School in Worcester, who wasn't involved in the study.
Future studies could use smartphone apps and wearable biosensors for
patients to record triggers and headaches on a daily basis to better
understand how and when migraines begin, as well as the progression
of migraines over time, she said.
"Migraines can be managed with medication and lifestyle choices,
using treatment options from both physicians and health
psychologists," she said in an email. "Although chronic pain
conditions can be debilitating, there are things people can do to
help improve their overall quality of life."
SOURCE: https://bit.ly/2FwSOJ5 European Journal of Neurology, online
December 18, 2018.
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