Key takeaways
- A useful migraine log captures onset, duration, severity, associated symptoms, and what you took, not much more.
- Record headache days and days using acute medication; both help a clinician understand the pattern.
- Optional app check-ins may add context, but should never delay rest, treatment, or medical care.
- Bring a short trend summary and the underlying log to a headache-clinic visit.
If you have lived with migraine for any length of time, someone has probably told you to keep a diary. And if you have actually tried, you have probably given up on one within a few weeks. The reason is almost always the same. The forms ask for too much, the writing has to happen when you feel your worst, and by the time you sit down at a headache-clinic appointment you cannot remember whether last Tuesday was a bad four or a bad six. A good migraine log is not a research instrument. It is a habit small enough to survive a real attack, structured enough that a clinician can look at three months of it and see something, and grounded in how migraine symptoms can change before and after head pain.
What to actually log during an attack
The temptation is to record everything. Resist it. The fields that turn out to be most useful, month after month, are boring and short: the date, the time you first noticed something was off, the time the pain became the main event, how long the attack lasted, the peak severity on a simple zero to ten scale, and a short list of associated features (aura, nausea, sensitivity to light or sound, dizziness). Add what you took, when, and whether it worked. That is roughly seven fields. It is the difference between a log you keep and a log you abandon.
- Date and rough time of the earliest warning sign
- Time the headache became the dominant symptom
- Peak severity on a 0-10 scale
- Duration in hours (estimate is fine)
- Associated features (aura, nausea, photophobia, phonophobia, vertigo)
- Medication taken, dose, and time
- One or two words about how it resolved
A compact log can be filled in after the attack if writing during symptoms is too difficult. The fictional example below shows the level of detail to aim for; it is not a patient record or a treatment recommendation. Keep medication names and doses exactly as used, including over-the-counter products, so your clinician can review the number of medication days as well as headache days.
| Field | Example entry | Why it helps |
|---|---|---|
| Start and duration | Tuesday, about 8 a.m.; lasted about 11 hours | Separates one attack from the next |
| Symptoms and function | Pain 6/10; light sensitivity; missed afternoon meeting | Shows burden beyond a pain score |
| Medication | Name, dose, and time taken; whether it helped | Lets a clinician review response and medication days |
| Context | Short sleep the night before; no clear trigger | Keeps observations without assigning a cause |
The prodrome and postdrome matter more than people think
The headache phase gets all the attention, but many people can look back and notice a prodrome hours or even a day before: yawning that will not stop, a strange food craving, a mood shift, blurred thinking, sensitivity to smells. The postdrome, that day-after fog when the pain is gone but you cannot focus, is often the phase that actually costs you a workday. If you log only the peak, you miss most of the burden. A single line noting how you felt the evening before and the morning after is worth more than an elaborate pain scale.
Trigger hunting: log first, look for patterns later
Almost every migraine patient has a mental list of triggers. Almost every list is partly wrong. Triggers are notoriously hard to identify in the moment because attacks often start well before the perceived trigger, and because the prodrome can create the very craving (sugar, caffeine, alcohol) later blamed for the attack. The way to actually find your patterns is to log neutrally for two or three months and then look back. Sleep timing, menstrual cycle, work stress, weather changes, and screen-heavy days tend to be more reliable signals than any single food. A headache specialist reading your log wants to see a pattern, not a suspect.
- Prodrome
- The early phase before the headache begins, sometimes hours to a day beforehand, when subtle warning signs such as mood shifts, food cravings, yawning, or blurred thinking appear.
Short cognitive check-ins add signal a diary misses
Migraine can involve more than head pain. Some people notice visual symptoms or difficulty concentrating before or after an attack. If a person already uses a reaction and processing speed check-in, they may choose to record when it was done relative to symptoms, but an app result is not an objective measure of migraine severity or a way to predict an attack. Skip any task that worsens symptoms or gets in the way of rest, prescribed treatment, or care.
An eye-brain vision check is likewise optional and should not be used to judge whether visual symptoms are harmless. New, unusual, or persistent visual changes need medical advice. See the reaction and processing speed and eye-brain vision check pages for what those assessments do and where their limits are.
Paper, spreadsheet, or app: it barely matters
The best format is the one you will still be using in ninety days. A folded index card by the bed works. A note on the phone works. What matters is that the same fields are captured every time, so that three months of data can actually be compared. If you switch tools every few weeks, you lose the comparability, which is the whole point.
What to bring to a headache clinic
Summarize the log on one page and bring the underlying entries in case the clinician needs detail. Include headache days and days using acute medication for each month, typical duration, associated features, functional impact, what you tried, and what seemed to help. If optional app check-ins were useful, label the task and timing without presenting the trend as a diagnosis. This format gives the clinician a quick overview while preserving the record behind it.
How Alumina Health fits in
Alumina Health does not replace a headache diary and does not diagnose migraine. It provides short, guided reaction-time, processing-speed, and vision check-ins that some people may record alongside a simple log. The most useful evidence for a headache visit may still be the dates, symptoms, medication days, and effect on daily life. Bring the summary to a neurologist or headache specialist for interpretation.