Is There a Link Between Sneezing and Migraines?

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If you have migraines and you also have frequent sneezing and congestion, you may be surprised to know that there's a potential connection between your head pain and your sniffles. Migraines are more common in people who have allergies and/or rhinitis, a health condition that causes nasal symptoms like sneezing and congestion, though experts aren't exactly sure how the two are connected.

Similarities

Rhinitis, particularly allergic rhinitis/allergies, and migraine have quite a few things in common.

  • They're both very common conditions.
  • They can significantly decrease your productivity, as well as your quality of life, thanks to fatigue, head pain, brain fog, and difficulty sleeping, especially when you have both conditions.
  • They affect the same areas of the body, i.e., eyes, forehead, nose, and face.
  • They have similar triggers, such as weather changes, strong smells, allergens, and smoke.
  • They both get worse during the seasons when allergies are at their peak due to allergic triggers.

Shared Symptoms

Symptoms that allergies, rhinitis, and migraine have in common include:

  • Nasal congestion
  • Watery eyes
  • Runny nose
  • Pain or pressure behind the eyes
  • Pain that gets worse when you bend forward

How and when you experience symptoms of rhinitis, however, depend on the type that you have.

Rhinitis Types

Rhinitis is a medical condition that causes inflammation in the lining of your nasal cavity, resulting in nasal symptoms. Almost everyone experiences it at some point, but some people deal with it seasonally or chronically.

There are a number of types of rhinitis. The most common ones include:

  • Allergic rhinitis: Also known as hay fever, this type of rhinitis occurs when your immune system reacts to certain airborne substances the same way it would to a virus or bacteria, causing an allergic reaction. Typical triggers include trees grass, pollen, mold, house dust mites, and pets, and allergic rhinitis may be seasonal or perennial (year-round).
  • Nonallergic rhinitis: Nasal congestion and postnasal drip are the main symptoms of this type of rhinitis, which is not related to allergies. Typical triggers include certain medications, smoke, weather changes, and strong fragrances, like car exhaust, cleaning products, or perfume. There are a variety of forms of nonallergic rhinitis.
  • Mixed rhinitis: This is the most common type of rhinitis in adults and includes both allergic and nonallergic rhinitis. However, it's usually diagnosed simply as allergic rhinitis since there isn't a diagnostic code in the United States for mixed rhinitis.

The term allergic rhinitis is often used interchangeably with the term allergies since most types of allergies involve allergic rhinitis.

Co-Occurrence

Multiple studies have found that migraine is more common in people who have rhinitis and/or allergies. For example, a 2014 study in Cephalalgia examined the potential link between migraines and rhinitis. In the study, a questionnaire was mailed to approximately 18,000 individuals. Of the 6,000 respondents who were identified as having migraines, 67 percent also had rhinitis.

The questionnaire also inquired about the number of migraines participants had per month, as well as how much their migraines affected them, as assessed by the Migraine Disability Assessment Scale (MIDAS).

Results showed that migraine attacks were 14 percent to 28 percent more frequent in those with migraine and rhinitis than in participants with migraine alone. People who had mixed rhinitis (both allergic and nonallergic) were the most likely to experience an increased frequency of migraines and have more disabling migraines than those without rhinitis.

A 2016 review of existing studies on allergic rhinitis and migraine also found data that supports the theory that people who have both conditions tend to have more severe migraines more frequently.

The Role of Sinusitis

Since sinusitis (inflammation of your sinus cavities) can cause headaches, and because rhinitis often causes symptoms of sinusitis, it's important to understand the role of sinusitis in this whole picture as well. Rhinitis is linked intimately with sinusitis for the following reasons:

  • The nose and sinuses are all essentially one passageway.
  • Having rhinitis often leads to developing sinusitis.
  • Having sinusitis commonly causes nasal symptoms.

The term rhinosinusitis is used interchangeably with sinusitis, but some experts prefer the former to the latter since sinusitis rarely occurs without rhinitis.

It's important to note that, too often, a headache in a patient with rhinitis is misdiagnosed as a sinus headache when it's really a migraine. In fact, multiple studies have found that the majority of sinus headaches are actually migraines. Unfortunately, many of these migraines are still treated as sinus infections, so treatment may not be effective in relieving your head pain.

The fact that rhinitis and migraine so often occur together suggests that doctors caring for patients with rhinitis and/or sinusitis should consider the possibility of migraine. Conversely, doctors treating migraine patients should consider whether rhinitis and/or sinusitis is causing or contributing to migraines, especially in cases where allergies seem to be present.

Theories About the Link

The scientific basis for the relationship between rhinitis, allergies, and migraine is not clear. Do migraines trigger or worsen symptoms of rhinitis and/or allergies or vice versa? No one really knows, but here are a few of the theories.

Trigeminal Nerve Activation

One hypothesis involves the trigeminal nerve, a large cranial nerve with endings in the face that supply sensation and some motor or movement function. Rhinitis-associated inflammation and swelling in the nose, as well as allergens, may stimulate trigeminal nerve endings, causing pain signals to be sent to the brain, which may then trigger a migraine.

Histamine

Other experts suspect that the release of chemicals from local immune system/inflammatory cells in allergic rhinitis may trigger migraine development in certain people. For example, when you have an allergic reaction, your body releases histamine, which can cause the blood vessels in your brain to constrict, resulting in or worsening a migraine.

Inflammation

These conditions involve inflammatory processes, which may help explain why they often occur together.

Overall, more studies are needed to better understand this link.

Remember: A link implies a possible relationship or association. It doesn't mean that one medical condition directly causes another. That said, there is clearly the potential for the coexistence of both rhinitis and/or allergies with migraines, especially in people who have both head pain and frequent sneezing or runny noses.

Treatment

Because rhinitis and/or allergies can make migraines worse, treating them may decrease the number of migraines you have and improve your quality of life, and it should be your main area of focus. You may want to consider seeing an allergist or an ear, nose, and throat doctor (otolaryngologist, or ENT) who can do tests to find out exactly what you're allergic to.

Medications

For allergic rhinitis, treatments like over-the-counter nasal sprays and antihistamines might be all you need. But if your allergies are more severe, you may need prescription medications like nasal steroids. Allergy shots might also be a good option for you.

Treating nonallergic rhinitis usually involves prescription nasal sprays. Your doctor may also recommend over-the-counter decongestants and saline nasal sprays.

Avoidance of Triggers

Both rhinitis and migraine involve your body's response to triggers, so avoiding whatever sets off each condition as much as possible can make a difference too. If you're not sure what your migraine triggers are, try keeping a migraine diary for a few weeks to see if you notice any patterns such as lack of sleep, certain foods, weather changes, or stress.

If you find that treating your allergies and/or rhinitis doesn't improve your migraines, talk to your doctor about the possibility of using preventive medications to help reduce the frequency of your migraines.

A Word From Verywell

If you have migraines and rhinitis and/or allergies, discuss your symptoms with your doctor. Effectively treating your rhinitis and/or allergies may be another tool you can use to help improve the severity and/or the number of migraines you have. Additionally, what you may be self-diagnosing as a sinus headache may, in fact, be a migraine. Since the treatment is different for a sinus headache than for a migraine, it's important to get the proper diagnosis.

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