4 Ways to Take Control and Reverse Your Chronic Migraines

There are a number of factors that could progressively increase the frequency of migraines from episodic (fewer than 15 per month) to chronic (15 or more per month). Medication overuse is a major one, but other culprits can include obesity, depression, excessive caffeine use, snoring, and sleep disorders.

For many people, progression to chronic migraine is triggered by more than just one of these factors. While challenging to determine the exact cause, evidence suggests that sticking to four healthy habits could help reduce migraine frequency to be episodic rather than chronic.

ways to reverse chronic migraine

Verywell / Emily Roberts

Implement Good Sleep Hygiene

Interestingly, the vast majority of people with migraines also deal with insomnia, a risk factor associated with the likelihood of progressing from episodic migraines to chronic. Because of this close connection between sleep and migraines, research is continuously being done on the relationship between the two.

Behavioral Sleep Modification

Changing your sleeping behaviors and habits can help keep the frequency of your migraines in check. The American Migraine Foundation recommends the following behavior modifications:

  • Going to bed at the same time and getting at least eight hours of sleep each night
  • No television, reading, computers, phones, or music in bed
  • No naps
  • Use of a visualization techniques to help get to sleep faster
  • Moving dinner to four or more hours before bedtime and limiting fluid intake within two hours of bedtime

Try Cognitive Behavioral Therapy for Insomnia

Cognitive behavioral therapy for insomnia (CBTI) is a short, structured, and evidence-based approach to combating the symptoms of insomnia. CGTI is considered a first-line approach for insomnia, meaning it should be tried prior to introducing other treatments.

CBTI usually consists of a combination of these components:

  • Cognitive therapy: Attempts to change inaccurate or unhelpful thoughts about sleep
  • Behavioral therapy: Relaxation training, stimulus control, and sleep restriction to promote relaxation and help to establish healthy sleep habits
  • Psychoeducational therapy: Learning about the connection between thoughts, feelings, behaviors, and sleep

Multiple studies show that an average of 70% to 80% of people who undergo CBTI have decreased insomnia and report sleeping better, with about 40% to 60% of these patients still experiencing these results long-term.

Talk to Your Healthcare Provider About Sleep Problems

Treatment for an underlying sleep disorder may make all the difference in the frequency and severity of your migraines.

Talk to your healthcare provider about getting diagnosed, and consider finding a sleep specialist who uses CBTI. Even implementing behavioral sleep modifications on your own and working to improve your sleep hygiene may have a significant impact.

Take Your Migraine Preventive Medications

Preventive migraine medications play an important role in treatment. Between 50% and 75% of patients who use them see the number of their migraines reduced by half.

There are several options that have been proven to be effective, including:

  • Anticonvulsants: Topamax (topiramate) and Depakote (valproate)
  • Antidepressants: Elavil (amitriptyline) and Effexor (venlafaxine)
  • Beta blockers: Lopressor (metoprolol), Inderal (propranolol), Tenormin (atenolol), Corgard (nadolol) and timolol

Newer medication options include:

  • Calcitonin gene-related peptide (cGRP) antagonists: Aimovig (erenumab-aooe), Ajovy (fremanezumab-vfrm), Nurtec ODT (rimegepant), Emgality (galcanezumab-gnlm), and Zavzpret (zavegepant)
  • Neurontin (gabapentin), an anticonvulsant
  • Botox (onabotulinumtoxin A), but only for chronic migraine

It is important to be patient with the medication process and to be communicative with your healthcare provider about any side effects you are experiencing. Finding the right preventive medication can be tricky and you may end up trying several different types before finding the best one for you.

Stop Overusing Your Migraine Medications

Overusing your pain-relieving migraine medications for acute migraines—whether it's a prescription medication like a triptan or an over-the-counter medication like a nonsteroidal anti-inflammatory drug (NSAID)—is a common trigger for the development of chronic migraine.

In addition, when you overuse pain-relieving medications, this can render your migraine preventive medications ineffective.

Stopping a medication you've used too much can eliminate your headaches and reverse your chronic migraines. But again, only do this under the guidance of your healthcare provider.

Important Warning

While most medications can be stopped immediately, be sure to talk with your healthcare provider if your medication contains butalbital compounds or if you're taking large amounts of an opioid, as these medications need to be stopped gradually under the guidance of a healthcare provider.

Get Regular Exercise

Exercising may feel like the last thing you want to do when it comes to managing migraines, but evidence does suggest getting enough aerobic movement can help play a role in preventing migraines.

The link between exercise and migraines lies in how your brain responds to movement. Aerobic exercise can reduce the intensity of pain you feel during a migraine by changing the way the pain is processed and by activating reward centers in your brain. It can also lessen the frequency of your migraines. This is especially good news if you can't take preventive medications.

An additional bonus is that, since obesity is considered a risk factor in the transformation from episodic to chronic migraine, regular aerobic exercise can help keep your weight under control. As a preventive treatment, exercise is also a great option because there are no side effects and it doesn't need to be too costly.

Aerobic exercise has also been shown to improve your overall quality of life, as well as help with other conditions that tend to be comorbid with migraine, including:

  • Insomnia, sleep apnea, and other sleep disorders: Regular exercise regulates your sleep, helping you snooze more soundly.
  • High blood pressure: Exercise can reduce your blood pressure and help your heart function more efficiently.
  • Depression and/or anxiety: The rush of feel-good endorphins you get from exercise boosts your mood and helps to keep it balanced.

Choose Exercise You Enjoy

Remember, exercise doesn't necessarily mean going to the gym—walking briskly with a friend, swimming, Zumba class, biking, hiking, or joining a competitive sports league are all great choices for aerobic exercise. Choose an activity that you enjoy so you'll stick with it and make it a part of your daily routine.

A Word From Verywell

It feels good to take an active stance in your migraine health. Start by making a list, asking your partner to help motivate you, and devising a concrete plan with your healthcare provider. Using these modifications, it is possible to reverse your migraines. Though it can take a lot of work and you may have ups and downs, the ups (no migraine days) will make it all worthwhile. You just might feel like you've gotten your life back.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Migraine Foundation. Understanding chronic migraine.

  2. Smitherman TA, Walters AB, Davis RE, et al. Randomized Controlled Pilot Trial of Behavioral Insomnia Treatment for Chronic Migraine With Comorbid Insomnia. Headache. 2016 Feb;56(2):276-91. doi: 10.1111/head.12760.

  3. American Migraine Foundation. Sleep, Insomnia and Migraine.

  4. The Sleep Foundation. Cognitive Behavioral Therapy for Insomnia.

  5. Anderson KN. Insomnia and cognitive behavioural therapy-how to assess your patient and why it should be a standard part of care. J Thorac Dis. 2018 Jan;10(Suppl 1):S94-S102. doi: 10.21037/jtd.2018.01.35.

  6. UptoDate. Acute treatment of migraine in adults.

  7. Amin FM, Aristeidou S, Baraldi C, et al. The association between migraine and physical exercise. J Headache Pain. 2018 Sep 10;19(1):83. doi: 10.1186/s10194-018-0902-y.

Additional Reading

By Colleen Doherty, MD
 Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis.