Migraine diary template: what to write down, with a filled example

Why these nine fields

The American Migraine Foundation (AMF) says a migraine diary should document your symptoms, triggers and medications, and that putting them in one place gives your doctor a complete overview and helps decide on a treatment plan. It also suggests describing pain on a 0 to 10 scale and with words such as throbbing or pounding, so the fields above follow that advice.

The NHS lists the usual signs of an attack: a throbbing headache, often on one side, nausea or vomiting, and sensitivity to light and sound. It says aura, such as zigzag lines, flashing lights, numbness or difficulty speaking, should not last longer than an hour. The NHS adds that attacks usually last between 4 hours and 3 days, so an end time and any hour of aura are worth recording.

A one-line row you can copy

Copy this line into a spreadsheet as column headings, or into a notes app as a template, and fill it in after each attack. These formats are our own suggestion.

• Attack row: Date | Start | End | Pain 0-10 | Location and type | Symptoms | Aura | Context | Medicine and time | Effect and impact
• Good-day row, optional: Date | Sleep hours | Meals | Water | Stress 0-10 | Medicine taken

A filled example

These two rows are made up to show the level of detail. They are not advice.

• Tue Oct 6 | 7:40 am | 2:00 pm | 7 | Left temple, throbbing | Nausea, light hurts | No | Slept 5 h, skipped breakfast, cloudy | Pain reliever at 8:00 am | Pain 4 by 10:00 am, missed work
• Sat Oct 10 | 4:15 pm | 6:30 pm | 3 | Both sides, pressing | None | No | Long drive, little water | None | Went away after a walk and a glass of water

What to skip

AMF says updating a journal should not feel overwhelming, and that you may only log on days with a headache or other symptoms. If a field is a chore, drop it and ask your doctor which details help. Our advice is to keep the five fields that never change (date, start, end, pain, medicine) and add the others only when you can.

Do not write down guesses about causes as facts. A food on the list is a possible trigger, and the diary only helps you see whether the pattern repeats. Our triggers guide explains how to read one without mistaking coincidence for cause, and the NHS says a diary can help you work out what might trigger your attacks.

Bring it to your appointment

AMF's guide to talking to your doctor suggests bringing your migraine diary, a list of medications or treatments you have tried and how each worked, any test results, and what you know of your family history. A few weeks of rows are more useful than a memory of the worst day.

A spreadsheet, a printout or a phone all work, and AMF notes that some people hand over the phone with their log open. Our advice is to open with a summary: how many attacks you had, how long they lasted and what you took.

When to get help

The NHS says to see a doctor if your attacks are severe, getting worse or lasting longer than usual, if you have them more than once a week, if you find them hard to control or if they come before or during your period. Ask for an urgent appointment if an attack lasts longer than 72 hours, aura lasts longer than an hour or you are pregnant or just had a baby. The NHS also advises trying not to take painkillers on more than 2 days a week, because that can cause more headaches, and the medicine column of your diary shows how close you are to that line. This is general information; ask your doctor what is right for you.

Call emergency services right away, says the NHS, for a headache that comes on suddenly and is extremely painful, problems speaking or remembering, loss of vision or double vision, drowsiness or confusion, a seizure, a high temperature with signs of meningitis, weakness on one side of the body or a recent head injury. The NHS number in the UK is 999; in the United States call 911.