Geographic Location May Affect Factors Serving as Triggers of Migraine

Geographic location and ethnicity may affect the nature of factors that act as triggers of migraine and tension-type headache (TTHs), according to a review published in Current Pain and Headache Reports.

Malaysian researchers reviewed the published medical literature that reported on trigger factors of TTHs across Asia and identified the most common triggers, as well as variations across populations.

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Sleep deprivation, stress, and weather changes were the most common triggers of TTHs and migraines in the included studies. Individuals with vs without migraine may have higher sensitivity and greater difficulty adapting to enhanced levels of sensitivity. Primary headaches in women vs men have a greater likelihood of being triggered by stress and odors. Sleep deprivation may be associated with migraine to a greater extent in women vs men, although supporting evidence is conflicting. Sleep deprivation may be more commonly reported by women vs men with TTH. Odors and noise were found to be a more common trigger for headache in chronic vs episodic migraine. The type of climate was also found to affect trigger factors. Sunlight, particularly in the tropical regions of Asia, was a frequent trigger factor, with 47% of patients in Malaysia with primary headache reporting sunlight as triggering their headache.

Study limitations include the lack of a pooled statistical meta-analysis, which may limit its clinical usefulness.

“More research…on trigger factors…will enable proper identification of trigger factors, leading to a reduction in the number of headache episodes and an improvement in quality of life for patients,” the researchers concluded.


Tai MS, Yet SXE, Lim TC, Pow ZY, Goh CB. Geographical differences in trigger factors of tension-type headaches and migraines. Curr Pain Headache Rep. 2019;23(2):12.

This article originally appeared on Clinical Pain Advisor