Preventing light/glare-triggered migraines in winter
October 25, 2017 8:56 AM   Subscribe

The clocks are changing soon in the UK and this is peak migraine season for me - looking for ways to reduce the impact of light and glare inside, and while driving, when it's dark outside.

I've had migraines since my early 20s (about five years now). The main triggers are bright light/glare, especially from overhead lighting, and neck posture. Low blood sugar makes them worse but isn't a trigger on its own. I don't have any other known triggers.

The neck posture stuff is super avoidable (I just don't hold my neck like that at all if I can help it, and try to turn up to events/meetings where I'll need to sit in a certain position early enough that I can get a seat that I know will work for this) but I have a lot more trouble with light triggers. The absolute worst is in winter, when it starts getting dark outside early but it's still really brightly lit in the office.

The typical pattern is that I start feeling tense and uncomfortable from the overhead lighting in the middle of the afternoon, with the headache coming on shortly after that and getting worse the longer I have to be in that lighting environment. I get nausea with the migraines anyway, and having to drive myself home when the headache has already begun makes this a lot worse (as do incredibly bright headlights/brake lights when it's dark). NSAIDs and weed help with pain toleration but don't completely solve the problem, and I usually end up going to bed early to sleep it off.

Most of the year I get one of these 1-2 times a month max, but during winter it's more like three times a week. I am doing well mental-health wise at the moment, but the thought of losing more than half of my weekday evenings this winter to feeling so lousy I can't really do anything but eat in the dark and then go to bed is really depressing. I need evening downtime for hobbies/leisure and resent the migraines eating into this, and they also interfere with my ability to social activities and hobbies outside of the home after work.

My eyes are very light-sensitive in general, and I prefer low/soft lighting. I can only drive without sunglasses on a handful of days during the year (mostly daytime in winter) and I tend need them when I'm outside at all nearly year-round, including on a lot of days when I'm the only person I see wearing them. I don't have any medical explanation for why this is - a previous optometrist thought it might be because of some medication I was taking, but I stopped taking it a while back and the light sensitivity is the same (or worse). I think I've been steadily getting more sensitive to light over time, but it's hard to know if this is because my level of sensitivity is actually changing, or because I've been conditioning my eyes to expect sunglasses/lower light over time.

I'm mildly short sighted with some astigmatism, but not so much so that I need to wear glasses most of the time. I've tried glasses a few times but never managed to find a prescription that felt comfortable to wear - it's always felt like forcing my eyes to focus through something unnatural, but I've not worn them enough overall to know whether this is normal or not (my mental assumption is that you're meant to put them on and they just work, but this might not be realistic or true). I do tend to do a little better migraine-wise if I wear my glasses in the late afternoon and on the drive home, but it's not totally preventative.

I can't change a lot about my work environment, unfortunately. Our building management have already taken out the light directly above my desk, but when it's dark outside I'd realistically need nearest six or seven light banks disabled to be comfortable, which would leave the ~10 or so people who sit near me in the dark (and I have other colleagues nearby who get headaches triggered by too-low lighting). We have no private offices (even the CEO sits open plan) and no meeting rooms without harsh overhead lighting. I need to sit roughly where I do now to be able to do my job effectively.

I also can't change the fact that I need to drive myself home at the end of every day - I'm the only person in my household who drives, I live too far away to walk or cycle, and there isn't reliable public transport from where I work to where I live. I don't believe any colleagues live nearby whom I could carpool with, and generally the sickness gets worse when someone else is driving - at least when I drive myself I can anticipate the car's motion a bit better.

My boss is willing to work with me to try and reduce the frequency of the migraines this year. Ideas we've had so far include the company paying for tinted glasses which are meant to specifically filter out fluorescent light (but these only seem to work for some people and have to be shipped from the US - if anyone has experience of using them or any other type of tint I would love to hear about that), and changing up my work schedule so that I can leave before the light change has a big impact and then picking up some work from home in the evening. I'm slightly less confident about being able to make this work as I'm busier than expected at the moment, working on a lot of complex streams of stuff in parallel, a lot of which involves face to face interaction with other people. I also suck at being assertive and prioritising my own needs and health, at least in part because of family of origin trauma, and I can already hear myself in my head agreeing to stay later even when it's not in my best interests just because someone asked me to and I felt too awkward and anxious to say no. I also hate needing accommodations in any way and on some level don't feel like I deserve any kind of special treatment. And I have anxiety about wearing weird glasses around the office and having people comment on them.

Things I have not tried include talking to an actual doctor or optometrist about this problem specifically - I've brought it up in the past and always answered yes when asked if I get migraines, but never presented them as a primary issue or tried any medication. This is at least partly because they're hardly a problem at all until the 2-3 months a year when they're suddenly a big problem, and the past few winters I've been too depressed to actively pursue treatment during the time of year when they get really bad. I am willing to do this and not trying to use this question instead of seeking medical advice, but I'm not clear on which of those two professionals (GP vs optometrist) would be better to see. I also don't know how to get an optometrist appointment in the UK without also booking a sight test - I'd prefer a consultation where I can raise this as an issue and discuss it, but the model here seems to be you book a sight test by default and that's the only way to see an eye doctor.

I would love to use glare-reducing glasses for driving at night, because the brake lights/super-bright-xenon-headlights-everyone-has-now are a big issue, but after doing some research the consensus seems to be that they're dangerous to wear while driving at night as they stop you from seeing stuff you need to be able to to drive safely.

So: if you also experience this problem, what's worked for you? I'm interested in prevention or cure. Glasses, medicine, lifestyle changes, anything else? I can't face losing another year's worth of winter evenings to feeling terrible, sitting in the dark and then going to bed at 8pm.
posted by terretu to Health & Fitness (22 answers total) 3 users marked this as a favorite
My only real recommendation is for the afternoon indoor lighting - buy yourself a pair of super-cheap glasses on line, with plano lenses, tinted medium, with anti-glare coating. There are glasses out there that claim to be specifically for migraine relief, I don't know how bullshit those are. There is apparently some discussion online on what colors might be best for your tint.

I think if you book a sight test, that's your consultation. I always have these conversations with my eye doctor at my routine appointments. I think it'll be okay and you'll get what you need as far as discussion, and also fresh results of testing your doctor can be looking at, as part of your conversation.
posted by Lyn Never at 9:07 AM on October 25, 2017

I would go to a GP and get migraine medication – it could help you, and there’s little harm in trying it. Something that has helped my migraines is changing my diet to be more migraine friendly – no chocolate, no alcohol, no caffeine, fewer processed foods in general. Here’s a site explaining the list. I haven’t had a migraine since I started eating this way, and I used to have them frequently.
posted by tooloudinhere at 9:14 AM on October 25, 2017

I've got similarly overhead-light-triggered migraines, and you've done most of what I do with the exception of consulting your GP and optometrist. You might want to see the optometrist for an exam first so that you'll know whether you need prescription eyeglasses. Your GP's likely to ask if you've had a recent eye exam, since there's not much point trying medication before confirming that your eyes aren't the problem.

Another thing that your GP may ask you to try is keeping a headache diary - duration, intensity, time of day, what you've been doing or eating. You can probably speed things up by starting that now and bringing it with you to your appointment. It could be that there's something simple you can change that would help, but if not, there are preventative drugs you can take that may help a lot.
posted by asperity at 9:22 AM on October 25, 2017

Please do talk to your GP now about the migraines and what kind of solutions they might have for you so you can get ahead of them this winter.

Random thoughts - for me, my sinuses and my migraines are tied together and winter is hard on your sinuses. Can you run a humidifier at home / do a saline rinse at work and see if this helps?

Can you wear a hat with a brim at work? I have a cap I wear sometimes when the glare from my overhead lights is getting to me.

I take a very low dose of topiramate (Topomax) every night as a preventative, and sumatriptan (Imitrex) when I do get a migraine. The sumatriptan comes in 100 mg doses but I have been trying splitting pills into smaller doses to see if I can still get relief while having fewer side effects.
posted by Squeak Attack at 9:32 AM on October 25, 2017 [1 favorite]

My fiance's family has terrible migraines from glare and movement and stuff, and what worked for everyone in their family was Lasik. They wanted someone "good" so they paid $4,000 USD for it. Just do your research and I'm sure you'll be fine, but the quality of life improvement for them was way more than $4 grand.
posted by bbqturtle at 9:35 AM on October 25, 2017

I have just gone through the same kind of week - migraine after migraine. I use dark sunglasses this time of year inside and out. I take verapamil daily as a preventive medication and Maxalt at fist sign of headache. For me that's loss of vision. I also have zofran and Percocet if two Maxalt fail to stop it. I can usually stop the headache with one Maxalt but cannot always stop the light , sound, and smell sensitivities, nausea, and general loopyness that occur.

There are so many treatment options today that you should go see your PCP. Glasses by themselves are not going to stop the headache but they have medications today that help most people.
posted by cairnoflore at 9:43 AM on October 25, 2017

Nthing going to your GP and getting medication - migraine meds are qualitatively different than OTC pain relievers and you are suffering needlessly. They can be life-changing and you take them at the first sign of migraine so you will skip all the nasty afternoon feelings as well as the headache itself.
posted by tatiana wishbone at 9:54 AM on October 25, 2017 [1 favorite]

I have four ideas:

1) Take frequent eye breaks. Set a timer for, say, 25 minutes (the time recommended for the time-management Pomodoro technique, just an example), and after that time's up, spend 2-5 minutes (maybe use another timer) with your eyes closed. Think about your work, focus, talk on the phone -- don't sleep, just rest your eyes. Maybe make a sign about it and/or tell your coworkers what you're doing so they know you're not sleeping.

2) Move desks so you are in a location where you can control the lighting more. Maybe facing into a corner, or in a little alcove, or near other people who would enjoy low lighting.

3) Magnesium/electrolytes - I'm not sure if this will help, but it helps me. Get an OTC electrolyte supplement and try that.

4) Remove other sources of eyestrain (I doubt this will help, but putting it out there just in case). Make sure your monitor isn't too close or too far, increase the type size in your operating system, get a stand to hold papers as you read them, take breaks where you look at things far away, learn some eye exercises.
posted by amtho at 10:03 AM on October 25, 2017

I bought Axon glasses and they changed my life. They're tinted to block out the specific part of the spectrum that triggers some people. I thought they wouldn't work foe me because they talk about flourescent light a lot in the explanations and I'm mainly triggered by glare but they're still great. I can go outside in summer now!

If it actually is flourescent light that bothers you, these would probably work even better for you. Because it is outdoor light that bothers me, I got an "outdoor" pair and an "outdoor, extra dark polarized." Note that extra dark and polarized were options they used to mention calling about. No longer mentioned, but I bet you could call and see if they'll do it if you want that. But for computer use you probably don't want polarized.

Anyway, you should order these right now. I have no relationship with this company beyond being a customer and loyal lover of their product.
posted by If only I had a penguin... at 10:06 AM on October 25, 2017 [1 favorite]

I am not sure if my migraines are light-triggered or not, it's hard to pin down, but my GP recommended that I take a multivitamin with increased levels of magnesium and B2 in it. I was having migraine headaches 3-4 days out of the week, started taking the multivitamin and I can go a month maybe having just 1-2 now. It is MUCH better than it was. It's the only thing I take since prescription medication made me really sick.

This is the one that I take:

Headache Free on Amazon
posted by fairlynearlyready at 10:46 AM on October 25, 2017

I feel like tinted glasses aren't really going to help with overhead office lighting because there's still like an inch of space between your eyeballs and the glasses for the nasty fluorescent glare to creep in. My halfassed solution to this problem was huddling in hoodies outside my office and not having any overhead lights in my own private office, and then infrequently leaving that windowless cave. Otherwise you could try wearing a dorky plastic visor like an old-timey accountant.

Really though the main reason that your pain meds are not taking care of the problem is that they're not migraine-specific pain meds. Triptans will, for most people, take care of the non-pain symptoms of migraines, like nausea, photosensitivity, noise sensitivity, overpowering smells, aura, etc. I have severe chronic intractable migraines which means that sometimes there isn't even a headache, I just can't be in any source of light at all, and this can last for days if I don't take an imitrex. The point of imitrex is that you take it AS SOON AS the light starts bothering you, without even waiting for it to trigger the migraine.
posted by poffin boffin at 11:23 AM on October 25, 2017

I was going to suggest Axon glasses as well, but If I only had a penguin beat me to it. I haven't tried them myself yet -- but I'd like to. I definitely would've taken the plunge by now, if light were the predominate trigger for me.

I want to let poffin boffin know that Axon has thought of the problem of blocking out overhead lights! They have a wrap around frame for that, that can be worn around your normal glasses, if you like!
posted by vitabellosi at 11:46 AM on October 25, 2017

I would agree to see your GP and an optometrist soon. While you may get an eye exam too, that would probably be recommended by your GP anyway, especially if it's been more than two years since your last. Getting glare-reducing glasses might help and getting adequate medication will definitely help. You might also investigate getting transitional lenses (I think that's what they're called) that adjust into various shades of sunglasses to reduce brightness depending on the setting.

One thing I didn't see mentioned is adjusting the settings on your computer monitor to be dimmer, darker, etc., and using an add-on like Flux, which gets rid of certain wavelengths to reduce eyestrain. You can also put Flux on your home computer and your phone. This has helped me and my migraines tremendously.
posted by stillmoving at 12:13 PM on October 25, 2017

Subjectively, glasses from Axon Optics have helped me a lot. I also wear them outside on overcast days when the sky is a bright grey.

On my iOS devices, I adjust the white point and sometimes apply color filters (in the Accessibility settings). On my computer, I often use f.lux.

(On a side note: yes to taking migraine-specific painkillers, but medication overuse headaches are no fun either. I have found that different doctors give very different advice on what constitutes overuse of triptans, for example.)
posted by wavelette at 12:33 PM on October 25, 2017

feel like tinted glasses aren't really going to help with overhead office lighting because there's still like an inch of space between your eyeballs and the glasses for the nasty fluorescent glare to creep in

Not a problem. Mine have a little rubber gasket to seal space between glasses and eye. Not a big giant thing like swim googles, but just a little strip of rubber. You can make out the gasket a little in the picture here.
posted by If only I had a penguin... at 1:03 PM on October 25, 2017

One thing that no one has mentioned so far is flickering light as a trigger. Both your computer monitor and fluorescent lights can flicker in a was that is imperceptible to the naked eye, but triggering on a neurological level. I think you should skip the GP and head right to a headache specialist.
posted by PorcineWithMe at 1:06 PM on October 25, 2017 [1 favorite]

If a brim would help block the overhead lights you can't have removed, I found this to be the least obtrusive and most comfortable visor for office wear.
posted by asperity at 1:55 PM on October 25, 2017

About wearing glasses for slight astigmatism, for whatever distance correction or none at all, it absolutely makes a difference. And no, it is not an instant adjustment, plug and play kind of thing. You have to wear the glasses all the time, and it will take a few days to get used to them (at least). Your eyes have to relax into wearing them.

I only have about 1 or 1.25 correction for astigmatism in each eye. But without my glasses, I see double on each side. On different axis on each one. It is really hard on the eye muscles, and more work for my brain, to keep things in focus when I don't wear my glasses. I have signifigantly fewer headaches than I did before I wore my glasses all the time. Also, prescription sunglasses for outdoors and driving.

I hope that you get things sorted out for fewer migraine problems. Migraines are miserable. Whatever works to reduce triggering is good, unless it makes other stuff worse. Keep trying, it is hard but worth it.
posted by monopas at 2:57 PM on October 25, 2017

Seconding magnesium and riboflavin (vitamin B2). I was getting migraines every second or third day for a couple weeks, and they ceased after I spent a few days supplementing with 600 mg magnesium and 400 mg riboflavin daily. I stopped taking the supplements shortly after the migraines stopped and they have not recurred.

My doctor also recommended butterbur 50-75 mg twice a day but I didn’t take it so I can’t personally vouch for it.

I was skeptical when my doctor recommended supplements to manage the migraines but I was very pleased with the results. Best of luck.
posted by delight at 2:58 PM on October 25, 2017

This is the style of cap I wear at work but your workplace chillness may vary.
posted by Squeak Attack at 3:30 PM on October 25, 2017

Thirding magnesium and riboflavin supplements: I started this about six months ago, and the number of days I have lost to migraine issues has gone way down.

Second, besides the glasses, it's possible to get filters that go between fluroescent lights and the room, that cut some of the wavelengths that are a problem. Not all building/facilities people know about them, but they're used in a variety of spaces (my office uses them because we work with historical materials, and the filtering is also better for the materials.)

I was having significant migraine issues in a previous job after moving work locations, and then moved to my current job which has them, and discovered a major difference in how I reacted to the light. (I also have noise triggers, and current job has a lot less of those, but I definitely notice the light is not as much of a problem.
posted by modernhypatia at 5:43 AM on October 26, 2017

I have the same issues with glare and light contrast conditions and i have been prescribed the anti migraine tinted lenses by Boots opticians. I think they are an extra £70 on top of the cost of your glasses. I havent tried them yet but they are available here in the uk. Good luck!
posted by RandomInconsistencies at 1:32 PM on October 26, 2017

« Older 2.5 Actual Days in Vegas   |   Was Crazy Scientist Hair Normal At One Time? Newer »
This thread is closed to new comments.