Migraine is a very common neurological disease. It affects one billion people in the world. Recent studies show 40% of Americans with migraine are either undiagnosed or misdiagnosed with another condition.
Many people with migraine are at risk for other chronic illnesses. People with asthma and allergies are more likely to have migraine disease.
- Migraine can make asthma more likely by 54%.
- Asthma can also make migraine more likely by 45%.
- About 37% of people with allergies get migraine attacks. Only 5% of people without allergies get migraines.
If you live with migraine, asthma, or allergies, talk to a healthcare professional for help.
What is Migraine?
Migraine is a disabling neurological disease. It can cause many different symptoms. The most well-known symptom is severe headaches, which can last for hours or days.
People can experience migraine attacks once a year or every day. When migraine attacks occur 1-14 times a month, it is called episodic migraine. Chronic migraine is when attacks occur 15 or more times a month.
Migraine is often under-diagnosed. Finding healthcare professionals willing to tackle this complex disease can be difficult.
What are the Symptoms of Migraine?
The symptoms, severity, and attack frequency of migraine are different for each person. Typical symptoms may include:
- Severe, throbbing pain, usually on one side of the head and/or face
- Sensitivity to light, sound, smell, or movement
- Nausea or vomiting
- Fatigue
- Difficulty thinking clearly
Who is at Risk for Migraine, Asthma and Allergies?
If you have migraine, asthma or allergies, you may have a greater chance of developing the other illnesses.
- People with asthma are at an increased risk of developing chronic migraine.
- Children with one or more allergic diseases are at a greater risk of developing migraine.
- Children are at a higher risk of developing asthma when their parents have a history of migraine.
In addition, women are three times more likely to have migraines than men.
A recent study found people with occasional migraine headaches may be at greater risk of chronic migraines if they also have asthma. Researchers found people diagnosed with asthma were more than twice as likely to progress to chronic migraine compared to those without asthma. Further, the risk of worsening migraine increased with more severe asthma symptoms.
Can You Have Asthma, Allergies and Migraines?
Yes, it is possible to have all three disorders. It’s important to speak with a healthcare professional to be evaluated and develop a management plan. Healthcare professionals who can treat each of these conditions include:
- primary care provider
- neurologist
- headache specialist
- pulmonologist
- otolaryngologist
- allergist
- other specialist
What Causes Migraine, Asthma, and Allergies?
Even though each disorder is different, migraine, asthma and allergies are caused by over-reactivity. In migraine, the nervous system becomes hyperactive. In asthma and allergies, this happens in the respiratory system. All of this results in inflammation. It’s caused by:
- parasympathetic hyperactivity
- elevated neuropeptides
- atopy
Parasympathetic Hyperactivity
The parasympathetic nervous system is designed to relax the body. However, when someone is exposed to an allergen, inflammation disrupts this process. As a result, certain blood vessels and nerves become activated. This can cause an asthma or migraine attack, or it can make seasonal allergies worse.
Elevated Neuropeptides
When your body encounters an irritant, certain nerves release chemical messengers called neuropeptides.
If you have asthma or allergies, this can make your symptoms worse. If you have migraine, this can cause a migraine attack.
Atopy
Atopy is when the immune system is more sensitive to allergic triggers. When children have migraine, it’s more likely that they also have atopy. This can lead to more frequent migraine attacks. It can also lead to allergic rhinitis and allergic asthma. Allergic asthma is asthma that is caused by contact with an allergen.
How Does the Environment Influence Migraine, Allergy, and Asthma?
Environmental and health factors can cause or worsen migraine, allergy, and asthma. These factors include:
- Long-term exposure to air pollutants
- Smoking
- Obesity
- Stress
- Poor sleep
What Role Do Genetics Play in Migraine, Asthma and Allergies?
Both migraine and asthma are believed to be influenced by changes in DNA. In migraine, these changes occur on trigeminal nerves in the face. In asthma, these changes are found on sensory nerves in the lungs.
Allergies likely have a genetic link as well. Many people with allergies have a family history of the condition.
Can Asthma or Allergies Cause Migraine?
Asthma and allergies do not cause migraine. However, the body’s reaction to inflammation, histamine, and allergens can trigger a migraine attack. Nasal congestion and swelling can induce migraine pain.
People with asthma and allergies may have problems with sleep. Too little sleep, too much sleep, or inconsistent sleep patterns can trigger a migraine attack.
Can Asthma or Allergy Medication Trigger Migraine?
Headache is a potential side effect when using certain asthma inhalers and allergy medications. Headaches may actually be, or progress to, migraine attacks.
Albuterol, a short-acting beta-agonist (SABA), and salmeterol, a long-acting beta-agonist (LABA), list headache as a potential side effect. Both are common asthma inhalers.
Corticosteroid nasal sprays for seasonal allergies can also trigger headache. Some antihistamines may also cause headache, but this is less common among second-generation antihistamines, which are used more often today.
Check each medication prescribing information to see if headache is a potential side effect. Talk with your doctor about alternatives.
How Does Misdiagnosis Affect People with Migraine, Asthma and Allergy?
People who are misdiagnosed with another condition may unknowingly be on the wrong treatment plan. Sometimes they are on the wrong plan for years. This can lead to worsening of symptoms.
How Often are Sinus Headaches Actually Migraine?
The most common misdiagnosis of migraine is sinus headache, according to Mark Mehle, MD, FACS, of Northeast Ohio Medical University and Southwest General Hospital.
Healthy sinuses are filled with air. When infection occurs, mucus can fill these sinus cavities. This can cause a sinus infection, or sinusitis. Many people complain of sinus headache, but less than 4% have sinusitis (sinus infection). “Between 80-90% of the time, those complaints are actually migraine,” says Dr. Mehle.
How are Sinusitis and Migraine Similar?
Shared features of and sinusitis and migraine include:
- Symptoms: pain or pressure in the face and sinus area, as well as fatigue, stuffiness, or runny nose.
- Occurrence: can coincide with weather or seasonal changes.
- Treatment: treated by corticosteroids, such as prednisone.
Two possible reasons why sinusitis and migraine are easily confused include:
- The sinuses are in the face and migraine pain is often in the face. These symptoms can easily overlap.
- The nervous system is believed to work differently in migraine. Symptoms of this can include a stuffy or runny nose and mucus, which is also common in sinusitis.
How are Sinusitis and Migraine Different?
Key differences of sinus headache and migraine include:
Symptoms
- Migraine: throbbing pain, nausea, sensory sensitivities (light, smell, sound and movement).
- Sinusitis: nasal congestion, mucus discharge, blunted sense of smell
Timing
- Migraine: lasts 4-72 hours
- Sinusitis: can last 7-10 days or longer
What is a Rhinogenic Headache?
A rhinogenic headache is caused by sinusitis, also called rhinosinusitis. It involves at least two of these symptoms:
- Pain and/or pressure in the face
- Nasal discharge
- Stuffy nose
- Reduced or no sense of smell
If the sinus and headache symptoms aren’t due to migraine, then rhinogenic headache may be the diagnosis.
Sinusitis is usually triggered by either a virus or inflammation. It can be acute or chronic.
- Acute rhinosinusitis lasts 7-10 days. It is usually caused by the common cold. While most colds get better with time, 2% of colds become a bacterial infection. This may call for antibiotic treatment.
- Chronic rhinosinusitis lasts at least 12 weeks. It is caused by inflammatory issues (such as allergies or nasal polyposis). Since there’s no infection, antibiotics do not treat chronic rhinosinusitis. Instead, nasal corticosteroid treatment is recommended.
How is Migraine Treated?
You should reach out to a healthcare professional if:
- you experience migraine symptoms more than one day per week;
- your current treatment does not work or side effects are hard to manage;
- the disability you experience from your symptoms is severe and prolonged.
Contact your primary care provider, a neurologist, or a headache specialist. Headache specialists are neurologists with dedicated training in headache care.
Why is Treating Migraine Important?
Untreated migraine puts people at risk for further disability. Your migraine symptoms may worsen. This can increase the chance of developing chronic migraine. You may develop or worsen other chronic illnesses.
Does Migraine Treatment Change if You Have Allergy or Asthma?
Treating asthma and allergies with or without migraine is generally the same, and vice versa. Migraine is a neurological disorder. Asthma and allergies are respiratory conditions. Despite the differences, similar threads tie these conditions together. Medication, lifestyle changes and preventive care are fundamental when living with asthma, allergies, and migraine.
Some medications used for asthma can trigger migraine attacks. And some medications for migraine can worsen asthma. An accurate diagnosis will help you and your doctor decide on the best treatment plan.
How Do You Treat Migraine and Co-occurring Asthma and Allergies?
Here are tips to help you manage migraine headaches, with or without asthma or allergy symptoms.
- Headache log. Start recording your migraine symptoms in a diary or log. Note the date, time, and any details you think are important. Over time you may be able to see connections.
- Trigger management. Identify what triggers your migraine attacks. This could be stress, poor sleep, skipped meals, or menstruation. Knowing your triggers is powerful. It can help you develop a plan to avoid them – if possible – and prevent migraine attacks.
- Decreasing stress. Stress is one of the biggest migraine triggers. Behavioral therapies (cognitive behavioral therapy, meditation) can help you cope with stressors.
- Lifestyle changes. A healthy diet, regular movement, and consistent sleep can help prevent migraine attacks.
- Medication. Medications are available to prevent a migraine attack and stop one after it has started. They can give you a better quality of life. A healthcare professional can help you develop a treatment plan.
- Alternative therapies. These may include herbal supplements, biofeedback, and acupuncture. Some may also help with asthma and allergies. Discuss these therapies with your healthcare team before trying them.
- Allergy shots. In younger patients with atopic migraine, allergy shots reduced migraine frequency by 48%.
What is the Migraine World Summit?
Living with migraine can be a painful and isolating experience. Because there is a shortage of headache specialists, many patients never get the opportunity to speak with one. If you are struggling to cope with and understand migraine, the Migraine World Summit can help. This online free web event occurs every March. Researchers, doctors, advocates, and other experts share insight into the latest treatments. You can register at any time to receive access to free talks and emails about migraine and headache disorders. Register today at migraineworldsummit.com.
This content was written by Crystal Llamas. Crystal writes for Migraine World Summit and Migraine Again, an online resource and wellness site.
Reviewed by:
Ruthie Marker, MSRC, RRT, RRT-NPS, AE-C, LSSYB, a respiratory therapist with more than 13 years of experience working in adult critical care, neonatal care, and patient education. She joined Allergy & Asthma Network to support the Trusted Messengers asthma coaching program as a Spanish-speaking asthma coach. Ruthie has worked as a respiratory therapist in Texas and has supported COVID-19 efforts in Maryland and Arkansas.
Bradley Chipps, MD, FACAAI, is a board-certified allergist and pediatric pulmonologist with Capital Allergy and Respiratory Disease Center in Sacramento, California. He earned his medical degree from University of Texas Medical Branch in Galveston in 1972. He is Past President of the American College of Allergy, Asthma and Immunology (ACAAI).
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