"Let Down" Headache Can Arise From Many Causes

Q. Is there anyone out there who gets vacation migraines?

My world is pretty stressed. With working out of town, crazy sleep schedules, and taking care of my elderly mother-in-law, I live at a pretty high level of stress all the time. I do have chronic migraines, but I seem to get headaches when we go on vacation or at least the first part of the vacation. My husband tries to keep my stress low when we go on vacation, but I still get the headaches, even without the stress of day-to-day life. Is it because of the change in hormones at the lack of stress? Is it the drastic change that gives me the headaches?

A. Many people experience “let down” headache when stress is suddenly lifted, for example, when they are on vacation. Some people experience headaches caused by travel, especially if they are not yet acclimated to another time zone or to a high altitude. Other triggers include changes in diet, fumes from jet planes, exposure to smokers, or a so-called “non-smoking room,” which has been sprayed with an air freshener to hide the smoke.

I don’t have a general guideline in this instance, but sometimes the medications that are used as “bursts” to break headache cycles, such as long-acting triptans or non-steroidal anti-inflammatory agents, can be used to ease the transition.

By the way, if you are on medications, avoid grapefruit or pomegranate juice because it can interfere with the normal breakdown of many medications.

Edmund Messina M.D., F.A.H.S.
Medical Director
Michigan Headache Clinic
Arbor Medicus, LLC
East Lansing, Michigan