20 Jul Reader's Mail: Specific Sounds Trigger Migraine
Q: It seems that certain types of music, especially loud, manufactured/synthesizer-type music, triggers my migraine headaches. I am wondering if any research has been done to determine the correlation of certain sounds or music to the onset of migraine headaches. An example of this music can be heard in some steakhouse-type restaurants. Sometimes my headaches are triggered by being placed on hold during a business phone call. I cannot listen to music using earplugs. Easy-listening music, live piano music, and/or Lawrence Welk-type music do not give me headaches. Shop vacuums and power scrubbers used in large stores also trigger my migraine headaches. Sometimes it is almost impossible to avoid this type of music or noise. I have non-classical, atypical migraine headaches.
I have tried earplugs, but they do not block out the sounds that are triggers. Also, any musical sounds transmitted by any type of ear phones directly against my ears are triggers as well. The last time I went shopping at Walmart, which was playing migraine-triggering music, I just started humming louder than the intercom music to block that music out and it seemed to help.
A: People with migraine are sensitive to very specific triggers, such as smells, light, or sound; usually the intensity makes a stimulus more of a trigger. Specific sound patterns, as described, can be specific to the individual. It may be helpful to use earplugs or to listen to less offensive music with earbuds when in uncontrolled environments.
There is a condition called misophonia, where certain sounds are unbearable, and it is not because of excessive loudness, like we experience in migraine. Drs. Margaret and Pawel Jastreboff at Emory University defined a selective sound sensitivity syndrome that produces various aggressive behaviors. What makes it interesting in the migraine world is that this may be yet another type of hyperconnectivity between the auditory system and the limbic system of the brain. Abnormal connectivity exists in people with fibromyalgia and probably in migraine. The real question is whether behavioral conditioning/cognitive behavioral therapy can help a patient learn to distract themselves or substitute other sounds.
Edmund Messina, MD
Michigan Headache Clinic
East Lansing, Michigan