How to Keep a Migraine Diary Your Doctor Will Actually Use

What to write in a migraine diary, how long to keep one, the two numbers doctors look at first, and a free template you can copy today.

You're sitting in the doctor's office, and the question comes: "How many migraines have you had in the last three months?" You think back. Was it six? Ten? Was the bad one in March or in April? And did the tablets help, or did you take a second dose?

Most people with migraine know this moment. A migraine diary is the simplest way to fix it.

In short: a migraine diary (also called a headache diary or migraine log) is a simple record of every attack: when it started, how strong it was, how long it lasted, what you took and whether it helped. Kept for at least two months, it gives your doctor facts instead of guesses. That makes it easier to confirm the diagnosis, choose a treatment and see whether the treatment works.

This guide explains what to write in a migraine diary, how long to keep one, and how to turn your notes into something a doctor can read in a minute.

Key takeaways

• A migraine diary records each attack: date, start time, how strong it was, how long it lasted, symptoms, medicine and whether it helped.
• UK health guidance (NICE) suggests keeping a headache diary for at least 8 weeks before and during treatment decisions.
• Short and regular beats long and occasional. Record the basics during an attack and add details later.
• Counting headache days per month and medicine days per month are the two numbers doctors look at most often.
• A diary can show patterns, but one bad day after a glass of wine doesn't prove wine is a trigger.

What is a migraine diary, and why do doctors ask for one?

A migraine diary is a day-by-day record of your headaches and the things around them. It can be a notebook, a printed template, a spreadsheet or an app. The format matters much less than the habit.

Doctors ask for one because there is no blood test or scan that shows migraine. Migraine is diagnosed from your history: the story of your attacks, told as accurately as possible. The NHS explains that there's no specific test for migraine, so a GP or neurologist (a doctor who specialises in the brain and nerves) relies on what you describe.

Memory is not a reliable witness. We tend to remember the worst attacks and forget the mild ones. We blur dates. We remember taking "something" but not what or when. A diary fills those gaps.

The UK's National Institute for Health and Care Excellence (NICE), which writes official treatment guidelines for doctors, recommends using a headache diary to support the diagnosis and to review how treatment is going. It suggests recording:

• how often headaches happen, how long they last and how severe they are
• any other symptoms
• all medicines taken for the headache
• possible triggers
• any link to periods, for people who menstruate

What should you write in a migraine diary?

You don't need to write an essay. Here is a practical list, split into what matters most and what's useful if you have the energy.

The essentials (record these for every attack)

1. Date and start time. When did you first notice it?
2. How strong it was. Use a simple scale: mild, moderate or severe. Mild means you can carry on. Moderate means it gets in the way. Severe means you have to stop and lie down.
3. How long it lasted. Note when it ended, or "still going at bedtime".
4. Medicine. The name, the dose and the time you took it.
5. Did it help? Check about two hours after taking it. Better, a little better, or no change?

Helpful extras (add when you feel up to it)

• Where it hurt: one side, both sides, behind the eye.
• Other symptoms: nausea (feeling sick), sensitivity to light or sound, dizziness.
• Aura: visual or sensory changes before or during the headache, such as zigzag lines, blind spots or tingling. About a third of people with migraine have aura at least sometimes.
• Warning signs: some people notice a "prodrome", an early phase hours or even a day before the pain. It can show up as yawning, food cravings, a stiff neck or mood changes.
• How you felt afterwards: the "postdrome" (often called a migraine hangover) is the tired, foggy phase after the pain eases.
• Possible triggers: sleep, meals, stress, alcohol, weather, screen time.
• Your period: if you menstruate, mark the days of your cycle.
• Impact on your day: missed work or school, cancelled plans, time spent in bed.

A simple migraine diary template

If you prefer paper, a table like this one is enough:

How long should you keep a headache diary?

Two months is a good minimum. NICE suggests at least 8 weeks, because migraine often comes and goes in waves. A single "good" or "bad" month can be misleading.

If your doctor starts you on a new treatment, keep the diary going. It's the most honest way to answer the question that will come at your next appointment: "Is it working?" Many treatments for preventing migraine are judged over two to three months, so the diary becomes your evidence.

Many people simply keep going. Once logging is a habit, it takes less than a minute a day.

The two numbers doctors care about most

If you remember only one thing from this guide, make it this: count your days.

Headache days per month. This is the number of days in a month when you had any headache, not the number of attacks. One attack that lasts three days counts as three headache days. Doctors use this number to describe how often migraine affects you. Migraine on fewer than 15 days a month is usually called "episodic". Headache on 15 or more days a month for over three months, with migraine features on at least 8 of them, is called "chronic migraine", according to the International Classification of Headache Disorders, the reference doctors use worldwide.

Medicine days per month. This is the number of days you took any painkiller or migraine medicine. It matters because using acute medicines (the ones you take during an attack) very often can itself lead to more headaches. This is called medication-overuse headache. The International Headache Society's criteria mention thresholds of about 10 or 15 days a month, depending on the medicine, over more than three months. You don't need to work this out yourself. Just keep the count, and your doctor will know what it means for you. Never stop or change a prescribed medicine without talking to your doctor or pharmacist first.

How to keep a migraine diary when you're in pain

This is where most diaries fail. People start with enthusiasm, then skip a few attacks because writing felt impossible, and then stop.

A few habits help:

• Log the basics now, details later. During an attack, record only the start time and how strong it is. Add the rest when you feel better.
• Make it easy to reach. Keep the notebook by your bed, or put the app on your phone's home screen.
• Use reminders. A daily evening reminder ("Any headache today?") catches the attacks you would have forgotten. Studies of headache diaries show that reminders help people keep records more consistently.
• Record headache-free days too. A quick "no headache today" makes your monthly count accurate and shows your good stretches.
• Be honest, not perfect. A diary with a few gaps is still far better than no diary.

Paper or app: what's the best way to track migraines?

Both work. Choose the one you'll actually use.

Paper is simple, private and needs no battery. It's harder to count days, spot patterns and share with a doctor, but a clear table, like the one above, goes a long way.

A migraine diary app can fill in the time for you, remind you, count your headache and medicine days automatically and create a summary for your doctor. When choosing one, check:

• How many taps does it take to log an attack? Fewer is better on a bad day.
• Can it make a report your doctor can read quickly?
• Where is your health data stored, who can see it, and can you delete it? In the EU, health data has extra protection under the GDPR. A good app explains clearly how it uses your data. You can see how we handle it in MIGMO's privacy policy.

How to use your diary at the appointment

A diary only helps if it reaches your doctor in a usable form. Before your appointment:

1. Summarise the last 2–3 months. Headache days per month, medicine days per month, and roughly how many attacks were severe.
2. Note what you tried. Which medicines, at what dose, and whether they helped.
3. Write down your questions. For example: "Is this still migraine?", "Should I be worried that it's getting more frequent?" or "Is there something I can take to prevent attacks?"
4. Bring the diary itself. Your doctor may want to look at the details.

Can a migraine diary find your triggers?

Partly, and it's worth being careful here. A diary can point to patterns, such as attacks clustering around your period, after short nights or on weekends. But one migraine after a glass of red wine doesn't prove that wine causes your migraines.

There's another twist. Some "triggers" may actually be early signs of an attack that has already started. For example, craving chocolate can be part of the prodrome. The migraine was coming anyway, and the chocolate gets the blame.

So treat possible triggers as questions to explore with your doctor, not as rules. Avoiding too many foods or activities can make life smaller without making migraine better.

When to get medical help straight away

A diary is for tracking, not for emergencies. Seek urgent medical help (in Europe, call 112) if you have:

• a sudden, very severe headache that peaks within a minute, often described as "the worst headache of my life"
• a headache with fever, a stiff neck or a rash
• a headache after a head injury
• new weakness, numbness, confusion or difficulty speaking
• aura that lasts more than an hour, or that feels different from your usual aura

The World Health Organization lists headache disorders among the most common disorders of the nervous system. Most headaches are not dangerous, but these signs always deserve to be checked quickly.

Frequently asked questions

What is the difference between a headache diary and a migraine diary? None, really. Both terms describe the same record. "Headache diary" is the more general name doctors often use.

How do I count migraine days if one attack lasts several days? Count every day on which you had a headache. A three-day attack counts as three headache days.

Should I record days without a headache? Yes, if you can. It makes your monthly count accurate and shows how long your good periods last.

Is there a free migraine diary template? Yes. The table in this article works as a template. Copy it into a notebook or spreadsheet, one row per attack.

How long does it take to see patterns? Usually two to three months. Patterns linked to your menstrual cycle often need at least three cycles to show up.

Can a migraine diary replace a doctor's visit? No. A diary helps you and your doctor understand your migraine, but it doesn't diagnose or treat anything.

Start small, start today

You don't need the perfect system. Start with the date, the time, how strong it was and what you took. In two months you'll walk into your appointment with facts instead of guesses, and that changes the conversation.

We're building MIGMO to make this as easy as possible: log a migraine in four taps, even mid-attack, and turn your records into a clear report for your doctor. It's available now on the App Store and Google Play. Find more practical guides on the MIGMO blog, or send us a question you'd like us to write about.

This article is for general information and is not medical advice. Talk to your doctor or pharmacist about your symptoms and before changing any medicine.

General information, not medical advice. It doesn’t replace a doctor’s assessment.

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