Prodrome, aura, headache and postdrome: what happens in each phase of a migraine attack, how long each one lasts and how to recognise your own pattern.
Many people think of a migraine as a headache that starts and stops. But if you live with migraine, you probably know it's more like a journey. There's the odd, restless feeling the evening before, the hours of pain, and the washed-out day afterwards when you're "not quite back".
Doctors describe this journey in four phases. Knowing them can help you recognise an attack earlier, explain your symptoms more clearly and plan your days with a bit more confidence.
In short: a migraine attack can have up to four phases. The prodrome brings early warning signs hours or days before the pain. The aura brings visual or sensory changes, and affects about one in three people with migraine. The headache phase usually lasts 4 to 72 hours. The postdrome, or "migraine hangover", leaves you tired and foggy for up to a day or two. Not everyone has every phase, and phases can overlap.
Key takeaways
- A migraine attack can last much longer than the headache itself, sometimes three days or more from start to finish.
- Prodrome: warning signs such as yawning, cravings, a stiff neck or mood changes.
- Aura: temporary visual or sensory symptoms, usually lasting 5 to 60 minutes.
- Headache: often throbbing and one-sided, with nausea and sensitivity to light and sound.
- Postdrome: tiredness, poor concentration and a "hangover" feeling after the pain.
Why it helps to know the phases of migraine
A migraine is a brain event, not just a pain event. Changes in the brain begin before the pain and continue after it. The International Classification of Headache Disorders (ICHD-3), the global reference doctors use, includes symptoms before and after the headache in its description of migraine.
Knowing the phases helps you to:
- Recognise an attack early and plan your day around it
- Avoid blaming the wrong things. Early symptoms are often mistaken for triggers, as we explain in our article on migraine triggers and warning signs
- Describe your migraine accurately to your doctor
- Understand the "lost days", the time before and after the pain that still affects your life
The UK charity the Migraine Trust also describes migraine in these stages, and notes that not every person, or every attack, goes through all of them.
Phase 1: Prodrome (the warning phase)
What it is: the prodrome, also called the premonitory phase, is the earliest part of a migraine attack. It can start a few hours, and sometimes a day or two, before the headache.
Common prodrome symptoms:
- yawning a lot
- food cravings, often for something sweet or salty
- a stiff or aching neck
- tiredness, or trouble concentrating
- feeling irritable, low, or unusually energetic
- needing to pass urine more often, or feeling thirsty
- becoming sensitive to light, sound or smells
What you can do: many people don't notice their prodrome until they start writing things down. A migraine diary that records the time of early symptoms, not just the pain, can reveal your personal pattern within a few months. Once you know it, the prodrome becomes a useful warning: a chance to rest, drink water, eat regularly, rearrange demanding plans and have your usual treatment within reach.
Phase 2: Aura (the sensory phase)
What it is: an aura is a set of temporary symptoms caused by a wave of changing activity spreading across the surface of the brain. It usually develops gradually over several minutes and lasts between 5 and 60 minutes, according to the ICHD-3 criteria for migraine with aura. The headache often follows within an hour, but aura can also come during the headache, or on its own with no headache at all.
How common is it? About one in three people with migraine have aura at least some of the time. Many people have attacks both with and without aura.
Common types of aura:
- Visual aura, the most common type: zigzag or shimmering lines, flashing lights, a blind spot that grows, or blurred patches in your vision
- Sensory aura: pins and needles or numbness that slowly spreads, often from the fingers up the arm to the face
- Speech aura: difficulty finding words or speaking clearly
Important: aura symptoms come on gradually and go away completely. Get urgent medical help if you have sudden weakness on one side of the body, a drooping face, slurred speech, aura lasting more than an hour, or aura that feels different from your usual pattern, especially the first time. These can be signs of something more serious, such as a stroke, and need to be checked straight away.
Phase 3: Headache (the pain phase)
What it is: the phase most people think of as "the migraine". Without treatment, the headache phase usually lasts 4 to 72 hours in adults.
Typical features, as described by the NHS and ICHD-3:
- moderate or severe pain, often throbbing (pulsing)
- often on one side of the head, though it can be on both sides or switch sides
- worse with everyday activity, such as walking or climbing stairs
- nausea (feeling sick) and sometimes vomiting
- sensitivity to light (photophobia) and sound (phonophobia), and sometimes to smells
Many people want to lie still in a dark, quiet room. Some also feel dizzy, sweaty, too hot or too cold.
What you can do: follow the treatment plan you've agreed with your doctor or pharmacist. Many people find that attack medicines work better when taken early in the headache phase rather than waiting until the pain is severe. Ask your doctor how and when you should take yours. Keep an eye on how often you take painkillers: taking them on many days a month can lead to more headaches, which is something to discuss with your doctor.
Phase 4: Postdrome (the "migraine hangover")
What it is: the postdrome is the recovery phase after the headache eases. Many people call it a migraine hangover. It can last from a few hours to a day or two.
Common postdrome symptoms:
- tiredness or exhaustion
- difficulty concentrating, or "brain fog"
- a dull ache or tenderness when moving your head
- low mood, or for some, a strange sense of relief or even euphoria
- stiff neck, or feeling dizzy or weak
What you can do: be gentle with yourself. Rest if you can, eat and drink regularly, and ease back into demanding tasks. Telling the people around you that recovery is part of the attack can help them understand why you're not "back to normal" the moment the pain stops.
Do all migraines have four phases?
No. Every person is different, and so is every attack. Some people:
- never have an aura
- don't notice a prodrome, or notice it only sometimes
- have a short postdrome, or almost none
- have phases that overlap, such as aura that starts while the headache is already building
So don't worry if your attacks don't match this description exactly. What matters most is learning your own pattern.
How long does a whole migraine attack last?
From the first warning signs to the end of the postdrome, a single attack can last anywhere from a few hours to three days or more. Roughly:
| Phase | Typical length | Who has it |
|---|---|---|
| Prodrome | a few hours to 1–2 days | many people with migraine |
| Aura | 5–60 minutes per symptom | about 1 in 3 people with migraine |
| Headache | 4–72 hours (untreated) | most attacks |
| Postdrome | a few hours to 1–2 days | many people with migraine |
This is why migraine can cost much more time than the headache alone suggests, and why the World Health Organization ranks migraine among the leading causes of disability worldwide.
How to track the phases of your migraine
Tracking phases gives you, and your doctor, a far more complete picture than tracking pain alone. For each attack, try to note:
- When early signs started, and what they were
- Whether you had aura, what it was like and how long it lasted
- When the headache started and ended, and how strong it was
- How long recovery took, and how you felt
Bring a summary to your next appointment. Our neurologist appointment checklist shows how to describe each phase clearly.
When to seek urgent medical help
Seek medical help straight away (in Europe, call 112) if you have:
- a sudden, very severe headache that reaches full strength within about a minute
- weakness or numbness on one side of the body, a drooping face or slurred speech
- aura lasting more than an hour, or aura that is new or different from your usual
- a headache with fever, a stiff neck, a rash or confusion
- a headache after a head injury
Frequently asked questions
What are the 4 stages of a migraine? Prodrome (early warning signs), aura (visual or sensory changes), headache (the pain phase) and postdrome (the recovery, or "migraine hangover").
Can you have aura without a headache? Yes. Some people have aura with little or no headache afterwards. If this happens for the first time, or the aura is unusual for you, see a doctor to rule out other causes.
How long does the prodrome last before a migraine? Usually a few hours, but sometimes up to a day or two before the headache.
Why do I feel so tired after a migraine? Tiredness is one of the most common symptoms of the postdrome. The brain changes involved in migraine continue for a while after the pain stops.
Is it normal for a migraine to last three days? The headache phase can last up to 72 hours without treatment, and the whole attack, including warning signs and recovery, can last longer. If your attacks often last longer than three days, or are changing, talk to your doctor.
Know your phases, know your migraine
Migraine is more than a headache, and seeing it as four phases can make it feel more predictable and less overwhelming. Start by noticing your warning signs, noting your aura if you have one, and giving yourself time to recover.
We're building MIGMO so you can log what's happening in four taps (warning signs, aura, pain or recovery) and see your own pattern over time. It's available now on the App Store and Google Play. Read more guides on the MIGMO blog.
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.