Managing Migraine at Work

If you live with migraine, you already know it’s not “just a headache.” It’s a full-body,
full-brain event that can turn a normal workday into an Olympic sport in surviving light,
noise, emails, and meetings. Yet millions of people with migraine still show up, do their
jobs, and build successful careers every day.

In the United States, tens of millions of adults live with migraine, and it’s one of the
leading causes of disability during working years. Lost productivity from migraine
between missed days and “presenteeism” (being there but functioning at half-speed)
costs employers billions of dollars annually. That’s the big-picture data; on a personal
level, it can simply feel like you’re constantly fighting your own brain while trying to
look “normal” on Zoom.

The good news: there are many practical ways to manage migraine at work from
understanding triggers and building a migraine-friendly routine to requesting workplace
accommodations and planning for flare days. This guide walks you through how to work
with your brain instead of against it, without sacrificing your livelihood or your
health.

What Migraine Really Looks Like at Work

Migraine is a neurological disease, not a character flaw and not a sign that you can’t
“handle stress.” Typical symptoms include moderate to severe head pain, sensitivity to
light, sound, and smells, nausea, visual changes, dizziness, and brain fog and they can
last hours to days. Many people also experience warning signs (aura or prodrome) such as
visual disturbances, mood changes, yawning, or food cravings before the pain even starts.

At work, that might show up as:

• Squinting at a bright screen while lights feel like they’re drilling into your skull
• Struggling to follow a conversation in a noisy open office or crowded meeting room
• Re-reading the same email three times because your brain fog is real
• Calling in sick or leaving early when symptoms are severe

Studies have found that migraine significantly reduces work productivity, especially via
presenteeism days where you’re technically there, but far from your best. On top of the
physical symptoms, there’s often stigma: co-workers may see “headache,” not “serious
neurological condition,” and assume you’re being dramatic or unreliable. That stigma can
make people hide how bad they feel, which only makes managing the condition harder.

Know Your Migraine Triggers on the Job

Triggers don’t cause migraine by themselves the condition is rooted in brain
biology and genetics but they can flip the switch on an attack. At work, common triggers
include:

• Stress and pressure: tight deadlines, conflicts, or constant multitasking
• Irregular sleep: late nights, early meetings, or rotating shifts
• Skipping meals or blood sugar swings: “I’ll just answer two more emails…”
• Dehydration: hours go by and your water bottle is still full
• Lighting: harsh fluorescent lights, glare from screens, flicker
• Noise: open offices, ringing phones, chatty colleagues, construction
• Strong smells: perfumes, cleaning products, reheated lunches
• Posture and ergonomics: hunching over a laptop or phone all day

Using a Migraine Diary to Spot Patterns

One of the most effective tools you can use is a migraine diary. Whether it’s a dedicated
app, a spreadsheet, or a simple notebook, track:

• When symptoms start and how long they last
• What you were doing (tasks, meetings, commute)
• Sleep the night before
• Meals, snacks, caffeine, and hydration
• Stress level, mood, or major events
• Environmental factors: noise, light, temperature, odors

After a few weeks, patterns usually start to show. Maybe late-afternoon meetings in a
loud conference room are a problem, or fasting until lunchtime almost guarantees an
attack. That information is gold you can use it to adjust your routine and to make
specific, reasonable accommodation requests such as “I need a desk away from flickering
lights” or “I benefit from a short mid-morning break to manage symptoms.”

Building a Migraine-Friendly Workday Routine

You can’t control everything about your job, but you often have more influence than you
think over how your day flows. A migraine-friendly routine focuses on stability:
consistent sleep, regular meals, hydration, and stress management.

Before You Even Log On

• Prioritize consistent sleep. Irregular sleep is a major migraine trigger for
  many people. Aim for roughly the same bedtime and wake time, even on weekends when possible.
• Hydrate early. Drink water first thing in the morning and keep a bottle handy.
  Dehydration can quietly nudge you toward an attack.
• Eat a balanced breakfast. Include protein and complex carbs (for example,
  eggs with whole-grain toast, or yogurt with fruit and nuts) to help keep your blood sugar
  steady.
• Use preventive strategies. If your clinician has recommended preventive
  medication, devices, or supplements, build them into your pre-work routine so you don’t
  forget them when work gets busy.

Smart Habits During the Workday

• Don’t skip meals. Set reminders if you have to. Even a small snack a
  handful of nuts, fruit, or a yogurt can keep blood sugar from crashing.
• Watch your caffeine. A little caffeine can help some people during an
  attack, but too much (or sudden withdrawal) can be a trigger. Track your pattern and aim
  for consistency rather than huge swings.
• Take “micro-breaks.” Every 20–30 minutes, look away from your screen for
  20 seconds, roll your shoulders, or stand and stretch. This can reduce eye strain,
  muscle tension, and stress.
• Move your body. Regular physical activity can help reduce headache
  frequency for many people, and it’s great for stress and sleep. At work, that might
  look like walking during calls, taking the stairs, or doing a quick walk at lunch.
• Manage stress in the moment. Short breathing exercises, a five-minute
  mindfulness app, or simply stepping away from your desk can break the stress spike that
  sometimes precedes migraine.

Adjusting Your Immediate Environment

You may be able to make small tweaks to your workspace that pay off in fewer attacks:

• Lighting: Use a desk lamp with softer light if possible; apply an
  anti-glare filter to your monitor; experiment with screen brightness and text size.
  If overhead fluorescent lighting is a big trigger, a visor or lightly tinted glasses
  may help.
• Noise: Noise-canceling headphones, soft background music, or white
  noise can buffer sudden sounds in open offices. If you can, book a quiet room for
  focus work or high-concentration tasks.
• Ergonomics: Ask for an ergonomic chair, keyboard, or monitor riser, or
  adjust what you have so your screen is at eye level and your shoulders are relaxed. A
  poorly set-up workstation can increase muscle strain and headaches.
• Smells: If strong fragrances trigger you, a small fan at your desk, a
  note asking coworkers to avoid heavy perfume, or a conversation with HR can help.

Workplace Accommodations and Your Rights

In the United States, migraine can qualify as a disability under the Americans with
Disabilities Act (ADA) if it “substantially limits one or more major life activities,”
including working. When that’s the case, many employees are entitled to reasonable
accommodations adjustments that help you do your job without creating an undue hardship
for the employer.

Common examples of migraine-related accommodations may include:

• A workspace away from flickering lights or loud equipment
• Flexible scheduling for medical appointments
• Occasional work-from-home days, especially during recovery
• Extra breaks to take medication, rest in a dark room, or hydrate
• Option to wear tinted lenses, hats, or noise-reducing headphones
• Access to a private, quiet space during attacks

How you request accommodations matters. Many advocacy groups recommend:

1. Gather documentation. Talk with your healthcare provider about how
   migraine affects your work. A note describing your diagnosis and functional
   limitations not necessarily all your medical history can be helpful.
2. Write a clear request. A short email to HR or your manager might say
   that you have a medical condition that substantially impacts your work and that you are
   requesting reasonable accommodations. Some people are comfortable naming migraine; others
   keep it more general.
3. Connect your request to your job duties. For example: “Because bright
   fluorescent lights and prolonged screen time can trigger severe migraine symptoms, I’d
   like to request a monitor filter, an adjustable desk lamp, and the option to take short
   breaks away from my screen.”
4. Be open to alternatives. Employers generally must consider reasonable
   accommodations, but they’re not required to agree to your preferred option if another
   effective approach exists.

If you’re unsure where to start, national resources like the Job Accommodation Network
(JAN) offer free guidance to workers and employers on how to navigate migraine at work,
accommodations, and disability rights. You can also talk with your HR department or a
qualified legal professional for personalized advice. This article is for general
information only and is not legal advice.

Making a Plan for Migraine Days

Even with the best prevention, flare days still happen. Having a plan can reduce anxiety
and make it easier to ask for what you need before the pain hits a 10/10.

Build a Personal “Migraine Playbook”

Consider writing down:

• Early warning signs: do you yawn more, feel unusually irritable, or see
  visual changes before attacks?
• Step-by-step actions: when symptoms start, you might take medication,
  finish a critical task, let your manager know, then relocate to a quieter space.
• Communication templates: short messages you can send when you’re not
  up for crafting a perfect email for example, “I’m having a migraine flare and may
  be slower to respond this afternoon. I’ll follow up on X by tomorrow.”
• A “rescue kit”: medications recommended by your clinician, a water
  bottle, a small snack, eye mask, earplugs or headphones, and a cold pack if you can
  store one at work.

Managing After an Attack

Recovery time (the “postdrome”) can bring brain fog, fatigue, and a feeling like you’ve
been hit by a truck. If possible:

• Schedule less cognitively demanding tasks after severe attacks
• Use checklists or reminders to keep track of follow-ups
• Be realistic: you may not bounce back to 100% immediately

It can help to remind yourself: needing recovery time is not laziness, it’s biology.
You’re managing a chronic neurological condition while holding down a job. That’s not a
failure it’s a lot of unrecognized work.

Partnering with Healthcare Professionals

Managing migraine at work is much easier when you have a treatment plan that fits your
life. That may involve:

• Accurate diagnosis: to rule out other causes and confirm migraine type
  (with or without aura, chronic vs. episodic, vestibular migraine, and more).
• Acute treatments: medications or devices you use at the onset of an
  attack to reduce severity and duration.
• Preventive options: daily or monthly treatments (medications, injectables,
  neuromodulation devices) that aim to lower attack frequency.
• Lifestyle strategies: guidance on sleep, nutrition, exercise, and
  stress management tailored to your situation.

If migraine is interfering with your ability to function at work, that’s a strong reason
to follow up with a healthcare professional ideally someone with experience in
headache medicine. Bring your migraine diary, a list of current medications, and notes on
how work affects your symptoms. Together, you can prioritize changes that have the best
chance of improving both your health and your career.

Real-World Experiences: What Managing Migraine at Work Can Feel Like

Advice is great, but real life is messy. Here are a few composite experiences based on
common situations people describe that show how “managing migraine at work” can look in
day-to-day life.

Case 1: The Open-Office Overachiever

Taylor works in marketing in a wide-open office with bright lights and a constant hum of
chatter. For years, Taylor quietly burned through migraine attacks with sunglasses on,
hoping no one noticed how bad it was. Eventually, after a particularly awful week that
included three attacks and a missed deadline, Taylor started tracking patterns.

The migraine diary showed something clear: big attacks often followed late nights working
under bright lights before a major campaign launch. Taylor brought this information to a
manager and HR, along with a note from a neurologist. With that documentation, Taylor was
able to request:

• A desk farther from overhead lights
• An anti-glare screen filter and adjustable desk lamp
• Permission to wear a cap and tinted glasses when needed
• One remote-work day during intense campaign weeks

None of these changes were expensive, and the payoff was huge: fewer attacks, more
reliable performance, and less fear that a migraine would ruin every deadline week. The
job didn’t become magically “easy,” but it became survivable and Taylor felt less like
a problem and more like a professional with a condition that’s being responsibly managed.

Case 2: The Remote Worker Who Still Struggles

Sam thought working from home would solve everything. No commute, no fluorescent lights,
no noisy coworkers. But migraine attacks still showed up: long days at the laptop, skipped
meals, and the habit of “just finishing one more task” led to late-night screen time and
poor sleep.

After talking with a clinician and tracking symptoms, Sam made changes:

• Set actual work hours, with alarms to log off
• Scheduled calendar reminders for water and snack breaks
• Switched to a larger monitor at eye level with bigger text
• Added a 20-minute walk at lunch to move, decompress, and reset

Sam also created an “out of office but online” message template: during bad attacks, it
explains that Sam is working at reduced capacity and gives realistic response times. That
honesty reduced anxiety and made it easier to stop over-promising on flare days.

Case 3: The Employee Who Finally Asked for Help

Jordan had chronic migraine 15 or more headache days per month and a demanding job in
healthcare. After years of powering through with over-the-counter pain relievers and
guilt, Jordan hit a breaking point and decided to treat migraine like the serious
condition it is.

With support from a headache specialist, Jordan started a preventive treatment plan and
tracked attacks for three months. The diary backed up what Jordan already felt: migraine
was substantially limiting work. Armed with those records and a letter from the clinician,
Jordan requested accommodations through HR: flexible scheduling around infusion days,
reduced back-to-back night shifts, and access to a quiet room when symptoms flared.

Was the process fun? Absolutely not. But it was worth it. Over time, with medical
treatment, accommodations, and better self-care habits, Jordan’s number of severe attack
days dropped. Work was still challenging, but no longer felt like a constant battle
between career and health.

Bringing It All Together

Managing migraine at work is not about “toughing it out” or pretending you’re fine while
your brain is staging a light-and-sound protest. It’s about combining science-based
strategies, smart routines, and your legal rights into a realistic plan that lets you
protect both your health and your paycheck.

When you understand your triggers, adjust your workday where you can, request reasonable
accommodations, and partner with your healthcare team, you move from feeling powerless to
feeling prepared. Migraine may still show up uninvited but you’ll be ready with a plan,
a toolkit, and a healthier, more sustainable way to work.