How Migraine Attacks Can Be Triggered or Worsened By Light
Of the more than 38 million people in the U.S. with migraine, an estimated 80% to 90% also experience extreme and often painful sensitivity to light—a symptom known as photophobia. Migraine light sensitivity can produce pain and discomfort during an attack as well as linger in the hours and days after an episode. In addition, migraines can be caused or triggered by light as well, based on the brightness, intensity, wavelengths or type of light that is being emitted. The fact is there are many ways in which light can be harmful to a person with migraine.
(You can also check out our migraine and light sensitivity infographic)
Light Sensitivity as a Symptom of Migraine
Light sensitivity is one of the most commonly-reported migraine symptoms behind headache or head pain. In fact, a recent survey of more than 4,000 people with migraine showed that 89% became sensitive to light during an attack. In addition, analyses have shown that photophobia and light sensitivity can linger during the postdrome or recovery phase after a migraine attack.(1) Although this postdrome period is not experienced by every person and their attacks can vary, light sensitivity and other residual symptoms can persist for a few hours or even several days after a migraine. Even between attacks, people with migraine tend to be more sensitive to light than those without. In one study, 75% of people with migraine had heightened sensitivity to light at all times.(2)
Light As A Trigger For Migraine Attacks
More than a third of patients have cited light as a trigger for their migraine attacks, along with other frequently reported triggers such as stress, hormones and sleep disturbances.(3) Furthermore, a migraine attack can occur within just a few seconds of exposure. Fluorescent lights, sunlight, and LED and LCD screens from computers or smartphones are just a few of the prominent sources that can cause or trigger migraines for those who are light sensitive. In addition, there are specific lighting characteristics and types of which you should be mindful, which we discuss in detail below:
- Perceived brightness of light source
- Blue wavelengths of light
- The invisible pulsing of fluorescent light
- Flashing and other high-contrast light
Brightness and Intensity
Can bright lights cause migraines? Migraine—the headache disorder—is a neurological condition that leads to hyperreactivity in the brain. This hyperreactivity responds to exposure to specific migraine “triggers,” which can result in a migraine attack. And bright, intense light—such as sunlight, overhead fluorescent lighting, or reflected glare—is one of the many reported triggers that can cause or worsen these migraine attacks. In fact, one study(4) showed that migraine patients reported attacks that were specifically triggered by sunlight, especially during the summer months when brightness was at its peak. Not only were the attacks more frequent and intense during the summer, but onset of head pain was a mere 5-10 minutes after exposure.
The perception of brightness can be equally as important as the actual intensity of the light source. People with migraine often have a lower threshold for light and light-related pain when compared to those without the condition. In fact, it has been shown headaches and pain can be caused by light that registers between 500 and 1000 lux, which is similar to the brightness of a cloudy day. Those without migraine reported light becoming too bright at 23,000 lux—the equivalent of a sunny, cloudless day.(5)
Wavelengths of Light
For those who have migraine, not all wavelengths of light are created equal. Studies show that blue light, specifically that which occurs at 480 nanometers, is particularly troubling. Not only can these wavelengths affect sleep patterns and contribute to eye strain, but it produces greater discomfort for people with migraine and can induce attacks more easily.(6) Unfortunately, the advent of technology has made these wavelengths prominent in our everyday lives, from computers, phones, televisions, energy-saving light bulbs, compact fluorescents and even sunlight. This is the main reason why TheraSpecs glasses precision filter these wavelengths (up to about 80%) for the benefit of those with migraine-related light sensitivity. They block up to 25 times more blue light that other brands marketed as blue light glasses. Learn more about why TheraSpecs are effective at blocking this particular range of light.
Fluorescent Light Pulsing
Fluorescent lights can cause or trigger headaches and migraines as well as make someone simply feel ill as a result of prolonged exposure. In addition to the high amount of blue light it emits, fluorescent lighting also displays an invisible pulsing that is imperceptible to the human eye but is still detected by the brain. The fact is these lights flicker at a rate of 100 to 20,000 times per second as part of their operational make-up. Sensitivity to this pulsing is so common it has been termed, “fluorescent sickness,” and those that experience migraine seem to be particularly susceptible. In fact, one study showed that this type of lighting doubled the headache frequency of workers.(7) Its cost effectiveness and energy efficiency have made fluorescents the preferred lighting for many offices, stores, schools, and businesses.
Flashing, Contrasting and Other Light Patterns
Light that reflects off of snow or water as well as car headlights have also been a frequent trigger for those who are prone to migraine attacks. Flashing strobe lights are another common issue as well as lighting that produces repetitive patterns. One study assessed 180 people to determine common external triggers of migraines and found that flickering light, repetitive patterns and stripes, and contrasting light and shade were all frequent factors.(8) For these reasons, activities such as attending sporting events, concerts, and movies can be particularly difficult for a person with migraine.
Why Light Causes Migraine Attacks
There are still many questions about why light sensitivity and photophobia occurs in people with migraine, but we are closer to understanding it as a result of recent studies. Some have suggested that specific neural pathways from the eye to the brain become activated at the onset of an attack, which may lead to the sudden light sensitivity and headache symptoms that many people with migraine experience immediately after exposure.(9) Others believe that there are special cells in the eye that are highly sensitive to certain wavelengths of light (including blue).
More recently, researchers from the University of Michigan discovered that fluctuations in dopamine released by the brain—which influences movement, emotion, and pleasure, among other key functions—may explain why migraine sufferers experience sensitivity to light during a migraine attack as well as other painful reactions to touch, sound and smell.
Light Sensitivity and Migraine with Aura
As many as one-third of people with migraine may regularly experience aura, which can include visual symptoms such as flashing light disturbances, peripheral distortions, or blind / dark spots. However, aura typically precedes attacks and is not just limited to light-related issues; it can include numbness, vertigo, nausea and other non-visual sensations. In rare instances, a person can even have aura without a headache. Migraine with aura can be especially hard to diagnose because symptoms may or may not vary from other migraine subtypes or from attack to attack; however, light is still capable of triggering an attack and photophobia can be a symptom during the aura phase, during the attack, or both.
Migraine Light Sensitivity Treatment
There are numerous options for treating migraine-related light sensitivity and photophobia—mostly by addressing the underlying condition—but some of the most effective methods involve minimizing light triggers and preventing attacks from happening at all.
A dark room
A dark, quiet room is perhaps the most common refuge during the headache phase of a migraine attack because it removes a majority of any external factors that may be worsening the attack. One published survey showed that it was in fact the most popular treatment method, with more than 90% of patients having tried it.(10) Additional research has shown that a quiet dark room can begin to diminish symptoms within 10-20 minutes after the onset of an attack.
Precision tinted glasses for indoor use
TheraSpecs are designed specifically for people with the headache disorder by filtering out the wavelengths that produce the most sensitivity. This includes blue wavelengths as well as the pulsing produced by fluorescent lighting. Several studies have shown that the TheraSpecs tint can reduce the frequency of attacks by as much as 74% when compared with other colored lenses, and their indoor glasses are light enough for everyday use.
A quality pair of sunglasses for outdoors
Dark, polarized sunglasses will help cut the glare of outdoor lights and are a great option for bright days. Finding a pair that also has wraparound protection may also be advantageous. If regular sunglasses do not work for you, TheraSpecs outdoor migraine sunglasses incorporate the same protective tint on darker, polarized lenses and can help reduce the harmful effects of the sun. However, it is important to remember that sunglasses should not be worn indoors on a regular basis because they can make your sensitivity to light worse over time.(11)
Wearing a wide-brimmed hat
Another common practice for dealing with migraine-related photophobia involves wearing a hat for either indoor or outdoor use. A wide-brimmed hat can be especially effective in providing coverage against direct overhead light from the sun or interior lighting in offices and shops.
Changing your light bulbs
If you want to avoid the troubles of fluorescents, you can consider changing the type of light you use. We have found that the best light bulbs for migraines and light sensitivity are warm white LEDs that give off less blue light; they are also a great alternative to fluorescent lighting. There may be other options as well, so it is best to experiment with different types in order to find what works best for you.
Adjust your Environment
Minor adjustments to your work or home environment can also yield tremendous benefits for your health. Computer monitor covers, the use of shades that block repetitive or contrasting patterns, as well as f.lux software to cut down on computer blue light are great ways to reduce the negative effects of light. If you do not have the ability to make these changes in your job or office, it may make sense to address light sensitivity in the workplace directly with your employer.
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1 Giffin NJ, Lipton RB, Silberstein SD, Olesen J, Goadsby PJ. The migraine postdrome: An electronic diary study. Neurology. 2016;87(3):309-313. doi:10.1212/WNL.0000000000002789.
2 Harriott, A. M., & Schwedt, T. J. (2014). Migraine is Associated With Altered Processing of Sensory Stimuli. Current pain and headache reports, 18(11), 1-7.
3 Kelman L. The triggers or precipitants of the acute migraine attack. Cephalalgia. 2007 May;27(5):394-402. Epub 2007 Mar 30.
4 Tekatas A, Mungen B. Migraine Headache Triggered Specifically by Sunlight: Report of 16 Cases. Eur Neurol 2013;70:263-266.
5 Vanagaite J, Pareja JA, Støren O, White LR, Sand T, Stovner LJ. Light-induced discomfort and pain in migraine. Cephalalgia. 17(7), 733-741.
6 M. Tatsumoto, T. Eda, T. Ishikawa, M. Ayama, K. Hirata. Light of Intrinsically Photosensitive Retinal Ganglion Cell (ipRGC) Causing Migraine Headache Exacerbation. IHC symposium OR3. 2013 June.
7 Wilkins A, Veitch J, Lehman B. LED lighting flicker and potential health concerns: IEEE standard PAR1789 update. Energy Conversion Congress and Exposition 2010;171-178.
8 Shepherd A. Visual Stimuli, Light and Lighting are Common Triggers of Migraine and Headache. Journal of Light & Visual Environment. Vol. 34 (2010) No. 2 P 94-100.
9 Noseda R, Kainz V, Jakubowski M, Gooley JJ, Saper CB, Digre K, Burstein R. A neural mechanism for exacerbation of headache by light. Nature Neuroscience 2010 Feb;13(2):239-45.
10 Malone CD, Bhowmick A, Wachholtz AB. Migraine: treatments, comorbidities, and quality of life, in the USA. Journal of Pain Research. 2015;8:537-547. doi:10.2147/JPR.S88207.
11 Digre KB. Photosensitivity and the headache patient. American Headache Society.