A weekend migraine, also known as a let-down migraine, is a type of headache that typically occurs on weekends, often after a hectic week. Changes in routine between the weekdays and weekends often trigger episodes.

Weekend migraine episodes can occur with the sudden release of stress and tension that has built up over the week, creating a kind of let-down effect. This is why it’s also called a let-down migraine. This sudden shift in stress levels can trigger a migraine episode.

Let’s explore the causes and symptoms of weekend migraine, how to treat it, how to prevent new episodes, and when to contact a doctor.

The primary trigger of a let-down or weekend migraine episode is a sudden decrease in stress levels. This might sound surprising, but your body reacts to the drastic shift from high tension to relaxation.

When you’re stressed, your body releases a hormone called cortisol, which helps manage stress and can reduce pain. However, when the stress subsides, so does your cortisol production, leaving you more susceptible to pain. This can trigger an episode.

Other common triggers include:

  • Anxiety: Too much anxiety can increase your risk of frequent headache episodes.
  • Changes in sleep patterns: Both lack of sleep and excessive sleep can trigger headaches.
  • Seed oils: Some eating patterns can increase or decrease the risk of getting a migraine episode. For example, consuming inflammatory seed oils like vegetable or canola oil increases your omega-6 levels. This raises your migraine risk by about 40%.
  • Lack of protein intake: Consuming less protein and omega-3 fats throughout the week increases your chance of migraine headaches.
  • Carbohydrates and sugar: There’s a link between migraine, type 2 diabetes, and insulin resistance. Eating bread, sugar, or carbohydrates during the week may increase your risk of getting an episode once the cortisol levels drop.
  • Caffeine withdrawal: If you’re used to having several cups of coffee during the week and suddenly cut back on the weekend, you may experience a let-down migraine episode.

The symptoms of a weekend migraine episode are similar to those of regular migraine episodes, but they typically show on weekends or during periods of relaxation after stress. Here are some of the symptoms you may experience:

Several treatments are available that can help manage the symptoms and reduce the severity of the headaches. Here are some options:

  • Pain relievers: Over-the-counter (OTC) drugs like ibuprofen can often provide relief. Your doctor may also prescribe stronger pain relievers if OTC medications are ineffective.
  • Triptans: Triptans, such as frovatriptan, can block pain pathways in the brain, and doctors often prescribe them for treating severe migraine.
  • Dihydroergotamines: Dihydroergotamines are especially effective for episodes that last longer than 24 hours. Various forms are available, including nasal sprays, intravenous fluid, and injections.
  • Anti-nausea medications: If your migraine episodes come with nausea, anti-nausea medications can help manage those symptoms.
  • Preventive medications: If you have frequent weekend migraine episodes, a doctor might recommend prophylactic medications before the weekend.

What works best for you depends on your specific symptoms, the severity of your headaches, and how often they occur.

Here are some practical tips to help you avoid weekend migraine headaches:

  • Keep stress levels steady: A sudden drop in stress can trigger a let-down migraine. Try to gradually wind down at the end of the week rather than abruptly switching from high stress to relaxation. You may also consider reducing stress at work, changing your job, or working from home.
  • Maintain a consistent sleep schedule: Try to wake up and go to bed at the same time every day, even on weekends. Irregular sleep patterns can trigger migraine.
  • Stay hydrated: Dehydration can trigger migraine episodes. Make sure to drink plenty of water throughout the day, especially if you’re active or it’s hot outside.
  • Manage caffeine intake: If you drink coffee during the week, don’t drastically cut back on the weekend, as this could lead to caffeine withdrawal migraine.
  • Reduce alcohol intake: There are links between alcohol and migraine. However, it’s not clear how much alcohol can affect migraine attacks. Cutting back may reduce the frequency or severity of episodes.
  • Reduce inflammation: Consider eliminating seed oils, added sugar, and processed carbohydrates from your diet.

What works for one person might not work for you. It’s helpful to understand your migraine triggers and discuss them with your doctor.

While an occasional migraine episode may not be a cause for concern, you may need to see a doctor if the episodes get worse. Here are some situations when you should consider contacting a doctor:

  • Increased frequency: You experience more than four headache days per month.
  • Severity: Your headaches are more severe than usual.
  • Medication use: You need to take pain medication more than 2 days per week to manage your headaches.
  • Ineffectiveness of medication: Your migraine symptoms don’t improve with medication, or they seem to worsen despite taking medication.
  • Change in symptoms: Your headache varies in intensity from previous headaches or lasts longer than you’re used to.

Let-down or weekend migraine attacks tend to occur when you go through a significant change in routine between the weekdays and the weekend. The most common cause is high-stress periods at work that end on Friday.

While there are many treatments available, you may want to consider nonprescription methods, such as reducing stress, to prevent episodes.