Updated May 19, 2015.

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

No one wants a headache after surviving another stressful work week or while on that much needed spring break vacation. Yet, this phenomenon does happen—it's not a myth—and in fact, these weekend  or vacation headaches can be more painful than your usual headaches.

Let's review the "let-down" hypothesis on headaches and what you can do to prevent them and get back to relaxing.

The Science

The idea of a vacation or weekend headache is supported by scientific evidence.

In one small study in Neurology, 17 migraineurs together completed over two thousand electronic headache diary entries documenting their migraine attack experiences and level of stress, over a one to three month period (Lipton et al., 2014).

The stress of the migraineurs was measured using two scales, the Self-Reported Stress Scale (SRSS) and the Perceived Stress Scale (PSS).

Results showed that stress levels were not associated with migraine occurrence. But, a decrease in stress level from one evening to the next was associated with an increased migraine occurrence over the subsequent 6, 12, and 18 hours.

So, for instance, you are more likely to have a migraine on Sunday if you have a stressful day at work on Friday followed by a decline in stress through Saturday.

Results were strongest during the first six hours after the decline in stress. In fact, at this six hour mark, you are five times more likely to develop a migraine attack.

Why Does This Happen?

Scientists are not totally sure. It could be that the period of high stress started the migraine process, but you didn't actually feel the pain until the low stress period.

In addition, those high stress periods could make you more vulnerable to a migraine attack, which then strike on the weekend when you can finally relax. Another theory is that stress hormones, like cortisol, decrease during relaxation periods, which may trigger your migraine.

What Can I Do?

Managing your high-stress level days is important in avoiding a headache. Remember, you cannot avoid all triggers. Rather, learning to cope with triggers is key. Here are a few healthy tidbits:

• Sleep: Sleep deprivation is a common migraine trigger, causing more frequent and more severe migraine attacks. So, while it may be tempting to stay up later to continue rehearsing a work presentation, in the end it may cause more harm than help. Be sure to get your Zzz's during high stress periods.
• Get in Shape: Maintaining a healthy weight can help your migraines. In fact, in one study in Neurology of nearly 3,800 migraineurs, obese individuals were more likely to have severe, disabling migraine attacks and a higher number of attacks than those who were not obese (Bigal, Liberman, & Lipton, 2006).
• Caffeine: Ideally, it's best to avoid caffeine all together in your diet. But, if you are a coffee or tea drinker, stick to your typical caffeine intake during periods of high stress, even though you may be tempted to drink more. Similarly, stick to your same caffeine regimen on the weekends or during periods of relaxation to avoid a withdrawal headache.

Take Home Message

Do not be surprised if you develop headaches during seemingly low stress periods. While scientists do not know the precise "why" behind this timing, coping with your stress during those high pressure times is helpful for both your headache and overall health. Talk with your doctor about strategies you can implement to adopt a healthier lifestyle.

 

<sub>Sources

Bigal ME, Liberman JN, & Lipton RB. Obesity and migraine: a population study. Neurology. 2006 Feb 28;66(4):545-50.

Bordeaux B, & Lieberman HR. Benefits and risks of caffeine and caffeinated beverages. In:UpToDate, Basow DS(Ed), UpToDate, Waltham, MA, 2014.

Kelman L, & Rains JC. Headache and sleep: examination of sleep patterns and complaints in a large clinical sample of migraineurs.Headache 2005; 45(7):904-10.

Lipton RB, et al. Reduction in perceived stress as a migraine trigger: testing the "let-down headache" hypothesis. Neurology. 2014 Apr 22;82(16):1395-401.

Martin PR. Behavioral management of migraine headache triggers: learning to cope with triggers.
Curr Pain Headache Rep. 2010 Jun;14(3):221-7.

Torelli P, Cologno D, & Manzoni GC. Weekend headache: a retrospective study in migraine without aura and episodic tension-type headache. Headache. 1999 Jan;39(1):11-20.</sub>

 

DISCLAIMER: The information in this site is for educational purposes only. It should not be used as a substitute for personal care by a licensed physician. Please see your doctor for advice, diagnosis, and treatment of any concerning symptoms or medical condition.