Healthcare providers have a significantly higher risk of migraine than the general population, and nurses have the highest migraine risk of all HCPs, according to a nationwide, population-based cohort study in The Journal of Headache and Pain. Emotional stress, heavy workloads, and rotating night shift sleep disturbances are among the most significant risk factors.

“Nurses and physician assistants are under unique stressors when it comes to their own health,” Noah Rosen, MD, Director of Northwell Health’s Headache Center in Great Neck, NY, says. “Often, they will skip meals or drink less to cut down on bathroom breaks, both of which can be triggers for migraines. In addition, shift work, with aberrant sleep, can also be a significant stressor.” Likewise, the researchers indicate that night shifts may result in sleep deprivation, poor quality sleep, and difficulty falling asleep, and epidemiological data of nurses show that working more than eight night shifts significantly increases the risk of migraine.

A migraine attack can happen at any time. However, some 113 million workdays are lost each year in the US due to migraine, and some 90% of individuals who live with migraine say they can’t function at work once the pain settles in. 

If migraines are affecting your ability to care for your patients, consider these points.  

Always eat breakfast

• Of course, you’re rushed! But fasting or skipping meals can trigger a migraine due to alterations in your blood glucose levels. Plan to eat a high-protein breakfast, skip the high-carbohydrate meals, and schedule snacks during your workday. Simply sneaking in a piece of fruit in between patients could help.

Stay well hydrated

• Drink at least eight ounces of water several times a day to avoid getting dehydrated. While caffeine may help the pain, it can also create withdrawal symptoms, so try limiting your caffeinated beverage intake.

Rethink your schedule to create time for yourself

• Dr. Rosen suggests that sleep, meals, hydration, and stress reduction techniques be built into your daily schedule. “Using break time is important: hydrate, meditate or take a walk,” he suggests. “These can be very effective at preventing migraine.”

Consider your workplace environment

• Since environmental factors can cause migraine, take a look around your workplace. Bright light can trigger migraine, so if possible, avoid fluorescent lighting. If you have your own office, see if you can get a lamp with an incandescent bulb instead. Since strong smells can trigger symptoms, you may need to respectfully converse with a co-worker who uses strong-smelling aftershave or perfume.

Be aware of early symptoms

• Some people notice symptoms of their migraine before the pain starts, Dr. Rosen emphasizes. “This is called the prodrome, and it can include yawning, a change in your energy level, mood changes, and hunger,” he says. “This awareness can be helpful to prepare you for a migraine, and so you can try to limit other triggers.”

‍Talk to your supervisor

• If you think migraine attacks are hindering your ability to function at work, it’s time to talk with your supervisor about getting some support. You may be covered under the Americans with Disabilities Act (ADA), which protects employees who have hidden or episodic disabilities, such as migraine.  

The Department of Labor’s Job Accommodation Network describes the ADA and explains how to request certain accommodations. Under Title 1, for example, you may request and secure certain reasonable accommodations at work. This could mean working in an environment with less exposure to chemical odors or requesting an alternate assignment or flex time. Be aware that if a migraine “substantially limits one or more major life activities,” you may be covered under the ADA.