Postdrome: The migraine hangover

By: Rachel Baxter, Communications Officer, The Migraine Trust

18th February 2022

If you’ve ever felt sleepy, hungry or even euphoric at the end of a migraine attack, you were probably experiencing a so-called ‘migraine hangover’. In this blog, we answer common questions about this lesser known part of migraine.

What is a migraine hangover?

Despite the name, a migraine hangover is not a migraine attack caused by alcohol, but rather a stage of a migraine attack that can mimic the symptoms of a traditional hangover.

Officially known as the postdrome, it is the last stage of a migraine attack and can involve a range of symptoms. It occurs after the main migraine attack symptoms like severe head pain, dizziness or vomiting have resolved. When these symptoms pass you might assume your migraine attack has completely gone, but you can actually still be experiencing it for hours or even days more. The postdrome is a normal part of a migraine attack that many people with migraine experience.

What causes a migraine hangover?

The postdrome, or migraine hangover, is part of a migraine attack rather than a reaction to the attack. That means that the cause of the migraine hangover feeling is the same as what kickstarted your migraine attack in the first place, even if that was a few days ago. Your migraine attack might have been triggered by something specific, or a combination of factors, such as lack of sleep, skipping a meal, dehydration or stress. Working out your migraine triggers can be difficult, but keeping a headache diary and showing it to your doctor can help. Find out more about keeping a headache diary here and more about triggers and avoiding them here.

A 2016 study found that the severity of a migraine attack doesn’t seem to affect the length of the postdrome stage. There also doesn’t seem to be a link between postdrome duration and medication taken during the migraine attack. The migraine hangover is the least studied and least understood stage of migraine, so we need further research to find out more about it and why it occurs at the end of an attack.

What does a migraine hangover feel like?

There’s a reason that the postdrome stage is nicknamed a migraine hangover; it’s because that’s just what it feels like even though you’ve not been drinking. Symptoms might vary from person to person, but can include:

  • Feeling drained, tired or weary
  • Aches
  • Stiff neck
  • Difficulties concentrating or brain fog
  • Digestive issues
  • Mild head pain or discomfort
  • Feeling very hungry or thirsty
  • Mood changes
  • Feeling euphoric and full of energy

The symptoms of postdrome are sometimes the opposite of how you felt at the very start of the migraine attack, so if you felt really tired in the lead up to the main headache stage of your attack, you might feel very energetic at the end and vice versa.

The first stage of a migraine attack is known as the premonitory stage and happens before more noticeable symptoms like aura, headache or nausea kick in. The symptoms of both the premonitory stage and postdrome/hangover stage can be quite subtle so many people don’t realise that they are actually part of a migraine attack. If you get to know your premonitory symptoms (keeping a headache diary will help), they can be a useful warning sign that nastier symptoms are on their way and you should take your rescue medication. For more about the stages of a migraine attack, click here.

How long can a migraine hangover last?

It varies from person to person but a migraine hangover can last from hours to a day, or even multiple days. Most people find that their migraine hangover resolves within 24 hours.

How to help a migraine hangover

There’s no proven cure for a migraine hangover, but a number of simple tricks might help. Some people find that gentle activity, stretching or massages can help them feel back to normal. For others, eating comfort foods can help, as can caffeine. However, if caffeine tends to trigger your migraine attacks, it’s best to avoid it. Resting can also help you get rid of a migraine hangover – take it easy and get some sleep if you can, and avoid strenuous activities. Some people also find ice packs or heat pads/hot water bottles beneficial.

Don’t punish yourself if you have a migraine hangover – it’s easy to feel guilty or frustrated when the main attack stage of a migraine has passed and you still don’t feel like getting work or chores done, going out or socialising, but remember, you’re still experiencing the migraine attack. Be kind to yourself, try to relax, drink plenty of water and listen to your body.

If your migraine symptoms are worrying you or having a big impact on your life, it’s worth speaking to your GP or headache specialist. You can read about migraine treatment options here and why you should keep persisting with your GP here.