To prevent vestibular migraine attacks, the most useful steps are to look after a few lifestyle habits and to find what triggers them for you. This page explains how to do this with a diary and simple measures, and when to seek advice. It complements any treatment your doctor prescribes.

What are these measures for?

Attacks of vestibular migraine have different triggers in different people. These measures aim to reduce how often and how severe your attacks are and to help you feel more secure.

They are a supporting measure. Studies on preventive measures are few and small, so we cannot say that any one works for everyone. But they are safe and improve general health.

Before you start

Follow these measures only if you have already been diagnosed with vestibular migraine.
If you have dizziness different from your usual, seek advice first.
It is normal not to notice any change at first. Give it a few weeks.
A notebook or an app to write in is enough.

How to do it

Keep an attack diary. Note the date and time, how long it lasted, symptoms, what you ate, how much you slept, stress, the weather and, for women, the day of the menstrual cycle. After a few weeks you will see patterns.
Sleep regularly. Go to bed and get up at similar times, including at weekends. Avoid late nights.
Eat at regular times. Do not skip meals or fast for long periods. Include protein, complex carbohydrates and healthy fats.
Drink water through the day, especially in hot weather or after exercise.
Exercise moderately and regularly. Walking, swimming or cycling, without getting exhausted.
Manage stress. Deep breathing, relaxation or yoga may help. If anxiety is overwhelming, talking therapy helps.
Watch caffeine and alcohol. Have caffeine in moderation and at regular times. Notice whether alcohol brings on attacks.
Test your possible triggers. If your diary shows that something keeps recurring (a food, a light, a smell), reduce it and see if you improve. Do not remove everything at once.
Do not overuse painkillers. Taking them almost daily can make attacks worse. Talk to your doctor if you need them more than 2-3 days a week.

Routine

Routine	What to do
How often	Note every attack; habits, every day
For how long	Diary for 8-12 weeks; habits, ongoing
When to stop	The diary, once you know your triggers and are stable. The habits, never

Always follow the routine your doctor gave you, which may be different.

Common mistakes

Banning many foods at once without checking whether they affect you.
Thinking there is a single diet that suits everyone.
Stopping caffeine suddenly: it can cause headache.
Taking painkillers daily to avoid attacks.
Doing exhausting exercise only occasionally.
Writing nothing down and relying on memory.

What is normal and when to seek advice

It is normal to:

Take weeks or months to see improvement.
Have an attack some days despite looking after yourself.
Find that your triggers change over time.

Seek advice if:

Attacks are more frequent or more severe.
A different kind of dizziness appears.
You need painkillers almost every day.
Anxiety or fear of attacks limits you.

Call 112 (in Spain) or your local emergency number, or go to A&E, if the dizziness comes with a very severe sudden headache, double vision, difficulty speaking, weakness or tingling on one side of the body, or sudden hearing loss.

Frequently asked questions

Do I have to give up chocolate and cheese? Not necessarily. Only if your diary shows that they bring on attacks.

Is coffee bad? In moderation and at regular times it is usually fine. Stopping suddenly can cause a headache.

Does exercise help? Yes, if it is moderate and regular. Very intense effort can trigger attacks in some people.

Does my period affect it? It can. That is why it helps to note the cycle day in your diary.

Can attacks be prevented completely? Not always, but many people reduce their attacks with habits and, if needed, preventive medication.

Do any supplements help? There is no firm evidence that they work in vestibular migraine. Check with your doctor before taking any.

References

For general information only. It does not replace a medical consultation and cannot be used for diagnosis. In an emergency in Spain, call 112.

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