Common Migraine Comorbidities: One Body, Many Health Conditions

Migraine often coexists with other health conditions. In fact, if you have migraine, you’re actually more likely to have certain other disorders. As if migraine alone weren’t enough to deal with!

When a health condition appears more often in the presence of other conditions than you’d expect by chance, they are called cormorbid conditions. (Don’t worry: The medical definition of “morbid” refers to illness or disease, not to anything gruesome or macabre.) It doesn’t necessarily mean one condition causes the other. But it does mean they tend to be fellow travelers: When you find one, you’re more likely to find the other. 

Why Are Comorbidities With Migraine Important?

Being aware of your migraine comorbidities and seeking treatment for them is important for several reasons.

Some comorbidities are risk factors for your migraine to worsen. Migraine can progress over time from episodic (fewer than 14 days per month) to chronic (15 or more headache days per month), becoming a more severe condition that’s harder to treat. The presence of certain comorbidities makes chronification more likely. But treating your comorbidities lessens that risk.

Comorbidities can provide clues toward an accurate migraine diagnosis. Migraine diagnoses can be notoriously challenging to pin down; misdiagnosis is horrendously common. But certain types of migraine are more common in the presence of other disorders. The presence of those comorbidities can give your doctor helpful hints toward an accurate diagnosis, which in turn will affect your migraine treatment plan.

They can affect your migraine medication options. If your doctor knows you have certain comorbidities, it may help them choose the best medication for you.

• • Certain medicines work to treat more than one condition. If one medication can treat both your migraine and a comorbidity, reducing the number of medications you have to take, that’s a win-win.
  • Certain medicines have safety risks in the presence of some comorbidities, and should be avoided.

Migraine is just one part of your health picture. Each health disorder contributes to the burden that weighs on your body, mind and life. The greater those burdens, the more challenging migraine treatment can be. Treating your comorbidities can actually help you manage migraine.

Common Migraine Comorbidities

Here’s an overview of the health disorders that are most closely associated with migraine.

Cardiovascular disorders and migraine

Perhaps surprisingly, migraine is linked to cardiovascular conditions. People with migraine are more likely to have a heart attack, stroke, blood clots or an irregular heartbeat (atrial fibrillation) than people without migraine.

Several studies have established this link, including one that looked at the medical histories of 51,000 people with migraine over 19 years. They found that people with migraine are:

• • 1.5 times more likely to have a heart attack or blood clots
  • Nearly twice as likely to have an ischemic stroke
  • More than twice as likely to experience peripheral artery disease, angina, or TIA

Two factors heighten cardiovascular risks with migraine even further:

• • Migraine with aura. The presence of aura doubles the risk of stroke.
  • Being female. Women with migraine are more likely to develop cardiovascular conditions than men.

Given the association between migraine and cardiovascular disease, one journal editorial concluded, “It is time to add migraine to the list of early life medical conditions that are markers for later life cardiovascular risk.”

Psychiatric disorders and migraine

People with migraine are also more likely to have certain psychological disorders. Interestingly enough, the relationship works in both directions: The presence of certain mental health disorders also means you’re more likely to develop migraine.

That includes:

• • Depression. People with depression are three times as likely to develop migraine, and vice versa. The fact that antidepressants are an effective treatment for both depression and migraine points to a biological link.
  • Anxiety. About half of people with migraine will develop an anxiety disorder at some point in their lives, making it the most common migraine comorbidity. Having anxiety is also a significant risk factor for developing migraine.
  • Bipolar disorder. People with migraine are three times as likely to have bipolar disorder than people without migraine.
  • Post traumatic stress disorder. People with PTSD are twice as likely to have migraine than those without.

Even on its own, a mood disorder has an enormous impact on a person’s quality of life. In someone with migraine, a mood disorder can erode quality of life even further, since it tends to increase the frequency, duration, and intensity of migraine attacks, and makes migraine harder to treat.

Sleep disorders and migraine

People with migraine are between two and eight times more likely to develop a sleep disorder such as:

• • Insomnia. This condition is defined as having difficulty falling or staying asleep; waking up too early; or having non-refreshing sleep for three nights per week or more, for at least six months. It’s three times more common among people with migraine than those without. People with chronic migraine (15 headache days per month or more) experience insomnia almost twice as much as those with episodic migraine (14 days per month or less). What’s more, people with migraine who also have insomnia are more likely to experience the additional migraine comorbidities of anxiety and depression.

• • Restless legs syndrome. This discomfort in the legs can interfere with sleep and is especially common with people with migraine and fibromyalgia. It can be made worse with antidepressants and anti-nausea medications that are used to treat migraine.
  • Snoring and sleep apnea. Both are risk factors for chronic daily headache, as well as for other comorbidities like cardiovascular disease.

Other common migraine comorbidities

• • Chronic pain disorders such as fibromyalgia and back pain.
  • Concussion. People with migraine are at a higher risk for concussions and post concussive syndrome. Concussion is also a risk factor for developing migraine.
  • Endometriosis. Having migraine puts women at a significantly higher risk for this painful disease. Having both conditions also elevates the risk of developing a mood disorder.
  • Epilepsy. Migraine makes you more than twice as likely to have epilepsy, and vice versa.
  • Obesity. The risk of migraine increases with increasing obesity status, from normal weight to overweight to obese. Obesity is also a risk factor for increasing migraine attacks. In addition, both obesity and migraine are risk factors for stroke.
  • Rheumatoid arthritis. People with migraine are more than twice as likely to experience this autoimmune disease.

3 Ways to Manage and Prevent Comorbidities with Migraine

Having migraine doesn’t mean that additional health disorders are your destiny. However, knowing you’re at greater risk gives you the power to take actions that can prevent or treat those diseases. There’s so much within your control, including three steps you can take right now.

• • Talk to your doctor. They’ll help you understand your risk for comorbidities and put together a treatment plan.
  • Coordinate your care. When you live with multiple health issues, it’s essential that all your providers are on the same page. Make them aware of your full health picture and keep an open line of communication with them.
  • Commit to making healthy lifestyle choices. Luckily, there’s a highly effective treatment that works for both migraine and many of its comorbidities: Making healthy changes to your exercise, sleep, diet, and stress management. A consistent commitment to basic health and wellness activities can make a world of difference in improving your migraine, your comorbidities, and your life.

Every part of you matters. If you have multiple comorbidities, take heart: Targeting just one condition has a positive domino effect on the others. The Care Tuner app helps you find the healthy behaviors that work best for you to decrease migraine attacks and improve overall health. To learn more click here.