Everybody knows that stress gives you a headache.

Everybody knows that a lack of sleep gives you a headache.

In fact, everybody knows that drinking wine, skipping a meal, and studying too hard for a test can give you a headache.

But why?

There’s no easy answer to this question, and the true answer likely includes multiple factors. People with migraine likely have genetic differences that lower pain thresholds and increase the likelihood of having migraine attacks. People with migraine are also more likely to have had early childhood trauma and high-stress times in their lives, which could change how their brains interact with their environment. However, oxidative stress may play an important role inlowering the threshold for triggering migraine attacks, making it easier for migraine attacks to happen more often.

Part of healthy cell functioning is producing by-products of cell metabolism called reactive oxygen species. Normally, these oxygen species are immediately neutralized by antioxidants that naturally occur in our brains. But in certain situations, the cells in our brains produce too much of these oxygen species, which can interfere with how our brain cells function. This is called "oxidative stress," because the reactive oxygen species are putting stress on the brain’s healthy functioning.

What are these situations that cause oxidative stress? It is a list you already know well: psychosocial stress, sleep deprivation, sedentary behavior, alcohol, and skipping meals. In fact, most of the factors people typically think of as migraine "triggers" could potentially act on the brain through oxidative stress.

So, will avoiding oxidative stress help you avoid headaches? Well, we are not sure yet. What we do know is that some medications that are effective for migraine, like topiramate, may work, in part, through reducing oxidative stress. We also know that certain lifestyle changes that reduce oxidative stress also have promising evidence to reduce headache symptoms. For example, interventions that reduce stress, such as relaxation, biofeedback, and stress management therapies, have all demonstrated efficacy in reducing migraine frequency. Mindfulness-based therapies, which reduce stress, have also shown promise for migraine management. Similarly, increasing exercise and improving sleep have also shown potential for reducing migraine attack frequency.

Headaches aren’t your fault. But there are biologically plausible reasons why you may notice some patterns in your life connecting how you live to how often you have headaches. If you’re looking to make some changes to improve your headache management, you may want to consider those that could improve oxidative stress.

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