If your head starts to pound the day the air turns hot and dry and the palm fronds begin to rattle, you are not imagining it. Southern California's environment gives people with migraine a set of triggers that the rest of the country does not have to think about. This guide leads with the one everyone asks about, then works through the other nineteen.
Santa Ana winds and migraine headaches: what patients should know
1. The Santa Ana winds
The Santa Anas are hot, dry, downslope winds that pour out of the Great Basin and the high desert, through the mountain passes, and across the Los Angeles basin toward the coast. Most events arrive between September and March, last from one to several days, and bring a sudden jump in temperature, a fall in humidity to below ten percent, and gusts that can top 40 miles per hour in the canyons and passes.
Several things happen at once during a Santa Ana event, and each is a recognised migraine trigger on its own.
- Rapid weather change. Temperature and barometric pressure both shift quickly. In population studies, a rise in temperature raises the odds of a migraine visit by roughly 7 to 15 percent, and pressure changes by a smaller margin. The change seems to matter more than the absolute value.
- Dry air and dehydration. Humidity this low pulls moisture out through the skin and airways faster than usual, and mild dehydration is one of the most reliable triggers there is.
- Dust and pollution. The winds lift dust and, in fire season, smoke, and they push the basin's smog around rather than clearing it. Fine particulate matter and ozone are both linked to more migraine attacks.
- Disrupted sleep. Hot nights and rattling windows cut into the deep sleep that a migraine brain depends on.
The honest caveat is that weather sensitivity varies. In surveys roughly half of people with migraine name weather as a trigger, but controlled studies find the effect is real for a subset and absent for others. Folklore about positive ions has not held up. If your attacks track the winds, they are worth planning around; if they do not, you can stop worrying about the forecast.
Planning around a Santa Ana event means drinking more water than usual starting the day before, keeping windows closed and running a filter if the air is dusty or smoky, wearing sunglasses outside, keeping your sleep as regular as the heat allows, and having whatever your neurologist has prescribed with you. What to do when an attack starts is a conversation to have with your neurologist in advance, and that plan is part of what a headache neurology visit sets up.
What this article covers
The remaining nineteen triggers fall into four groups: other environmental triggers particular to Southern California (2 to 6), sensory triggers (7 to 9), lifestyle triggers (10 to 16), and dietary triggers (17 to 20). If you are not sure whether what you have is migraine, our guide to what migraines are and how they unfold and our page on the types of headaches are the place to start.
Other environmental triggers in Southern California
2. Wildfire smoke and smog
Fire season and freeway traffic both fill the basin with fine particles, nitrogen dioxide, and ozone. Breathing them irritates the airways and is linked, in several studies, to more migraine attacks and more emergency visits for headache. Check the daily air quality index on the AirNow site, and on bad days stay indoors with windows closed, run an air purifier if you have one, and move exercise inside.
3. Bright sunshine and glare
A migraine brain is unusually sensitive to light. Midday sun reflected off the ocean, a windshield, or a white building can be enough on its own. Polarised sunglasses, a hat with a brim, and a car visor with a UV coating remove most of the problem; tinted migraine glasses help people who are very light-sensitive.
4. Heat and dehydration
Summer heatwaves and the winter days in the eighties both cost fluid through sweat you may not notice. Dehydration is a trigger for most people with migraine, and it sneaks up on hikes, at the beach, and during outdoor work. Drink before you are thirsty, carry water, and move strenuous exercise to early morning or evening in hot weather.
5. Barometric pressure swings
Barometric pressure and headaches are among the most searched pairings in headache medicine. The evidence is mixed: some careful studies find a small rise in attacks with falling pressure, others find none, and the effect in any individual is what matters. June Gloom mornings that burn off into warm afternoons, marine layer arrivals, and the front edge of winter storms are the local examples. A diary that notes the forecast is the only way to know whether pressure is one of yours.
6. Year-round pollen
Because something is always in bloom here, allergy season never quite ends. Congestion and sinus pressure lower the migraine threshold, and a good share of what people call sinus headaches turn out to be migraine with nasal symptoms. Keeping windows closed on high-pollen days and running a filter help; if allergies are persistent, ask your doctor which treatment is appropriate for you.
Visual guide
Local weather is one part of the picture
- Wind and heat: Hot, dry conditions can be relevant for some migraine patterns.
- Air quality: Smoke and smog are exposures worth noting in a diary.
- Hydration: Heat and dehydration can occur together in daily life.
Sensory triggers
7. Loud noise and overstimulation
Concerts at the Bowl, stadium games, and a Friday-night restaurant all push a lot of sound into a nervous system that processes it more intensely than most. High-fidelity earplugs lower the volume without muffling the music, breaks in a quieter spot help, and noise-cancelling headphones make a commute or an open-plan office more tolerable.
8. Strong smells
Osmophobia, an aversion to smell, is reported by the large majority of people with migraine, and strong odours can bring on an attack within minutes. Perfume and cologne, scented cleaning products and air fresheners, vehicle exhaust, fresh paint, and, on a warm evening, night-blooming jasmine are the usual local culprits. Unscented products at home, a word with colleagues about fragrance, and stepping out of a smell quickly are the practical measures.
9. Flickering and harsh light
Strobe lighting at clubs and rides, fluorescent tubes that flicker, and screens with a low refresh rate are all triggers separate from brightness. Softer, diffused lighting at home and work, LED replacements for fluorescents, and briefly closing your eyes during a strobe sequence reduce exposure.
Lifestyle triggers
10. Traffic stress
Sitting tense in a long commute, with vehicle exhaust coming through the vents, combines stress and pollution. Calmer audio, breathing slowly at red lights, stretching the neck and shoulders when stopped, off-peak timing where possible, and a couple of days a week on transit or carpooling all help.
11. The weekend let-down
Some people get their attacks not during the stressful week but on Saturday morning, when stress hormones fall, wake time shifts, and the usual coffee arrives late. Keeping wake time within an hour of weekdays and keeping caffeine timing steady prevents most of these.
12. Irregular sleep
Too little sleep and too much are both triggers, and a schedule that lurches between them is worse than either. Shift work and late nights followed by long lie-ins are the common local versions. Regular bed and wake times, even on weekends, are among the most effective preventive measures available, and persistent insomnia is worth treating in its own right.
13. Why do I get headaches only at home?
This is a question we hear often from people in Los Angeles, and the answer is usually in the house. Fragranced candles, plug-in air fresheners, and scented laundry products are triggers you may not notice because you are used to them. Bright or flickering overhead lighting, an old monitor, and long evenings on a screen add light and eye strain. A hot, closed bedroom, a mattress or pillow that leaves the neck stiff, and the weekend sleep and caffeine shift in item 11 finish the picture. Mould or poor ventilation is a less common cause. If headaches reliably arrive at home and lift when you leave, work through those one at a time, and mention the pattern to your neurologist, because it is a useful clue.
14. Travel, jet lag, and altitude
Flights from LAX disrupt sleep and dehydrate; drives to Big Bear or Mammoth add a rapid climb to altitude, where lower oxygen and pressure trigger headaches in many people. Shifting your schedule gradually before a time-zone change, drinking water through the flight, and ascending in stages with an easy first day at altitude all reduce the risk. If travel reliably triggers attacks, discuss it with your neurologist before the trip rather than after.
15. Overexertion and hard training
Regular moderate exercise reduces migraine frequency over time. Sudden maximal effort, especially in heat, does the opposite: a steep trail run at noon or a heavy lifting session without warming up can trigger an attack within the hour. Warm up, cool down, build intensity gradually, and keep hard sessions out of the heat of the day.
16. Screen time
Long hours on screens combine light, flicker, sustained focus, and a fixed neck posture. The 20-20-20 rule, looking twenty feet away for twenty seconds every twenty minutes, a screen at eye level, warmer display settings in the evening, and breaks that involve moving reduce the load. Migraine-specific tinted lenses help some people.
Dietary triggers
Food triggers are the most personal of all, and the least consistent between people. A diary is more useful than an elimination diet, which tends to remove foods that were never the problem.
17. Caffeine swings
Caffeine can ease a migraine and can trigger one, depending mostly on consistency. A steady daily amount is usually fine; a large swing, in either direction, is not, and a missed morning coffee is one of the most common causes of a weekend headache. Find a level you can keep and keep it, including on weekends, and taper rather than quit if you want to cut down.
18. Alcohol, especially red wine
Red wine is the classic trigger, and beer, champagne, and spirits affect some people too. Alcohol dilates blood vessels, dehydrates, and disturbs sleep, and some drinks carry histamine and other compounds that add to the effect. If you notice a pattern, identifying which drinks are worst is more useful than giving up everything, and a glass of water for each drink limits the dehydration.
19. Additives and aged foods
Monosodium glutamate, nitrates and nitrites in cured meats, some artificial sweeteners, and tyramine in aged cheese, cured meat, and fermented foods are reported triggers for some people. The evidence for each is weaker than its reputation, so treat these as things to check in your diary rather than things to avoid on principle.
20. Skipped meals and fasting
Going too long without food drops blood sugar, and a missed lunch is one of the most reliable ways to produce a late-afternoon migraine. Regular meals, a snack on long days, and caution with intermittent fasting, which triggers attacks in a proportion of people with migraine, are the answers. If you want to try fasting, do it gradually and discuss it with your doctor.
How to find your own triggers
Twenty triggers is a list, not a diagnosis. Most people are sensitive to a handful, and triggers often work in combination: the wind alone does nothing, but the wind plus a short night plus a skipped breakfast does. For two to three months, note each attack with the date, the weather and air quality, your sleep, meals, drinks, stress, and any unusual exposure. Patterns emerge that no list could predict. Bring the diary to your appointment; it is the single most useful thing a headache neurologist can be handed.
Trigger management is also only half of migraine care. When attacks are frequent, disabling, or changing in character, the bigger gains come from a preventive plan and effective acute treatment, chosen for you. Our page on when to worry about a headache lists the warning signs that need urgent care rather than a diary. For everything else, you can request a visit with our headache neurologist in Beverly Hills or Los Angeles, or by video anywhere in California.
Visual guide
Find the triggers that matter to you
- Notice exposures: Wind, glare, heat, and air quality may matter for some people.
- Keep a diary: Record attacks and possible triggers over time.
- Build a care plan: Frequent or disabling attacks deserve more than trigger avoidance alone.
Frequently asked questions
References
- American Headache Society. Migraine triggers.
- Silva-Néto RP, et al. Odorant substances that trigger headaches in migraine patients. Cephalalgia, 2014.
- Mukamal KJ, et al. Weather and air pollution as triggers of severe headaches. Neurology, 2009.
- National Institute of Neurological Disorders and Stroke. Migraine.
- American Headache Society. What's that smell?
- AirNow. Air quality index for your area.