Barometric Pressure Headache: What the Research Says and How to Track It

If your head starts to hurt before the rain arrives, you are not alone. Weather is one of the most commonly reported migraine triggers, and "barometric pressure headache" is how many people describe pain that seems to arrive with a storm front.

The research is more mixed than most articles admit. The best explanation so far is that weather matters a lot for some people and very little for others. This guide covers what the evidence says, the proposed mechanisms, other weather factors, and how to find out whether weather is one of your triggers.

Not medical advice. This article is general information about weather and headache. It is not a diagnosis or a treatment plan. Talk to a doctor or other qualified health professional about your symptoms, and seek urgent care for any of the warning signs listed near the end.

What is a barometric pressure headache?

Barometric pressure is the weight of the air above you, measured in hectopascals (hPa, the same as millibars) or, in US weather reports, inches of mercury (inHg). It tends to fall as a storm approaches and rise as it clears.

"Barometric pressure headache" isn't a formal diagnosis. People use the phrase for a headache or migraine attack that seems to start when the weather changes.

Cleveland Clinic headache specialist Dr Emad Estemalik warns that the label can be misleading: many people who believe they get "barometric pressure headaches" or sinus headaches turn out to have migraine (Cleveland Clinic).

What does a barometric pressure headache feel like?

There is no single pattern. A weather-triggered migraine usually looks like your other attacks: often throbbing, often on one side, with nausea or sensitivity to light and sound (NHS). Cleveland Clinic notes that weather-triggered migraine can also come with facial discomfort around the sinuses, postnasal drip and teary eyes, which is why it is often mistaken for a sinus problem (Cleveland Clinic).

Sinusitis is different. The NHS lists pain and tenderness around the cheeks, eyes or forehead, a blocked or runny nose, green or yellow mucus and a high temperature (NHS). Our guide to headache vs migraine explains how doctors tell the main headache types apart.

Can barometric pressure cause headaches? What the research says

Mayo Clinic, NINDS and The Migraine Trust all list changes in weather or barometric pressure as a possible migraine trigger (Mayo Clinic; NINDS; The Migraine Trust). In a survey of 1,207 people at a US headache centre, 53.2% reported weather as a trigger (Kelman, 2007).

But the American Migraine Foundation notes that researchers haven't shown a clear link between weather and migraine, and results are mixed (American Migraine Foundation).

Studies that found a link

• Falling pressure in Japan. 28 people with migraine kept a headache diary for a year. Migraine was more frequent when pressure dropped by more than 5 hPa between the day of an attack and the next day, but not linked to the monthly average pressure. Weather change was associated with migraine in 18 of the 28 (64%) (Kimoto et al., 2011).
• Small drops below normal. In another small Japanese study of 34 people, attacks happened most often when pressure was between 1003 and 1007 hPa, a drop of 6 to 10 hPa below the standard 1013 hPa (Okuma et al., 2015). It was a small study, so treat this as a hint, not a threshold.
• Chinook winds in Canada. In 75 people in Alberta, migraine was more likely the day before a chinook (a warm westerly wind) and on high-wind chinook days. But the majority weren't sensitive to either (Cooke et al., 2000).
• Lightning. In 90 people with migraine, the odds of headache were higher on days with nearby lightning, though the authors urged caution until the result is repeated (Martin et al., 2013).

Studies that found little or nothing

• Vienna, 238 people. Over 90-day diaries, a few weather factors looked linked to headache at first, but none stayed significant after correcting for multiple testing, and people's own sense of the weather didn't match their attacks. The authors concluded that the influence of weather on migraine is "small and questionable" (Zebenholzer et al., 2011).
• Berlin, 100 people over a year. Pooled, there was no significant link between attacks and pressure, humidity or temperature. A subgroup was weather-sensitive, but individual attacks couldn't be predicted from the weather (Hoffmann et al., 2015).

Why the results disagree

The most consistent finding is that weather sensitivity is individual. In a study of 77 people with migraine, about half (50.6%) were sensitive to at least one weather factor, but more (62.3%) believed they were. About a third reacted to temperature and humidity, 14% to changing weather and 13% to pressure (Prince et al., 2004).

Pool people who react to falling pressure with people who react to heat and people who don't react at all, and the effects can cancel out. That is why your own records matter more than any average.

Why might pressure changes trigger a headache?

Nobody knows for certain. The main ideas are:

• Brain chemistry. Mayo Clinic says weather changes may cause imbalances in brain chemicals, including serotonin, which can prompt a migraine (Mayo Clinic).
• Sinuses and fluid balance. The sinuses are air-filled spaces. Cleveland Clinic describes how a fall in pressure may affect them and shift fluid balance in the surrounding tissues (Cleveland Clinic).
• Pain processing. Some researchers think pressure changes may affect pressure on the brain or the way the brain blocks pain (Cleveland Clinic).
• The inner ear. In mice, lowering pressure by 40 hPa activated neurons in part of the vestibular (balance) system (Sato et al., 2019). This is animal research, not proof.

There is also the threshold idea. An attack often follows a combination of factors rather than any single one (The Migraine Trust), so weather may only tip you into an attack when you are already vulnerable (American Migraine Foundation). That could explain why the same storm triggers an attack one week and not the next.

Other weather factors: heat, humidity, storms and sun

Mayo Clinic's list of weather triggers also includes bright sunlight, sun glare, extreme heat or cold, high humidity, dry air, and windy or stormy weather (Mayo Clinic).

• Heat. In a study of 7,054 people seen in an emergency department for headache, higher temperatures in the previous 24 hours raised the short-term risk. Lower pressure was linked only to non-migraine headaches, two to three days later (Mukamal et al., 2009).
• Rapid swings. Dr Estemalik notes that for some people the trigger is a fall in pressure, and for others a quick rise in temperature (Cleveland Clinic).

How to tell if weather is your trigger

The only way to know whether weather affects you is to compare your attacks with the weather over time, including days you were fine. Mayo Clinic recommends a headache diary for this (Mayo Clinic).

1. Log every attack: start time, duration, severity and symptoms. Our free headache diary covers these.
2. Log the weather with it: local pressure from a weather app, whether it was rising, falling or steady, plus temperature, humidity and any storm.
3. Look either side of the attack. Kimoto's study compared pressure from two days before to two days after onset (Kimoto et al., 2011), and the Chinook study found an effect on the day before the wind (Cooke et al., 2000). How pressure changed over a day or two tells you more than one reading.
4. Mark big pressure drops on good days too. An attack after two of ten sharp drops is weak evidence; after eight of ten, it's worth raising with your doctor.
5. Keep logging other suspects like sleep, meals, stress and your period. Our guide to migraine triggers explains how to compare trigger days with attack-free days fairly.
6. Give it a few months. Two or three months is a sensible minimum, since weather varies by season.

Stick with one weather source and unit. For reference, the standard sea-level pressure of 1013 hPa is about 29.92 inHg, and a 5 hPa drop is about 0.15 inHg.

Tracking it in an app

If you use an iPhone or iPad, Mira is a free migraine tracker that logs severity, duration, pain location, symptoms, medication and what helped for each attack. You can tag Weather as a trigger, add your own custom triggers such as "pressure drop", and note the pressure reading. Its insights show how often each trigger comes up, and you can export your history as a PDF or CSV for your doctor. Your data stays on your device and in your private iCloud, with no account needed. Mira doesn't record weather automatically, so add the reading yourself.

What you can do when the weather changes

You can't change the weather, but you can plan around it. Mayo Clinic and Cleveland Clinic suggest (Mayo Clinic; Cleveland Clinic):

• Watch the forecast if you know a type of weather affects you, and stay indoors in very cold or windy weather if that triggers attacks.
• Avoid stacking triggers. On risky days, try to avoid your other known triggers.
• Stay hydrated, especially in hot and humid weather.
• Wear sunglasses if bright light or glare bothers you.
• Keep your acute medication with you, and take it at the first sign of an attack, as your doctor has advised.
• Ask about prevention. If weather-linked attacks are frequent or disabling, ask your doctor whether a preventive treatment is right for you. Bring your diary, and consider taking the MIDAS calculator beforehand to show how much attacks are affecting your life.

Don't start supplements or change any medication without talking to your doctor first.

One caveat: the Berlin study found weather couldn't predict individual attacks, so weather-based prevention isn't feasible as a general approach (Hoffmann et al., 2015). If your own records show a strong link, plan around it. If not, don't let the forecast run your week.

When to see a doctor

See a GP if your migraine attacks are severe, getting worse or lasting longer than usual, or happening more than once a week (NHS).

Don't put warning signs down to the weather. The NHS advises calling 999 (or your local emergency number) if you have a headache that came on suddenly and is extremely painful, problems speaking or remembering, loss of vision or double vision, drowsiness or confusion, a seizure, a very high temperature with symptoms of meningitis, weakness on one side of the body or face, or a recent head injury (NHS).

FAQ

What barometric pressure causes headaches?

There is no single number. In small Japanese studies, migraine was more common after pressure fell by more than 5 hPa from one day to the next, or when it was 6 to 10 hPa below the standard 1013 hPa. In the first study, the change mattered, not the monthly average.

Does low or high pressure cause migraine?

Falling, low pressure is the most commonly reported trigger, but some people react to heat, humidity or wind instead, and many don't react to weather at all. Your own diary is the best guide.

Why do I get a headache when the weather changes?

Nobody knows for sure. Ideas include shifts in brain chemicals such as serotonin, effects on the sinuses, changes in pain processing and the inner ear. Weather may also only trigger an attack alongside factors like poor sleep or stress.

How do I know if weather triggers my migraines?

Log every attack with the local pressure and whether it was rising or falling, plus temperature and humidity, for at least two to three months. Compare how often big pressure changes were followed by an attack with how often they weren't.

Is a barometric pressure headache the same as a sinus headache?

Not usually. Cleveland Clinic notes that many people with "sinus" or "barometric pressure" headaches turn out to have migraine. Sinusitis comes with a blocked nose, coloured mucus and sometimes fever. A doctor can tell them apart.

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This article is for general information only and is not medical advice. It does not replace a consultation with a qualified health professional.