For those who suffer from migraines, the holy month of Ramadan can pose unique challenges. While fasting itself is not a direct cause of migraines, certain lifestyle adjustments during Ramadan can help minimise the risk of attacks. With expert advice and careful planning, patients can better manage their condition and observe the month with greater comfort.

Migraines are headaches, typically on one side of the head and often of a pulsating nature, lasting anywhere between 4-72 hours at a stretch. Only patients suffering from migraine know how taxing the month of Ramadan can be as fasting can initiate several triggers to induce attacks.

In a previous interview given to The Daily Star, Dr Amir Ali, a retired Ear, Nose and Throat specialist, said that migraines are not regular headaches but are caused by specific triggers to the brain which may seem mild to most people — such as sunlight or strong smells — but feel like an outright assault to a patient during an attack.

"Fasting is not directly associated with migraine as hunger is not a common trigger but if fasting happens to include exhaustion that typically causes someone to experience migraine, then an attack may be imminent," says Dr Ali.

During Ramadan, people need to wake up in the middle of the night to eat sehri and this sudden disruption in sleep patterns can cause migraine. A person used to a certain level of caffeine intake throughout the day or someone habituated to consuming a lot of water will experience discomfort during fasting hours, at least until they get habituated to fasting, and this can become a pain inducer.

Patients can often predict an imminent attack, which they call the migraine "aura". These sensory disturbances could be anything from seeing flashes of light to blind spots, or even a tingling sensation in the limbs.

"Removing oneself from the situation that may be the cause of migraine will help improve the situation," said Dr Amir Ali. "Pain, when unbearable, may cause the patient to vomit, which will invariably make them feel better but this may not be the best outcome for someone fasting. Therefore, avoiding triggers is the only solution to evade or minimise the intensity of these attacks."

Changing one's lifestyle a few weeks ahead of Ramadan like altering the sleep routine, curbing caffeine intake, drinking more water in the later part of the day, adding food (like yoghurt, oats and whole wheat) in the diet to keep one feeling fuller for longer and avoiding crowds, dust, and harsh sunlight can all help to relax common triggers of migraine.