Experts are unclear on what exactly causes chronic migraine. However, they believe some possible causes or triggers are genetics, environment, stress, diet, vascular changes, sleep disturbances, or underlying medical conditions.

It is also likely that more than one factor contributes to chronic migraine. This is a type of headache that has occurred for 15 or more days per month for over 3 months. In addition, at least eight of these headaches will have been severe, affected one side of the head, and worsened with physical activity.

Research from 2021 notes that around 4% of people with migraine develop chronic migraine yearly. Various potential causes of chronic migraine exist, and these factors differ for each person.

This article discusses some causes of chronic migraine and common treatment options.

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Individuals with a family history of migraine are likely to be more susceptible to the condition. The American Migraine Foundation (AMF) reports that children with at least one biological parent who experiences migraine have a 50% risk of also developing them.

One theory is that genetic factors can affect an individual’s nerve cell functions, pain signals, and sensitivity. Still, experts are unsure about why having genetic factors cause migraine.

Learn more about the link between genetics and migraine.

CNS disorders that alter the brain’s blood supply or electrical activity may lead to chronic migraine. For example, individuals with epilepsy are more likely to develop chronic migraine than the general population.

People with CNS disorders should seek early and proper medical intervention if they experience chronic or recurrent migraine.

Environmental factors may play a role in causing chronic migraine in some people. Some factors might include:

  • light
  • loud sounds
  • strong odors
  • extreme temperatures or weather changes

Individuals respond differently to these environmental factors. Therefore, a person experiencing chronic migraine can pay attention and become self-aware of environmental factors that could be causing them.

Learn more about the link between migraine and air pollution.

Overusing certain medications may contribute to chronic migraine development. For example, using analgesics to alleviate symptoms of headaches or other health conditions.

Examples of analgesic medications that can cause chronic migraine when overused include:

Learn more about the connection between medication overuse and migraine.

The AMF states the risk for chronic migraine increases with weight gain, usually from a moderate weight to having overweight or obesity.

Still, it is important to note that obesity does not cause migraine. Rather, it is a risk factor. This means that having obesity makes it more likely for a person to experience migraine. In addition, doctors consider it a modifiable risk factor, meaning lifestyle changes can help manage risk.

Mental health conditions, such as anxiety and depression, may play a role in chronic migraine. The AMF reports that 20% of people with episodic migraine have anxiety, and 30–50% of people with chronic migraine also have anxiety.

The relationship is complex. Some people may develop anxiety or depression as a result of experiencing migraine for some time. However, for many others, migraine can develop after living with anxiety or depression.

Genetic or hereditary factors can affect both mental health conditions and chronic migraine.

Learn more about depression and migraine.

Experiencing difficulty sleeping can contribute chronic migraine. Distorted sleep can lead to the following:

  • increased stress levels
  • altered electrochemical activity in the brain
  • inflammation

These functional changes may lead to chronic migraine in some people.

A 2018 study found that people with insomnia are more at risk of developing migraine and other headache types than those without insomnia.

Learn more about why sleep is important.

Stress may be a factor in chronic migraine development. The body’s response to stressful events can lead to the following changes:

  • hormonal changes
  • inflammatory reactions
  • vascular distortions that affect nerves in the brain

These physiological responses can lead to chronic migraine in some cases.

Learn more about the link between stress and migraine.

Experts recognize that diet can contribute to migraine, and some ingredients can trigger migraine attacks. Potential dietary triggers include:

  • caffeine
  • alcoholic beverages
  • chocolate
  • aged cheeses

This list is not exhaustive, and many other dietary triggers exist.

Still, other nondietary factors lead to chronic migraine. For example, if someone is already feeling stressed or not sleeping well, eating a certain foodstuff may make migraine more likely. In this case, the food trigger is not solely responsible for causing migraine, but rather a combination of factors led to its cause.

The triggers for chronic migraine differ for each person. Some are listed above, but some common triggers of chronic migraine include:

  • motion sickness
  • loud or sudden noises
  • low blood sugar
  • sudden weather or environmental changes
  • strong odors or fumes
  • skipped meals
  • tobacco
  • head trauma
  • certain medications
  • hormonal changes
  • bright or flashing lights

Learn more about what might trigger a migraine.

If anyone has any concerns about chronic migraine or feels they are unable to manage recurrent episodes, seeking advice from a specialist would be beneficial.

Neurologists or headache specialists can conduct in-depth clinical evaluations, working with a person to determine the cause of chronic migraine. Finding the underlying issue of chronic migraine also plays an important role in treatment. A specialist can also recommend medications or lifestyle changes to help treat migraine.

The goal of migraine treatment is to relieve symptoms and prevent recurrent attacks with:


Doctors may prescribe medications to relieve distressing symptoms of migraine, for example, ergotamine and triptan. Supplements containing vitamin B2, magnesium, and Coenzyme 10 could be beneficial.

Furthermore, a doctor may prescribe other medications to resolve underlying conditions responsible for migraine.

Lifestyle modifications

Making adjustments in lifestyle behaviors can also help reduce the severity of migraine symptoms. For instance, improving sleep quality, managing stress, and avoiding environmental triggers can help a person with chronic migraine.

Other strategies can be beneficial in finding out what could be causing migraine in the first place. For example, keeping a food log to track foods or beverages properly.

Migraine is a type of recurrent and severe headache that can occur due to multiple factors. Individuals with a family history of migraine, exposure to environmental factors, stress, or inadequate sleep are typically more prone to developing migraine.

Sometimes, migraine triggers could be food ingredients, low blood sugar, head injury, or hormonal changes. Adequate hydration and avoiding environmental triggers like extremes of temperature or intense light can help to reduce the frequency and duration of migraine attacks.

Seeking early medical help is beneficial for those with severe and recurrent migraine attacks. Working with a doctor or neurologist, a person can identify any underlying cause of chronic migraine and make necessary adjustments to treat or avoid the trigger.