Autism and Migraines/Headaches

Introduction

Living with autism often means dealing with many sensory challenges. However, one health issue frequently goes unnoticed: headaches and migraines. In fact, these painful conditions affect many autistic people. Fortunately, new research now sheds light on this important connection.

In this guide, we'll look at how autism and migraines are linked. Additionally, we'll share practical tips for spotting, preventing, and treating headaches in autistic individuals.

The Numbers: Headaches Are More Common in Autism

Key Statistics

Research clearly shows that people with autism get more headaches than others. Here are some important facts:

First of all, about 28% of autistic people have regular headaches, compared to only 16% of non-autistic people (Journal of Autism and Developmental Disorders, 2021).
Moreover, migraines affect 16-27% of autistic individuals – almost twice the rate found in the general population (12-14%).
Furthermore, as autistic children grow older, they report more headaches, especially during teen years.
Additionally, a study of 103 autistic children showed that by age 15, nearly one-third had been diagnosed with migraines.

These numbers are probably even higher in reality. This is because many autistic people may not report their headaches due to communication differences. Also, doctors sometimes mistake headache symptoms for autism-related behaviors.

Gender Patterns

Typically, women get migraines three times more often than men. However, this difference is smaller in autistic people:

In contrast to the general population, autistic males (22%) have nearly as many migraines as autistic females (29%), according to University of California research.
Consequently, this suggests that autism-related factors may affect migraine risk regardless of gender.

Why This Happens: Explaining the Connection

Several factors likely explain why autism and migraines often occur together.

Shared Genetic Links

Research points to overlapping genetic causes:

Both conditions involve multiple genes rather than just one.
Similarly, genes that control brain chemicals like serotonin and dopamine show changes in both conditions.
Most importantly, a 2023 study found shared genetic patterns between migraine and autism, especially in genes that control how brain cells develop and communicate.

Sensory Processing Issues

Perhaps the strongest connection comes through sensory processing:

On one hand, autism often involves being extra sensitive to lights, sounds, smells, and touch.
On the other hand, these are the same triggers that commonly cause migraines.
Brain scans show that both autistic people and migraine sufferers process sensory information differently in the thalamus (a key brain area).
As a result, sensory overload in autism may make migraine attacks more likely.

Inflammation and Immune System

New evidence suggests inflammation may connect these conditions:

First, both autism and migraine show changes in inflammation markers.
Second, brain inflammation appears in both conditions.
Third, both conditions show signs of oxidative stress, which can make nerve cells more sensitive.

Nervous System Differences

The autonomic nervous system (which controls automatic body functions) works differently in both conditions:

Heart rate studies show similar patterns of irregularity in both autism and migraine.
Therefore, these irregularities may affect blood flow in ways that trigger migraines.
Meanwhile, sleep problems, common in autism, can further disrupt these systems.

Spotting Headaches in Autism: What to Look For

Recognizing headaches in autistic people can be challenging, especially when communication is limited. Instead of verbal complaints, look for behavioral changes.

Behavior Signs

In autistic people who don't communicate verbally, headaches may show up as:

More self-stimulating behaviors (stimming)
Pressing or banging the head
Sudden irritability or agitation
Seeking dark, quiet places
Increased sensitivity to light or sound
Changes in sleep patterns
Eating less than usual
Unexplained nausea or vomiting

Communication Differences

Even autistic people who speak fluently may express pain differently:

They might struggle to identify where the pain is located.
Some may be either extra sensitive to pain or less aware of it.
They might use unusual language to describe headache symptoms.
Many find it hard to notice patterns in what triggers their headaches.
Often, they have trouble connecting physical feelings to emotions.

Better Diagnosis Methods

Diagnosing migraines in autism requires different approaches:

Using visual pain scales designed for autism
Keeping headache diaries that track behaviors rather than just feelings
Providing tools for caregivers to record symptoms
Focusing on visible signs (like paleness or vomiting)
Taking more time to establish symptom patterns

Migraine Triggers: What Sets Off Headaches in Autism

Many things can trigger migraines, but autistic people may be especially sensitive to certain factors.

Common Triggers

Sensory Triggers

Bright or flickering lights (especially fluorescent bulbs)
Loud or ongoing noise
Strong smells
Uncomfortable clothing textures
Visual patterns like stripes or checkerboards

Schedule Changes

Disrupted sleep routines
Skipped or late meals
Travel or new environments
Switching between activities

Body Factors

Not drinking enough water
Certain foods (often overlapping with autism dietary preferences)
Hormone changes
Too much physical activity

Environment

Weather or air pressure changes
Seasonal allergies
Poor air quality

Tracking Triggers

To help autistic individuals recognize their personal migraine triggers:

Use visual schedules that include symptom tracking
Try smartphone apps with customizable interfaces
Help them recognize patterns
Teach them specifically about body signals (interoception)

Treatment Options: Managing Migraines in Autism

Treating migraines in autism requires special consideration of medication interactions, sensory issues, and communication needs.

Medications

When using medications with autistic patients:

Always start with low doses and increase slowly to reduce side effects
Consider liquid forms for those who struggle with pills
Watch for interactions with other medications often prescribed for autism
Pay attention to any unusual responses due to sensory differences

Common treatments include:

Basic pain relievers (like Tylenol or ibuprofen)
Migraine-specific medications (triptans)
Anti-nausea medications
Preventive medications (including certain seizure medications, beta-blockers, or CGRP blockers)

Non-Drug Approaches

Several other strategies can help manage migraines in autism:

Sensory Management

Use noise-canceling headphones
Try special tinted glasses (especially FL-41 tint)
Create fragrance-free spaces
Adjust sensory activities based on needs
Consider weighted blankets during migraine attacks

Lifestyle Changes

Keep regular sleep times
Eat meals on a consistent schedule
Monitor water intake
Start exercise programs gradually
Adapt stress management techniques for autism

Other Helpful Approaches

Try biofeedback training
Adapt relaxation techniques for autism
Use cold or heat therapy
Apply gentle pressure
Consider diet changes that respect existing food preferences

Creating Supportive Environments

Simple changes at home, school, or work can reduce migraine frequency:

Modify lighting (remove fluorescent lights, add dimmers)
Create quiet recovery spaces
Allow flexible schedules around migraine episodes
Reduce sensory input during vulnerable times
Develop emergency plans for schools and workplaces

Real Life Impact: How This Affects Daily Living

Having both autism and migraines can significantly impact many areas of life.

Daily Challenges

Research shows increased difficulties in:

School attendance and performance
Keeping steady employment
Social activities
Family relationships
Healthcare costs
Mental health

For instance, a 2022 University of Michigan study found that autistic teens with migraines missed 8 more school days yearly than those without migraines.

Hidden Effects

The combination of autism and migraines creates unique challenges:

Sensory sensitivities often get worse before, during, and after migraines
Recovery from migraines may take longer
Migraine management becomes harder during autism-related stress
Communication during medical situations can be challenging
Disrupted routines can increase anxiety

Looking Ahead: Future Research and Treatments

While we now understand more about autism and migraines, many questions remain unanswered.

Research Needs

Future studies should focus on:

Creating autism-specific headache assessment tools
Tracking headache patterns across different age groups
Testing how well migraine medications work for autistic people
Exploring sensory integration techniques for prevention
Using brain imaging to study migraine processes in autistic brains
Measuring quality of life improvements from treatments

Promising New Approaches

Several new developments show potential:

Wearable devices that detect early migraine signs
Virtual healthcare options for migraine management
Treatments targeting shared biological pathways
Therapy approaches adapted for autistic migraine patients
New types of migraine prevention medications for autism

Practical Tips for Individuals and Caregivers

Creating a Migraine Plan

An effective management plan should include:

Tracking and Assessment
- Keep a headache diary (paper or digital)
- Record triggers, warning signs, and what helps
- Track how well medications work
Prevention Strategies
- Identify and avoid personal triggers
- Stick to regular sleep, meal, and exercise routines
- Develop sensory regulation techniques
- Consider preventive medications for frequent headaches
Treatment Plan
- Create step-by-step instructions for when migraines start
- Keep rescue medications easily accessible
- Set up a sensory-friendly recovery space
- Develop ways to communicate pain levels
Recovery Support
- Allow enough time to recover after migraines
- Slowly reintroduce sensory input
- Drink fluids and return to normal eating
- Update your plan based on what works

Building Your Support Network

Effective management usually requires help from:

A neurologist or headache specialist familiar with autism
A primary care doctor to coordinate care
A mental health provider for coping strategies
An occupational therapist for sensory help
School or workplace accommodation specialists
Educated family members and caregivers

Conclusion

The link between autism and migraines represents an important area for healthcare improvement. By understanding this connection, doctors can provide better care, while individuals and families can develop strategies to reduce headache impact and improve quality of life.

As research moves forward, we expect to see autism-specific approaches to migraine management. In the meantime, greater awareness, personalized treatment plans, and coordinated care offer the best approaches for handling this challenging combination of conditions.