For most people, all of these changes may be no big deal. In fact, they can be a nice break from the daily grind. But if you’re living with migraine, any or all of these could trigger an attack. “Anything that gets you out of your normal routine can cause a headache, because the migraine brain likes to be as steady and stable as possible,” says Katherine Hamilton, MD, an assistant professor of clinical neurology and a headache specialist at Penn Medicine in Philadelphia. This time of year can also bring on anxiety for people with migraine and headaches, even people who are looking forward to the festivities, she says. “There can be a lot of expectations and things to do, and so the thought of having a debilitating migraine episode or a severe headache that puts you out of commission for a day or two can be a real concern,” says Dr. Hamilton. “Most of us know that stress can be a trigger for headaches, but keep in mind, it doesn’t always have to be perceived as negative stress,” says Lauren Doyle Strauss, DO, an associate professor of neurology at the Wake Forest School of Medicine in Winston-Salem, North Carolina. “Sometime positive stress can trigger a migraine. It doesn’t have to be something you’re worried about or dreading — it could be because you’re excited that you have a lot of good things going on.” Whatever your expectations for the season are, addressing potential problems may make you feel less anxious about how you’ll manage your headaches. Keep reading for expert advice on how to anticipate and deal with migraine-related holiday challenges.

Getting vaccinated against COVID-19 and influenza is very important, because both vaccines can offer protection against getting severe disease, says Hamilton. “We also know that COVID-19 can lead to significant worsening or development of new headaches, which can persist well beyond the acute phase of the infection. The vaccine is an important part of preventing this type of headache, as well as all the other symptoms and potential complications,” she says. If you are due for a second dose of a COVID-19 vaccine, or if you haven’t gotten your flu shot yet, keep in mind that it can take two weeks for antibodies to develop and offer protection against the infection, according to the Centers for Disease Control and Prevention (CDC). If you feel a headache that is persisting and doesn’t respond to your medication the way it normally does, or if you have any other symptoms of COVID-19, it’s a good idea to get tested for COVID-19 or the flu before socializing with anyone, says Dr. Strauss. “Symptoms of a virus can include a fever, but not always,” she adds. Other common symptoms of COVID-19 can include cough, fatigue, sore throat, runny nose, and shortness of breath, according to the CDC.

2. Stay Hydrated, Especially While Traveling

Dehydration is a common trigger for migraine, according to the American Migraine Foundation. If you’re traveling, make sure you have water or whatever you’re drinking with you in case you don’t make as many pit stops due to COVID-19, says Strauss. “It’s also important to drink plenty of fluids if you’re taking a flight, because the air is very dry on airplanes,” she says. Alcohol causes your body to produce more urine, which can contribute to dehydration, according to the Mayo Clinic. “If you drink alcohol, make sure you are also drinking plenty of water to compensate,” says Hamilton. RELATED: 12 Foods to Help Get Rid of Headache or Migraine Attack Naturally

3. Consider Taking Your Acute Medication as a Preventive Measure

If you’re going to be traveling for a relatively short window — four to six hours — and you’re concerned about having a debilitating migraine attack, it’s okay to take one of your acute abortive migraine medications, says Strauss. “Take it before you start your travel. Then you know your medicine is onboard, and it can potentially prevent a headache from happening,” she says.

4. Make Time to Eat, Even if It’s Just a Snack

If you’re traveling during the holidays, you may need to take food with you. After all, many flights don’t offer meals these days, and if you’re traveling by car, you may be reluctant to stop at restaurants along the way due to the pandemic, says Strauss. “Make sure you are still scheduling time to eat,” she says. Try setting an alarm on your phone to remind you to pull over or pull out a snack. Even if you don’t travel, mealtimes during the holidays can be irregular, she adds. “Plan to have three moments during the day when you stop and eat. It doesn’t have to be a big sit-down meal. It can be a snack,” says Strauss. RELATED: 9 Tips for Migraine and Headache Prevention

5. Make Sure You Have Enough of the Medications You Need to Manage Migraine

It may be harder to reach your provider once the holiday season ramps up, says Hamilton. “Make sure you have enough refills on your medications, and if you have any unanswered questions you’ve been concerned about, reach out to your provider. You don’t want to be stuck in a place of not knowing what to do,” she says.

6. Complementary Therapies and Exercise May Help Manage Stress

Having some nonmedication options in your toolbox for managing stress or headache pain can be helpful, says Hamilton. “Things like ice, heat, and relaxation exercises may be beneficial,” she says. “Make sure you continue to do all the things that help you manage your stress level, whether that’s exercise, meditation, or listening to music. During the holidays, it’s important to make time for those things, even if it’s only for a few minutes,” says Hamilton. These can be just as important, or in some cases, even more important than your medications for migraine, she adds. RELATED: Home Remedies for Headache and Migraine Relief

7. Try to Keep to a Regular Sleep Schedule

Not getting enough sleep and sleeping too much can both be headache triggers, according to the American Migraine Foundation. The organization recommends getting between seven and eight hours of sleep each night. “You may not be able to keep your normal sleep and wake times during the holidays, but try to stick to your usual schedule as much as possible,” says Hamilton. If you don’t always manage that, don’t beat yourself up, says Strauss. “During the holidays, priorities can shift, and if you don’t hit that goal, it’s okay. It’s a choice you can make.” Set yourself up for a good night’s sleep by eliminating caffeine later in the day, using a natural sleep aid like melatonin, and blocking out light with a sleep mask or light-blocking shades, says Strauss. RELATED: 6 Sleep Tips for People With Migraine

8. Make a Migraine or Headache Action Plan

Strauss recommends creating a headache or migraine action plan to get you through the holidays. “That can take some of the worry out of it, because you know what you will do if an attack occurs,” she says. The plan can include knowing what medication you will take if you feel an attack coming on, going to a dark room if you need some quiet time, or planning how you’ll get home if you choose to leave an event, says Strauss. “I also recommend putting together a migraine or headache pouch. Put all your medicine in it and make it easy to identify, so if someone else needs to grab it for you, they don’t need to sift through your whole bag,” she says.

9. Avoid Triggers When You Can, but Be Ready to Pivot

You may encounter situations that are full of potential migraine triggers, such as loud music or bright lights. “That’s part of life: There are always scenarios we can’t control. That’s not unique to the holidays, but there can be a lot more emotion and expectation around them,” says Strauss. Be aware of the following triggers for migraine, and if possible, think ahead about how you’ll deal with them: Alcohol For some people, alcohol can be a trigger for headache, but that risk is overstated, according to the American Migraine Foundation. Red wine has been known to cause headaches for many people because it can contain tyramine, histamine, and sulfites — all substances that have been linked to headache. Chances are, you’ll know whether alcohol is a trigger for you before you arrive at any holiday meals or parties, and if it is, you can request a nonalcoholic beverage at the outset. Cigarettes Both smoking and inhaling secondhand smoke can bring on a migraine attack, according to the American Migraine Foundation. Nicotine can constrict the blood vessels in your brain, causing less blood flow to the brain and surrounding area, thereby contributing to a migraine attack or headache, according to the Cleveland Clinic. Cigarette smoke can also trigger headache pain by irritating your nose and throat, or by causing an allergic reaction, according to the Asthma and Allergy Foundation of America. Bright Lights Bright fluorescent lights, flickering lights, and even very bright natural light can all trigger a migraine attack, according to the American Migraine Foundation.

10. Create Reminders to Help You Stay on Track

Holidays can be hectic, to the point that you forget basic needs like hydration or eating on a regular schedule. Putting a reminder in your phone or an old-fashioned sticky note on your mirror or dashboard can prompt you to practice self-care, says Hamilton.

11. Check In With Yourself or a Friend if You Begin to Feel Down

It’s common for people with depression to have their condition worsen during the holidays, for a variety of reasons, but good self-care practices, including making an effort to connect with other people, can help alleviate stress and depression at this time of year. People with migraine are more likely to have anxiety or depression than people who don’t have migraine, says Shae Datta, MD, a neurologist at NYU Langone Health in New York City. “Sometimes people have migraine first and then they develop depression, or vice versa: They have depression or anxiety, and then they develop migraine,” she says. If you sense that your mood is changing, it’s important to seek professional help and be diagnosed and treated, says Dr. Datta. “Be honest with yourself, and if you aren’t sure, talk to someone who knows you well,” she suggests. “Ask them if you seem different — are you going out less, laughing less, and seeming more down? A lot of times we can’t see ourselves objectively, and a friend or family member can give you that perspective,” she says. RELATED: 5 Ways to Cope With Depression During the Holiday Season

12. Trust Your Instincts, and Let Your Friends and Family Know What You Need

Rely on your own personal experiences about what works for you, says Strauss. “That’s not always what’s best for everyone else. One thing I hear from my patients is that when they aren’t feeling well, there can be this pressure. They are anxious about letting other people down if they have a migraine attack,” she says. This can be exacerbated by well-meaning friends and family who ask you what you’ve done to prevent or treat your headache or tell you what you should be doing, she says. “Let people know that you appreciate their concern, but you have a plan in place that works for you,” says Strauss.