What is this Strange Feeling after the Migraine Stops? [Updated]

Medical review by Annika Ehrlich, RN (nurse practitioner specializing in headache medicine)

It’s not over until you say it is. The Migraine hangover is a pretty common phase that few people talk about.

You are not alone if you’ve ever thought to yourself, “I just don’t feel right” or “I don’t trust myself to drive,” even after your Migraine attack is on its way out.

The postdrome phase, aka the Migraine hangover, is a real phenomenon, and it’s more common than you might think. Most people think of alcohol when they hear the word “hangover.” People with Migraine, though, experience all the symptoms of a hangover without the fun of a party.

Migraine hangover symptoms can leave you feeling like you’re in a fog, exhausted, and unable to concentrate. They can linger for hours or days after the ‘attack phase’ of the Migraine is over.

To fully understand why this happens, it’s helpful to get a ‘big picture’ look at a Migraine attack including all the phases so that you have an understanding of how the typical attack progresses and where your symptoms fit into the picture.

The Migraine hangover, or the postdrome phase, is often overlooked, even though 60-80 percent of people with Migraine experience it (¹).

How do you know if you are experiencing the Migraine postdrome phase? Wondering how long your Migraine hangover will last? Discover more about this often misunderstood phase of Migraine here.

After the Migraine Stops, it’s Time for the Postdrome Phase

tired black woman looks at computer screen with hand on forehead, migraine hangover postdrome

Migraine hangovers symptoms can linger for hours or days after the worst of the attack pain dissipates.

A Migraine attack actually has four potential stages. Not every person will experience each of the phases, nor will every Migraine attack.

Prodrome phase (aka the warning phase): This initial phase can last from 1-24 hours. Symptoms include yawning, fatigue, mood changes, neck stiffness, excessive thirst, and food cravings.
Aura phase: This phase of a Migraine may or may not be present in all attacks. It can last anywhere from 5-60 minutes. Symptoms of Migraine aura include changes in vision like flashes of light or zig zags, and sensory changes like facial numbness, tingling, vertigo, and speech difficulties (²).
Pain or attack phase: During the attack phase, severe throbbing headache pain is typically present. Other symptoms include head pressure, nausea, vomiting, and sensitivity to light, sound, and smell (³).
Postdrome phase, or Migraine hangover phase: Not everyone experiences a Migraine hangover which has symptoms similar to a typical hangover. Common symptoms include brain fog, fatigue, moodiness, and a general sense of “feeling like a zombie.” The hangover phase can last hours or days, but it typically lasts around 24 hours (⁴) (⁵).

Some of what is thought of as strictly hangover symptoms may be prodromal symptoms continuing throughout the Migraine attack and persisting afterward, rather than new symptoms popping up after the headache pain is over (⁶).

There is still a great deal we have to learn about why the postdrome occurs, and how to best treat it.

Here’s what we do know:

How Long Does a Migraine Postdrome Last?

This phase can last anywhere from hours to days, explain the Migraine Trust and The American Migraine Foundation. Both organizations advise people to pay attention to minimizing their exposure to things that trigger symptoms (⁷) (⁸).

One recent study of people with Migraine found most participants reported relief of their symptoms within about 24 hours (⁹). If you are feeling the effects of a Migraine hangover, make yourself cozy, pour a glass of water, and rest assured that you’ll most likely be feeling better soon.

Age Can Play a Role Migraine Hangover Symptoms

Symptoms of the postdrome phase vary from person to person, and may also vary in adults, adolescents, and children. Migraine hangover symptoms in adults tend to last a little longer – up to a full day – than symptoms in younger folks.

Common Migraine hangover symptoms in adults include (¹⁰):

Tiredness
Concentration difficulty
Drowsiness
Neck stiffness
Weakness
Sensitivity to light and/or sound
Mood changes, like sudden unhappiness
Head pain
Yawning
Gastrointestinal symptoms (e.g., nausea)

Studies focused on children and adolescents report postdrome symptoms of:

Thirst
Sleepiness
Visual disturbances
Food cravings
Eye pain
Numbness or tingling

The Misunderstood Postdrome: It’s Not Just About the Pain

The non-headache symptoms of a Migraine hangover can be distressing and just as disabling as the pain phase itself (¹¹). In fact, during an interview at the Migraine World Summit, Dr. Andrew Charles, Director of UCLA’s David Geffen School of Medicine, explained that, for him, the postdrome phase has more of an impact on him than the headache.

A fellow Migraine Warrior, Dr. Charles said, “My pain is not what disables me. It’s actually the other stuff. Particularly for me, it’s the fatigue and the need to sleep afterward.”

Coping with a Migraine Hangover

You are more susceptible to another Migraine attack during the hangover phase, so coping involves avoiding things that trigger your symptoms.

Currently, there are no treatments available specifically for the postdrome phase of a Migraine. To add insult to injury, you are more susceptible to having another Migraine attack during the hangover, too.

This is why it is so important to manage Migraine triggers during this phase.

There are strategies that you can try to prevent or manage a Migraine hangover like: (¹²):

Drinking plenty of water
Getting enough rest
Trying relaxation techniques like yoga or meditation
Avoiding common triggers like electronics use and stress
Getting regular exercise and eating a healthy diet
Limit light exposure

While it may be tempting to get an extra-large cup of coffee to battle brain fog or take a 3-hour nap to fight an overwhelming sense of fatigue during a Migraine hangover, try to avoid doing so.

Excess sleep and caffeine may, in fact, make these symptoms worse, which is not what you want.

Even after the worst of the Migraine symptoms subside, fatigue and pain can stick around. Image: Unsplash

If these symptoms do not go away on their own after a day or two, you should seek care with your primary care provider or headache specialist. Your doctor will want to make sure there isn’t anything else going on, especially if you have symptoms like weakness, cognition trouble, fatigue, moodiness, and dizziness.

Other possible causes of these symptoms are anemia, thyroid problems, mood disorders, or medication side effects. Of course, true or actual weakness, which includes motor loss or limb weakness so that there is strength loss or inability of the limb to function properly, warrants urgent neurological exam and referral.

The Take-Away

If you’ve experienced a Migraine hangover (or fifty), you know how debilitating they can be. Paying attention to your symptoms – even the subtle ones – can help you identify and cope with your own patterns.

Speak with your doctor or headache specialist about the best tools available to prevent and treat the postdrome phase. You are not alone on this journey. A little help can ease a lot of suffering.