A complete migraine diary checklist covering every field worth recording, why each one matters, and how your doctor uses the data at your next appointment.
What to log in a migraine diary is a question worth answering precisely, because the answer changes depending on what you are trying to accomplish. A diary kept to identify personal triggers looks different from one kept to document treatment response for a CGRP renewal. This checklist covers both, explains what each field actually tells your doctor, and points out the few fields you should never skip.
These go in the log every single time an attack occurs, without exception.
Date of onset. The calendar day the headache began. This is how monthly migraine days are calculated. Without a date, the entry is not usable for frequency tracking.
Time of onset. When the headache actually started, not when you noticed it had already been going on for a while. Onset time helps identify patterns (early morning attacks suggest different mechanisms than evening attacks) and gives context if an attack crosses midnight.
Duration. From onset to the point the pain resolved or became negligible. This is distinct from when you went to sleep or when you took medication. Duration tells your doctor whether attacks are getting shorter on treatment.
Peak severity. Use a consistent 1 to 10 scale. Anchor it: 10 is the worst attack you have ever had. Stay consistent about what your 6 means each month so severity trends across time are comparable.
Pain location. One side, both sides, shifting, frontal, behind the eye, occipital. Location can inform diagnosis and is sometimes relevant to treatment decisions.
Whether the headache met migraine criteria. Did you have nausea, light sensitivity, or sound sensitivity? Was the pain pulsating or throbbing? Noting this helps your doctor distinguish migraine days from tension-type headache days in your log.
Medication logging is one of the most clinically important parts of a diary and one of the most commonly skipped.
Medication name and dose. Record every medication taken for the attack, including over-the-counter options, not just prescription ones.
Time taken after onset. Was the medication taken at the first sign of pain, or after two hours of worsening? Timing matters for evaluating acute treatment efficacy.
Response. Did pain drop to zero within two hours? Did it return within 24 hours (recurrence)? Did you need a second dose? Did it not work at all? Documenting consistent non-response is evidence your prescriber needs.
Total acute medication use days per month. This number matters beyond just individual attacks. High monthly acute medication use is a risk factor for medication overuse headache, and your prescriber uses this number to guide both acute and preventive treatment decisions.
These fields add clinical depth and help your doctor see the full picture of each attack.
Aura. If you experience aura, log the type (visual, sensory, language), duration, and whether it preceded the headache or occurred without one. Aura frequency is tracked separately because it sometimes responds to treatment differently than headache frequency.
Nausea or vomiting. Present or absent, and severity.
Photophobia and phonophobia. Light sensitivity and sound sensitivity during the attack. These are part of the diagnostic criteria and help distinguish migraine from other headache types.
Cognitive symptoms. Difficulty concentrating, word-finding problems, or "migraine fog" during and after the attack.
Postdrome. The recovery phase after pain resolves. Fatigue, cognitive fog, mood changes, or a sense of feeling "washed out" after an attack can extend disability well beyond the headache itself. Logging it gives your doctor a fuller disability picture and contributes to MIDAS scoring.
Premonitory symptoms. Fatigue, mood changes, food cravings, yawning, neck stiffness, or increased light sensitivity in the hours or day before headache onset. This is the phase where people most often misidentify their own triggers, so logging it separately from "what might have caused this" is useful.
Log trigger observations at the time of the attack, not reconstructed days later. Memory-based trigger identification is unreliable and prone to confirmation bias. For a full discussion of why real-time logging matters for trigger data, see migraine triggers tracking.
Useful trigger fields:
The point is not to mark everything as a trigger. It is to capture what was happening around the attack so patterns can emerge over many events, not from a single data point.
Barometric pressure changes are among the most biologically plausible environmental migraine triggers, and they are also entirely out of your control. Still worth logging, because the pattern tells you something real about your attack predictors.
Barometric pressure or weather change. Note significant weather events (storms arriving, pressure drops, temperature swings). You do not need to record exact millibars daily; noting "storm moving in" is enough to identify a pattern over time.
Travel or altitude change. Time zone changes and high altitude both affect headache biology.
Environmental exposures. Strong odors, prolonged screen exposure, or unusual noise or light conditions.
These fields belong in the log on every day, not just attack days.
| Field | Why It Matters |
|---|---|
| Headache-free confirmation | Required to calculate monthly migraine days accurately |
| Sleep hours and quality | Sleep disruption is a major threshold factor for most patients |
| Stress rating (1 to 5) | Helps identify whether stress clustering precedes attack clusters |
| Menstrual cycle day | Hormonal patterns often explain cyclical attack timing |
| Notable caffeine or dietary changes | Context for individual attacks and pattern identification |
The daily context log does not need to be long. A 30-second entry confirming sleep quality, stress level, and whether you had a headache is enough. The value is in the pattern across months, not the detail of any single entry.
These are not logged daily but completed periodically (monthly or quarterly) and are among the most clinically useful data in your entire diary.
MIDAS (Migraine Disability Assessment): Asks how many days in the last three months headaches limited your productivity at work, household tasks, and non-work activities. Produces a total score that categorizes disability as minimal, mild, moderate, or severe.
HIT-6 (Headache Impact Test): Six questions about how headaches affect your life, scored on a severity scale. Your prescriber tracks this alongside migraine day counts to see whether treatment is reducing disability, not just frequency.
Both scores are what your neurologist needs at renewal appointments and what insurance often requires for CGRP prior authorization continuations. For a detailed breakdown of how these scores are calculated and used, see MIDAS and HIT-6 explained.
Raw diary entries are a starting point. What your prescriber needs at an appointment is a summary: monthly migraine day counts for the past three months, acute medication use days per month, your current MIDAS score, and any notable patterns in triggers or attack features.
If you are on a CGRP preventive, the most important comparison is your baseline monthly migraine days (before treatment) versus your current average. That number drives the renewal conversation. See share migraine log with doctor and prepare for neurologist appointment for how to structure that conversation.
Migraine Tracker: CGRP Log is built around exactly this checklist. Every field above is capturable with one-thumb logging, the app tracks daily context automatically, and it generates a one-page report with your monthly migraine day counts, medication use, MIDAS and HIT-6 scores, and baseline comparison. The diary does the work. You just have to log it.
Educational, not medical advice. Migraine Tracker: CGRP Log is a personal tracking tool, not a medical device. It does not diagnose, treat, or provide medical advice. Always talk to your clinician.
Attack date and duration, at minimum. Without these two fields you cannot calculate monthly migraine days, which is the core metric for assessing severity and treatment response. Everything else adds clinical depth, but those two are non-negotiable.
Accurate migraine tracking requires more than writing down headache days. This guide covers what counts, what to log, and the mistakes that corrupt your data.
Measuring CGRP progress requires more than a gut feeling. Here is how to use objective tracking to tell whether your preventive is actually helping.
Not every migraine trigger is real, and chasing the wrong ones wastes energy. Here's how to use systematic tracking to find your actual patterns.
