Headache diary: what to write down for your doctor

In short

• Write each headache down soon after it happens, with the date, start and end time, and how severe it was.
• Record where the pain is, what it feels like, and any other symptoms such as nausea, vomiting or sensitivity to light and sound.
• Note possible triggers like sleep, meals, stress, screens and your period, but do not treat one coincidence as proof of a cause.
• List every medicine you take for headaches, including over-the-counter ones, and how many days a week you take them.
• Never wait for the diary to fill up if you have red-flag symptoms. Get help right away.

Why keep a diary

At an appointment it is hard to remember how many headaches you had last month, how long they lasted and what else was going on. A diary replaces memory with a short record. The NHS says a headache diary might help you work out what triggers your headaches, and the WHO lists a headache calendar among the measures that help identify triggers.

A diary is not a test. Similar-sounding descriptions can have different causes, so use it to describe what happened, not to pick a diagnosis from the internet. Your clinician combines it with your health history and an exam.

What to record for each headache

• Date, time it started and roughly when it ended.
• Severity on one scale you always use, for example 0 to 10, with a note on how it affected your day.
• Whether it came on gradually or suddenly, and where you felt it, such as one side, both sides, behind an eye or around the head.
• What it felt like, in your own words: throbbing, pressing, tight like a band, stabbing.
• Other symptoms: nausea or vomiting, sensitivity to light or sound, visual changes such as flashing lights or zig-zag lines, pins and needles, dizziness, fever or a stiff neck.
• Whether you could keep working, study, walk or sleep, or had to stop.

Mark days without a headache too. A short tick on a good day helps your clinician see how often headaches really occur.

Context and possible triggers

Sources describe many common triggers: periods, stress and tiredness, skipped meals, too much caffeine or caffeine withdrawal, alcohol, long stretches in one position at a screen, changes in sleep, bright or flashing lights, strong smells and weather changes. Jot down sleep the night before, meals, fluids, caffeine, alcohol, exercise, screen time, stress, travel and, if it applies, where you are in your menstrual cycle.

One headache after a hard day does not prove that stress caused it. Look for patterns over several episodes and talk them through with your clinician instead of cutting out foods or habits on the strength of a single day.

Logging medicines without self-treating

Write down the name of each medicine you take for headaches, when you took it and whether it helped. Copy the amount from the label or your prescription exactly if you know it. Also list other medicines, vitamins and supplements, especially if they changed before the headaches began.

Frequency matters because frequent use of pain medicine can itself cause headaches. The WHO calls this medication-overuse headache and describes it as the most common secondary headache disorder, often worst on waking. The NHS migraine page advises trying not to take painkillers for more than 2 days a week, while MedlinePlus warns that taking pain medicine more than 3 days a week may cause rebound headaches. Your clinician can tell you what is safe for you. Do not change or stop a prescribed medicine because of what you see in your diary.

Format and routine

Use whatever you will actually fill in: a notebook, a calendar, a spreadsheet or an app. What matters is using the same fields every time. Fill it in once after each headache, and set a short evening reminder if you tend to forget. If keeping the diary makes you more anxious or you find yourself checking symptoms all day, tell your clinician and switch to a simpler format.

Treat the diary as private health information. Keep a paper notebook somewhere safe, protect any app or file with a passcode, and use your clinic's secure patient portal if you want to send it ahead of a visit.

Getting ready for the appointment

1. Summarize.Note the period you tracked, the number of days with a headache and the main changes you noticed.
2. Bring the original.Bring the full record, including days that do not seem to fit a pattern. Do not tidy it up.
3. List medicines.Bring a current list of every medicine and supplement, separate from the diary.
4. Be honest.Say if you took more or less medicine than directed, or if something did not work.

When to see a doctor, and red flags

Make an appointment if headaches return regularly, are getting worse, or self-treatment is not working. The NHS also lists headache with vision or eye problems, headache triggered or worsened by coughing, sneezing, bending or exercise, headache with vomiting, and headache with jaw pain when eating or a sore, tender scalp as reasons to be seen urgently.

Red flags: call 911 for a sudden, extremely severe headache, a headache after a head injury, or a headache with a seizure, drowsiness or confusion, numbness or weakness in the face or body, trouble speaking, balancing, walking or remembering things, vision loss, a rash that does not fade under pressure, or a very high temperature with a stiff neck. The CDC lists sudden severe headache with no known cause among stroke warning signs and advises calling 911 right away. Do not drive yourself.

Questions to ask your clinician

• Which parts of my diary matter most?
• Should I change the scale, the format or how long I keep it?
• What causes are you considering, and what would help tell them apart?
• How often can I safely take pain medicine?
• Do I need any tests, and what is each one for?
• Which changes mean I should call sooner?

Questions and answers

Sources

1. NHS — Headaches
2. NHS — Migraine
3. MedlinePlus — Tension headache
4. MedlinePlus — Headache
5. WHO — Headache disorders
6. CDC — Signs and Symptoms of Stroke

Sources checked on 29 October 2026.