Migraine diary: what to track, how long to keep it, and a free template

If your GP or neurologist has asked you to keep a migraine diary, you are in the right place. A diary is simply a record of your headaches that you bring to your next appointment. You can start today with a notebook, a printed sheet or your phone. Below you will find what to write, how long to keep going, and a free template you can copy.

Why do doctors ask for a headache diary?

Memory is a poor record keeper, especially during a bad attack. A written log gives your doctor facts instead of guesses. NICE, which writes guidelines for doctors in England and Wales, says doctors should “consider using a headache diary to aid the diagnosis of primary headaches.”

The Migraine Trust, a UK charity, says a diary can help:

• your doctor make a diagnosis
• you recognise triggers and warning signs
• check whether your acute or preventive medicine is working
• show patterns in your attacks

NICE also suggests using a diary “as a basis for discussion” about your headaches and how they affect your life. In other words, it turns a rushed chat into a clear picture. The details you record also help your doctor tell a migraine apart from other kinds of headache, which we explain in migraine vs headache.

What to track in a migraine diary

NICE lists what a headache diary should record:

1. How often headaches happen, how long they last, and how bad they are
2. Any symptoms that come with them
3. “All prescribed and over the counter medications taken to relieve headaches”
4. Possible triggers (NICE calls them “possible precipitants”)
5. Any link to your period

The Migraine Trust suggests you “keep it simple and record basic information.” For pain, it suggests either mild, moderate or severe, or a scale from 1 to 10, “where 10 is the worst pain you can imagine.” It also suggests noting if you took a second dose of a medicine.

Other symptoms worth writing down include feeling sick, dizziness, and being bothered by light, sound or smells. Cleveland Clinic says your provider may ask where the pain is, what it feels like, how long it lasted, and whether anything made it better or worse. Your diary can answer all of these in advance.

For triggers, the NHS lists common ones such as your period, stress and tiredness, skipping meals, too much caffeine, and not getting enough regular exercise. Note what seems relevant, but don’t worry about logging every meal. The American Migraine Foundation says the goal is useful information, “not to add another stressful task into your daily routine.”

A free migraine diary template you can print

Copy this table into a document or spreadsheet, or draw it in a notebook. Use one row per day. On a day with no headache, write “No headache” in the first column and leave the rest blank.

At the end of each month, fill in a short summary. This is the part your doctor will often look at first.

If you prefer a ready-made sheet, The Migraine Trust offers a free monthly headache diary in Word and PDF on its headache diary page.

How long should you keep a headache diary?

NICE says that when a diary is used to help with diagnosis, a person should record their headaches “for a minimum of 8 weeks.” That is about 2 months. If your attacks seem tied to your period, NICE suggests a diary covering “at least 2 menstrual cycles.”

Many people keep going after that. The American Migraine Foundation says “the longer you track your migraine symptoms, the more you will get out of your headache journal,” because patterns can take time to show up. A diary is also useful after any change in treatment, so you and your doctor can see if things are getting better.

If your doctor or clinic asks for a set length of time, follow what they say. They know what they need for your care.

Why count headache days and medicine days?

Two numbers matter a lot to doctors: how many days a month you have a headache, and how many days you take medicine for it.

The first number helps with diagnosis. The International Headache Society (ICHD-3) describes chronic migraine as headache “on 15 or more days/month for more than 3 months,” with migraine features on at least 8 days a month.

The second number matters because using some headache medicines too often can cause more headaches. NICE asks doctors to be alert to medication overuse headache when triptans, opioids, ergots or combination painkillers are taken on 10 days a month or more, or when paracetamol, aspirin or an NSAID is taken on 15 days a month or more, for 3 months or more.

This is why marking headache-free days helps. A blank line could mean a good day or a forgotten one, and only a mark tells your doctor which. Please don’t stop or change any medicine based on these numbers alone. Bring the count to your doctor or pharmacist and decide together.

How to use your diary at the appointment

A full diary is most useful when it is easy to read in a short visit. Try these steps:

1. Add up the totals before you go: headache days and medicine days for each month.
2. Pick your worst attack and be ready to describe it: how it started, how long it lasted and what helped.
3. Note any patterns you spotted, such as attacks around your period or after poor sleep.
4. List your medicines with doses, including anything you bought over the counter.
5. Write down a few questions you want answered, so they don’t get lost.
6. Bring the diary itself, on paper or on your phone, so your doctor can look at the details.

The American Migraine Foundation says sharing this information with your healthcare provider “helps improve your treatment strategy.” If keeping the diary feels like too much, tell your doctor. The AMF suggests asking them about ways to make it simpler, such as only writing on days when you have symptoms.

How Headache Pal can help

A paper diary works well, and the template above is all you need. If you’d rather use your phone, Headache Pal lets you log a headache in seconds with a pain dial from 0 to 10, a head map, symptoms, triggers and medicines, plus a daily “No headache” check-in so good days count too. Your logs appear on a calendar and stay on your iPhone with no account (privacy), and a doctor report PDF of the last 30 days is a Pro feature. The app is iPhone only and is not medical advice: it helps you keep the record, and your doctor helps you make sense of it.

When to get medical help now

A diary is for tracking your usual headaches. Some headaches need help right away and should not wait for your next appointment.

The NHS says to call 999 or go to A&E if you or a child has a headache and:

• it started suddenly and is extremely painful
• you have had a seizure (fit)
• you have numbness or weakness in the body or face
• you have had a head injury within the last 3 months
• you find it difficult to speak, balance, walk or remember things
• you are drowsy or confused
• you have loss of vision
• you have a rash that does not fade when a glass is rolled over it
• you have a very high temperature, a stiff neck, or bright lights are bothering you

The NHS also says not to drive yourself to A&E. In the US, Cleveland Clinic advises calling 911 or going to an emergency department for “the worst headache of your life,” new symptoms such as trouble speaking, balance problems, vision issues, confusion, seizures or numbness, or a headache after a head injury.

For migraine, the NHS says to ask for an urgent GP appointment or contact NHS 111 if an attack has lasted longer than 72 hours, if aura symptoms last longer than 1 hour at a time, or if you are pregnant or have just had a baby.

If something feels very wrong, trust that feeling and get help. Your diary can wait.