Holiday cheer can mean holiday hell for America’s 28 million migraine sufferers – but it doesn’t have to. “Headaches tend to get worse this time of year,” says Richard Lipton, M.D., Director of the Montefiore Headache Center in New York, “because exposure to a number of important triggers increases.”

To prepare for the season, Lipton suggests keeping a headache diary. Knowing how your body reacts and minimizing exposure can help you avoid attacks.

Common Holiday Migraine Triggers

1.      Alcohol – abstain if you’re sensitive – but if you choose not to, Lipton advises drinking moderately and sticking to clear rather than colored spirits. Vodka and gin spark fewer headaches than scotch or bourbon, and white wine is better than red. Alcohol is dehydrating – another potential trigger – so match each potent potable with at least one glass of water.

2.      Stress – along with joy, the holidays can bring social pressure, family friction and angst. For some, acute stress sparks migraine, but the "letdown" headache – when you’re relaxing post-pressure – is more common. The best antidote? “Plan for and anticipate problems before they come up,” encourages Lipton, who is also Professor of Neurology at Albert Einstein College of Medicine. “Allow yourself extra time, have realistic expectations about how much you're going to get done, and practice relaxation techniques ten minutes a day.” Meditation and yoga won’t change your circumstances, but practiced consistently, they can change brain chemistry and alter your body’s reaction to stress – thus preventing headache.

3.      Deviations in routine – the festivities are fun but if you’re sensitive to change, they can wreak havoc with your headaches. “Strive to be consistent with your sleeping and eating habits,” advises Lipton. “Don't miss meals.”

4.      Foods – dietary triggers include lots of holiday goodies: chocolate, cheese, processed meats and MSG. Avoid them if you’re vulnerable.

5.      Travel – whether related to changes in routine or stress, travel is a known trigger for some. If the holidays take you on the road, Lipton encourages plenty of rest, hydration and healthy eating.