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‘Tripped Up’ Returns With a New Columnist

As travel comes back with a vengeance, The New York Times’s Travel advice column, “Tripped Up”, returns to help readers with travel headaches, hiccups and other difficulties. Read more in this note from Amy Virshup and Elisabeth Goodridge.

Seth Kugel is the new columnist for “ Tripped Up, ” an advice column that helps readers navigate the often confusing world of travel, which can sometimes offer as many disasters as triumphs. Especially now, as the world continues to reopen, travelers are faced with changing rules, airline dramas, opaque refund policies and ethical conundrums. Seth will help readers steer through it all.

Seth is no stranger to The Times. A frequent contributor to the paper, he has written for Travel since 2004 and, for more than five years was our Frugal Traveler columnist, taking readers on, among other budget adventures, a five-day riverboat trip along Brazil’s Rio Negro and a “$1,000 day in London” for $100 .

Beyond his global travels, he also teaches journalism at New York University and hosts a Portuguese-language YouTube channel, “ Amigo Gringo ,” popular with Brazilian travelers.

Have a tricky travel problem you need advice on? Email Seth at [email protected] and your question may be answered in a future column.

Amy and Elisabeth

Explore Further

Elisabeth goodridge named deputy editor, travel, amy virshup named travel editor, tacey rychter joining travel.

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Travel headache Mini Crossword

The clue Travel headache Mini Crossword recently appeared on the 'NYTimes Mini' crossword puzzle on December 30, 2022. The nyt mini clues are usually easy to solve but sometimes they can get tricky. The latest answer we have is five letters long.

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6 Reasons Why You Might Get Travel Headaches

For people who get migraines, vacation headaches are all too common—here's what might be at play.

Browsing through vacation photos can be a fun trip down memory lane. However, for some, recalling a vacation might bring back memories of migraines —headaches with neck pain, dizziness , and sound sensitivity.

Here are some of the precipitating factors for travel headaches. Health spoke with experts to understand six reasons why vacationing can literally be a headache for some people—and what you can do to keep them from making traveling more difficult.

What Is a Vacation Headache?

Headaches that occur while on vacation can result because you are finally relaxing and taking it easy with less stress , in a perceived less stressful environment. Headaches can, unfortunately, happen at any time, and getting them while traveling isn't as uncommon as you might think.

You might go on vacation to take a step away from the stress of your job or to renew your focus on your well-being. However, one outcome of a disruption to your usual daily routine is headaches.

Six Reasons You Have a Travel Headache

Headaches can happen for many reasons. Travel headaches can happen because of the travel itself or for reasons that are separate from traveling.

You Get a "Let-Down Headache"

You've just settled into a beach chair in the midst of a tranquil scene when you feel a migraine starting. Or maybe you're finally able to take that walk or hike following your college finals, and then your head starts to hurt. Perhaps you're meeting some friends for brunch after what seems like weeks of emergency room visits with your sick child when you feel that all too familiar head pain. You might even suddenly feel sick after finishing a stressful work project.

These headache phenomena are known as "let-down headaches."

"A let-down headache is a headache which occurs when there has been a drop in stress levels," Deena Kuruvilla, MD , neurologist, headache specialist, and director of the Westport Headache Institute, told Health . "Many patients with chronic or episodic migraines tell me that their headache frequency [was] really well controlled on preventive migraine treatments , but then boom, they go on vacation and experience an attack!"

There is evidence for and against this type of headache. The data could be mixed because this type of headache seems to be mainly a result of perceived stress. How you react to your perceived stress. such as drinking caffeine or alcohol and changing your sleeping patterns, seems to influence whether you have a "let-down headache."

Fortunately, to keep your relaxation from backfiring into a headache, there are options. To stabilize stress levels, especially prior to leaving for vacation, try:

• Clearly communicating your needs and feelings
• Getting more sleep
• Making lists to help prioritize what's important
• Managing time commitments
• Spending quality time with a partner or friend

These and other stress management activities can help avoid the spike-and-drop pattern that might trigger a migraine.

Lots of Smaller Stressors

The truth is not every aspect of vacation is stress-free bliss. From last-minute packing woes to the difficult in-laws you may be visiting, there are a number of reasons why you might need a vacation from your vacation. All of these can add up to stress headaches —literally and figuratively.

Remaining or becoming calm is easier said than done when you are stressed. However, self-care strategies for de-stressing are your best bet for preventing the onset of a headache. Try these suggestions to help guide you to a calmer place of well-being,

• Download a guided meditation to listen to in the car
• Give yourself quiet, unscheduled breaks throughout your trip
• Practice deep breathing exercises in the airport terminal

You’re Off Your Typical Sleep Schedule

When you're away from your own bed, sleep doesn't always come easily. "Migraine and sleep run hand in hand," said Dr. Kuruvilla, "[especially when] traveling across time zones [which] can throw off a person's circadian rhythm, [and] contribute to sleep disruption and migraine attacks."

You may want to have a melatonin supplement on hand to help. "Melatonin is a hormone that helps regulate the circadian rhythm," stated Dr. Kuruvilla. In addition, melatonin can offer migraine relief by reducing the intensity of the headache.

For better shuteye on vacation, practice healthy sleep hygiene:

• Discontinue the use of devices before heading to bed
• Keep a cool, dark bedroom
• Stick to your usual bedtime routine as much as possible

You're Dehydrated

It's hard to overstate the importance of staying hydrated to prevent a headache. "Even 1 to 2% of body water loss can increase your chances of developing headaches," dietitian Maryann Walsh, MFN, RD, CDE , told Health . "It's critical to get adequate water ."

While air travel alone can be dehydrating, the low humidity in a plane cabin isn't the only factor that can lead to vacation dehydration. Simply switching environments can bump you out of your usual healthy habits.

"Being out of your normal routine can lead to not hydrating as you normally would, especially if you are on a road trip or flight and you'd rather not have to stop or get up to use the restroom every hour," stated Walsh.

Then there's the ubiquitous vacation culprit: alcohol. "Because alcohol acts as a diuretic, it can further cause us to be dehydrated," indicated Walsh. "If we aren't drinking enough water before, in between, and after a day or night of cocktails, this can lead not only to a dreaded hangover but also headaches."

Follow these tips to stay hydrated:

• Drink electrolytes if you feel dehydrated or have been sweating a lot
• Drink more water than you normally would, especially if you're somewhere it's hot
• Keep a bottle of water in your travel bag and refill it throughout the day
• Keep the non-alcoholic beverages flowing alongside any alcoholic drinks

Diet Changes

Could that dinner you enjoyed at a restaurant send you reaching for the ibuprofen the next day? For some people, foods high in substances like tyramine, nitrates, sulfites, and artificial ingredients can trigger head pain. Common culprits include aged cheeses, cured and processed meats, pickled foods, and alcohol—all of which you'll frequently encounter in restaurant dining.

Travel can disrupt other individual diet choices you might normally make to live pain-free. "Some of us may have dietary headache triggers that we usually avoid in our daily lives but may not be able to avoid if there are sneaky ingredients we are consuming out at restaurants," said Walsh. If you know the foods that trigger your headaches, avoid eating them as best you can. You could also try eating more frequent, smaller meals and sticking with unprocessed, fresh foods.

There's also the impact of caffeine. Fluctuations in caffeine intake are known for tripping the headache wire. If vacation mode has you chilling out sans coffee—when you'd normally drink several cups a day—a headache can result. With that, keep your caffeine intake consistent and stick to your usual food intake if possible.

You’re at a Higher Altitude

As you make your way up winding roads for a mountain getaway and look forward to fresh air and cooler temps, the altitude change may cause headaches. Hypoxia occurs when the oxygen supply to your body is inadequate because of low blood flow or low oxygen in the air.

You don't have to be scaling Mount Everest for altitude to mess with your head. Even small elevation changes may lead to discomfort. "Studies have confirmed that all migraine-associated symptoms, headache frequency, and headache severity tend to worsen with increasing altitude," noted Dr. Kuruvilla. You may even experience a headache when you're on an airplane due to the sudden change in altitude.

The higher you go the more likely you are to experience hypoxia because your lungs and heart have to work harder to deliver oxygen, so your brain tissues may not get enough oxygen. To get relief from altitude headaches:

• Descend 1,000 to 3,300 feet
• Take ibuprofen
• Stay hydrated and take frequent breaks

A Quick Review

Going on a vacation may be a wanted break from your normal routine, but the changes to your routine may be what bring on headaches. Try to stick to your usual routine and habits as much as possible to keep the headaches at bay.

Stubberud A, Buse DC, Kristoffersen ES, Linde M, Tronvik E. Is there a causal relationship between stress and migraine? Current evidence and implications for management .  The Journal of Headache and Pain . 2021;22(1):155. doi:10.1186/s10194-021-01369-6

National Migraine Foundation. Stress and Migraine .

Long R, Zhu Y, Zhou S. Therapeutic role of melatonin in migraine prophylaxis: A systematic review .  Medicine . 2019;98(3):e14099. doi:10.1097/MD.0000000000014099

Zduńska A, Cegielska J, Domitrz I. The pathogenetic role of melatonin in migraine and its theoretic implications for pharmacotherapy: a brief overview of the research .  Nutrients . 2022;14(16):3335. doi:10.3390/nu14163335

American Migraine Foundation. Alcohol and Migraine .

MedlinPlus. Dehydration .

Center for Disease Control and Prevention. Water and Healthier Drinks .

National Headache Foundation. Low Tyramine Diet Guide .

American Migraine Foundation. Diet and Headache Control .

Sajadi-Ernazarova KR, Anderson J, Dhakal A, Hamilton RJ. Caffeine withdrawal . In:  StatPearls . StatPearls Publishing; 2023.

Bhutta BS, Alghoula F, Berim I. Hypoxia . In:  StatPearls . StatPearls Publishing; 2022.

Frank F, Kaltseis K, Filippi V, Broessner G. Hypoxia-related mechanisms inducing acute mountain sickness and migraine .  Front Physiol . 2022;13:994469. doi:10.3389%2Ffphys.2022.994469

American Migraine Foundation. Altitude, Acute Mountain Sickness and Headache .

Luks AM, Auerbach PS, Freer L, et al. Wilderness medical society clinical practice guidelines for the prevention and treatment of acute altitude illness: 2019 update .  Wilderness & Environmental Medicine . 2019;30(4):S3-S18. doi:10.1016/j.wem.2019.04.006

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When Should You Worry About a Headache?

Types and causes.

• Serious Symptoms

Frequently Asked Questions

• Next in Headache Guide What Is a Headache?

Most headaches are not a cause for alarm or unnecessary worry. That said, a severe headache, or a headache associated with specific symptoms like a high fever or a new neurologic deficit (alteration of brain, nerve, or muscle function), may be a sign of a potentially life-threatening condition like a brain infection or stroke.

Other scenarios like a new headache in pregnancy or a headache changing in pattern also warrant further investigation.

This article explains some of the key headache symptoms that should alert you to seek medical attention. It also provides an overview of headache types and basic treatment and preventive strategies.

Illustration by Joules Garcia for Verywell Health

Most headaches are primary headaches , meaning they exist on their own and are not caused by an underlying health problem.

The most common types of primary headaches are:

• Migraine is an intense, throbbing headache often associated with nausea, vomiting, and light/noise sensitivity that can last up to 72 hours .
• Tension-type headaches cause a dull, "band-like" tightening or pressure sensation on both sides of the head and can last anywhere from 30 minutes to seven days.
• Cluster headaches cause an excruciating stabbing or burning pain in or around the eye or temple on one side and last between 15 and 180 minutes. Associated symptoms include eye redness and tearing, stuffy nose, and sweating.

It's likely that most primary headaches arise from a complex interplay of factors (e.g., genetics, structural brain changes, and/or sensitization of pain pathways). Environmental factors, such as stress, lack of sleep, weather changes, alcohol intake, and menstruation, also appear to contribute to headache development.

Unlike primary headaches, secondary headaches arise from an underlying condition or situation (e.g., illness, pregnancy, or medication). Most secondary headaches are not serious or dangerous, except in rare instances.

Examples of less serious (typically) secondary headaches include:

• Sinus headaches stem from sinus inflammation/infection and are usually associated with thick nasal green or yellow discharge.
• Post-infectious headaches are usually caused by viruses like the common cold , flu , or COVID-19 .
• Cold-stimulus headaches, also known as ice-cream or brain freeze headaches , occur after eating cold foods or exposing the unprotected head to low temperatures.
• Cervicogenic headaches are caused by a bone, joint, or soft tissue problem in the neck.

Serious Headaches and Symptoms

While not a complete list, here are examples of possible serious causes and symptoms of a secondary headache. These are conditions for which you should seek out a medical opinion urgently or get emergency medical help.

A stroke develops when blood flow to the brain is cut off. There are two types of strokes— ischemic and hemorrhagic —and both may cause a headache:

• Ischemic stroke   occurs when an artery that supplies blood to the brain becomes clogged.
• Hemorrhagic stroke  occurs when an artery in the brain breaks open and starts bleeding within or around the brain.

A headache from an ischemic stroke is more common in younger patients, those with migraine, and those who have had a larger stroke. The headache classically resembles a tension headache and develops around the same time as the neurological deficit (e.g., weakness or numbness on one side of the body or slurred speech).

A common example of a hemorrhagic stroke is a subarachnoid hemorrhage . This type of brain bleed classically causes a thunderclap headache —an explosive headache that comes on suddenly and becomes severely painful within seconds or less than one minute.

Besides a subarachnoid hemorrhage, a thunderclap headache may also occur with other serious health conditions, including:

• Reversible cerebral vasoconstriction syndrome (blood vessels in the brain suddenly narrow)
• Cervical artery dissection (formation of a tear in the wall of the carotid or vertebral artery in the neck)
• Pituitary apoplexy (bleeding into or loss of blood supply to the pituitary gland, located in the brain)

Brain Infection

The combination of a headache and fever may indicate a type of brain infection such as:

• Meningitis : Inflammation of the meninges, the protective coverings around the brain and spinal cord.
• Encephalitis : Inflammation of the brain tissues.
• Brain abscess : When a collection of infected fluid builds up in the brain.

Besides a fever and headache, other potential symptoms of a brain infection include:

• Neck stiffness
• Altered consciousness or loss of consciousness

Brain Tumor

A brain tumor is a collection of abnormal cells that grows in the brain. While headache is a common (and may be the only or worst) symptom of a brain tumor, keep in mind that brain tumors are overall rare occurrences.

The headache from a brain tumor may feel like a migraine or tension-type headache and tends to worsen with coughing or bending over .

A headache from a brain tumor may also be accompanied by nausea and vomiting. This tends to result from increased intracranial pressure (ICP) or hydrocephalus—when there is too much cerebrospinal fluid (CSF) in the brain.

Brain Injury

A headache may occur within days after a traumatic brain injury , such as a concussion . Post-traumatic headaches often feel like a dull, aching sensation felt all over and may be accompanied by dizziness, fatigue, problems with concentration and memory, and irritability.

Post-traumatic headaches due to concussion are generally not attributable to a structural cause, but occasionally can be caused by abnormal blood collections within the skull caused by head or neck trauma.

When to Seek Medical Attention

Below are worrisome signs that your headache may be stemming from a serious underlying condition.

Seek medical attention right away if:

• Your headache is severe and starts suddenly.
• Your headache occurs with fever, stiff neck, seizures, fainting, confusion, or neurological symptoms like weakness or numbness.
• Your headache is accompanied by a painful red eye or tenderness near the temples.
• Your headache pattern is changing (e.g., becoming more frequent) or interfering with daily activities.
• Your headache is triggered by sneezing, coughing, or exercising.
• Your headache occurs after a blow or injury to the head.
• You are experiencing a new headache or a change in headache during pregnancy  or immediately after giving birth.
• You have a headache and a history of cancer or a weakened immune system (e.g., HIV/AIDS ).
• You are age 65 and over and are experiencing a new type of headache.
• Your headaches are accompanied by painkiller overuse (indicative of possible medication overuse headache ).

The treatment of headaches depend on the type and severity.

Primary Headaches

Most primary headaches can be treated with a combination of medication and home remedies.

For example, tension-type headaches can often be treated with over-the-counter (OTC) pain relievers like Tylenol (acetaminophen) or the nonsteroidal anti-inflammatory drug (NSAID) Advil (ibuprofen). Soaking in a warm bath or drinking a caffeinated beverage may also be helpful.

Likewise, mild to moderate migraines are often treated with NSAIDs. A class of oral drugs known as  triptans —for example, Imitrex (sumatriptan)—is used to treat moderate to severe migraines. For those who cannot tolerate triptans, Reyvow (lasmiditan) may be tried.

Napping in a quiet, dark room and applying a cold compress to the forehead can also be effective in helping to soothe a migraine.

For cluster headaches, oxygen therapy (inhaling high flow oxygen), Imitrex (sumatriptan) injection, and Zomig (zolmitriptan) nasal spray may be used as an acute treatment.

Talk With Your Doctor

Before taking any medication for your headache, talk with your healthcare professional. If you are on a blood thinner or have kidney, liver, or ulcer disease, your doctor will want you to avoid certain OTC drugs or take a lower dose.

Secondary Headaches

The treatment of secondary headaches requires addressing the underlying condition.

For example, a sinus headache may be treated with OTC pain relievers like Tylenol or ibuprofen. Your doctor may also recommend saline nasal sprays and/or a  corticosteroid nasal spray to reduce sinus inflammation. In rare cases of bacterial sinusitis, an antibiotic may be prescribed.

Dangerous secondary headaches like stroke or a brain infection require more intensive care, such as close hospital monitoring, intravenous (IV) medications, and/or surgery.

As with treatment, prevention depends on the type and severity of the headache.

Lifestyle modifications and pharmacologic and non-pharmacologic therapies can help prevent primary headaches.

Migraines, for example, may be prevented by avoiding triggering foods, sounds, and smells, sticking to a regular sleep routine, and engaging in certain therapies like acupuncture . For patients with chronic migraine, Botox or taking a preventive medication may be recommended.

For patients with cluster headaches, a preventive medication, like Calan (verapamil) , may be advised. Adopting certain lifestyle behaviors like smoking cessation is also usually recommended.

Depending on the underlying cause, certain types of secondary headaches may be prevented.

For example, a stroke may be prevented by ensuring that risk factors like high blood pressure and high cholesterol are under control.

Likewise, a post-traumatic headache may be prevented by wearing a helmet during potentially high-impact sports or recreational activities.

Headaches that result from viral infections like the cold or flu can be prevented by washing your hands frequently and getting vaccinated, when applicable.

Most headaches are not anything to worry about and go away with medication, self-care strategies, and/or addressing the underlying cause. That said, headaches associated with certain symptoms or features like fever, neurologic deficit, pregnancy, older age, or a weakened immune system require prompt medical attention.

Headaches in the morning have multiple possible causes. They may be a primary headache like a migraine or tension-type headache. They may also arise from a hangover, caffeine withdrawal, or an underlying health problem like sleep apnea.

A tension headache (also called a tension-type headache) is the most common form of headache. It causes pressure or a tightening sensation around the head or neck and can last from 30 minutes to seven days.

There are different descriptions of headaches reported in patients with COVID-19. A typical one is a moderate-severe headache located on both sides of the head, forehead, or around the eyes, that is throbbing or pressing in nature.

Dodick DW.  A phase-by-phase review of migraine pathophysiology .  Headache . 2018;58:1:4-16. doi:10.1111/head.13300

Ghadiri-Sani M, Silver N. Headache (chronic tension-type) . BMJ Clin Evid.  2016;2016:1205.

Weaver-Agostoni J.  Cluster headache .  Am Fam Physician . 2013;88(2):122-128.

Van Os HJA, Wermer MJH, Rosendaal FR, Govers-riemslag JW, Algra A, Siegerink BS.  Intrinsic coagulation pathway, history of headache, and risk of ischemic stroke .  Stroke . 2019;50(8):2181-2186. doi:10.1161/STROKEAHA.118.023124

Oliveira FAA, Rocha-Filho PAS. Headaches attributed to ischemic stroke and transient ischemic attack . Headache . 2019;59(3):469-476. doi:10.1111/head.13478

Yang C-W, Fuh J-L. Thunderclap headache: an update . Expert Rev Neurother. 2018;18(12):915-924. doi:10.1080/14737175.2018.1537782

Rasul CH, Muhammad F, Hossain MJ, Ahmed KU, Rahman M.  Acute meningoencephalitis in hospitalised children in southern Bangladesh.   Malays J Med Sci.  2012;19(2):67-73.

Nelson S, Taylor LP. Headaches in brain tumor patients: primary or secondary? Headache . 2014;54(4):776-785. doi:10.1111/head.12326

Taylor LP.  Mechanism of brain tumor headache .  Headache . 2014;54(4):772-775. doi:10.1111/head.12317

International Headache Society.  Headache attributed to trauma or injury to the head and/or neck .

Phu Do T, Remmers A, Schytz HW, et al. Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list . Neurology. 2019;92(3):134-144. doi:10.1212/WNL.0000000000006697

Tepper SJ. Medication-overuse headache . Continuum . 2012;18(4):807-822. doi:10.1212/01.CON.0000418644.32032.7b

Ashina M, Buse DC, Ashina H et al. Migraine: integrated approaches to clinical management and emerging treatments . Lancet 2021;397(10283):1505-1518. doi:10.1016/S0140-6736(20)32342-4

Robbins MS, Starling AJ, Pringsheim TM, Becker WJ, Schwedt TJ. Treatment of cluster headache: the American Headache Society evidence-based guidelines . Headache . 2016;56(7):1093-1106. doi:10.1111/head.12866

Aring AM, Chan MM. Current concepts in adult acute rhinosinusitis . Am Fam Physician.  2016;94(2):97-105.

Zhao L, Chen J, Li Y, et al.  The long-term effect of acupuncture for migraine prophylaxis: a randomized clinical trial .  JAMA Intern Med . 2017;177(4):508-515. doi:10.1001/jamainternmed.2016.9378

Bolay H, Gül A, Baykan B. COVID-19 is a real headache! Headache . 2020;60(7):1415-1421. doi:10.1111/head.13856

By Colleen Doherty, MD Dr. Doherty is a board-certified internist and writer living with multiple sclerosis. She is based in Chicago.

Get a Headache on the Plane? Know This Before Boarding

4 Simple Steps to Avoid Headaches While Flying

As if plane travel itself isn't enough of a headache, researchers have detected a distinctive pain pattern at 35,000 feet. If you notice a pattern of headaches while flying, you're not alone. As a Million Mile flyer whose advocacy work requires a lot of plane travel, I find it a personal challenge. Here's what I've learned about why an airplane headache happens. Discover what you can do to prevent a headache while flying — before you book your next trip.

Are Airplane Headaches a Real Thing?

Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018;8(Suppl 7):1–96

A headache when flying, also known as "headache attributed to airplane travel," can occur during takeoff and landing as the plane changes altitude.

Flying is also a migraine trigger for many. "In many headache clinics, people with migraine often report that their attacks are exacerbated by air travel ," said Andrew Charles, MD, director of the Goldberg Migraine Program at UCLA and president-elect of the American Headache Society. "The interesting question is whether it's the change in barometric pressure or the change in oxygenation that triggers pain. It is known experimentally that low oxygen levels are a migraine trigger, but there is also a notion that even if you didn't change oxygen levels, changing barometric pressure is also potentially a migraine trigger. It may, therefore, be either one of those, or both in combination, that are responsible for causing high altitude headache and migraine."

The Difference Between an Airplane Headache and a Migraine Attack

Even though headaches while flying are not always the same as migraine attacks, it can be difficult to tell the difference at first, especially when you're in pain and stressed. But, fundamentally, the cause and the symptoms of an airplane headache are different from those of migraine.

During a migraine attack, head pain is often just one of several symptoms . Your migraine head pain is more likely to be on one side of your head, behind your eye, and is caused by a genetic neurological response in the brain to your personal triggers.

Oxygen Therapy for Migraine: A Fresh Treatment or Just More Hot Air?

Feet in Hot Water and Ice Baths for Migraine Pain: Do They Work?

‘I Still Struggle With My Own Internalized Ableism’

Some of those biggest migraine triggers  include stress, dehydration, dry air, strong odors, alcohol, foods with nitrites — all things we can be exposed to during the air travel experience.

Airplane headaches can also be severe, one-sided, and are usually located behind the eye. The pain intensity can be great and the pain is often stabbing. Sounds like a migraine, right?

The difference is an airplane headache will worsen when the plane ascends or descends, and they typically resolve within 30 minutes of takeoff or landing. That makes airplane headaches much shorter than a typical migraine attack, which often lasts hours or even days.

Bui SBD, Gazerani P. Headache attributed to airplane travel: diagnosis, pathophysiology, and treatment - a systematic review. J Headache Pain. 2017;18:84.

Bui SBD, Petersen T, Poulsen JN, Gazerani P. Simulated airplane headache: a proxy towards identification of underlying mechanisms. J Headache Pain . 2017;18:9.3).

Mainardi F, Lisotto C, Maggioni F, Headache Attributed to airplane travel (‘airplane headache’): Clinical profile based on a large case series.  Cephalalgia , 2012; 32:8.

That's in contrast to migraine, which affects three times as many women as men.

Airline Accommodations to Help Prevent Headaches While Flying

While there's a lot we can do to prevent an airplane headache or a migraine attack while flying, airlines have a vested interest in making the flight experience less painful. After all, how many people want to fly an airline if they associate it with painful attacks?

Among the triggers within an airline's control: optimizing light, sound, and offensive odors; offering healthy food and drink options; supporting passenger hydration; offering ice bags, earplugs, and eye masks; stabilizing cabin pressure changes; and ensuring flight attendant training. Some airlines do a better job than others with healthy food options and walking the aisles with water cups every 30 to 60 minutes.

Still, cabin lighting, jet engine sound, and food odors cannot be individually controlled, as I experienced on a recent Delta cross-country flight. With no way to dim the cabin lights or diffuse the nauseating combination of hot chicken and the lavatory, it was pure misery.

Treating an Airplane Headache or In-Flight Migraine Attack

Doctors advise that an airplane headache is best treated with either a  nonsteroidal anti-inflammatory drug  or a triptan that you've packed in your carry-on bag. Obviously, airlines don't stock them. For years, I wouldn't take off without an injectable sumatriptan syringe in my carry-on for migraine attacks, often discreetly administered in an airplane bathroom. Today, sublingual medication or nasal sprays are good options when you need relief quickly.

Ice or heat, supplemental oxygen, water, blankets, and pillows can provide additional comfort in midair and are a flight attendant call button away.

Delva I, Delva M: Successful Treatment of Airplane Headache with Rizatriptan: Case Report. Case Rep Neurol 2021;13:375-379

4 Simple Steps to Avoid Headaches When Flying

Step 1 — schedule wisely.

While it may be tempting to choose that less expensive red-eye or 6 a.m. flight, it's possible you'll pay for it later. Sleep disruption may not affect an aviation headache, but it's a commonly reported trigger for migraine and could increase your odds of a headache while flying. The money you save on the cheaper flight could cost you more in pain medication and lost wages later.

Changing time zones is especially difficult, which I do often as I fly coast to coast and cross oceans to attend medical conferences and advocate for people with migraine. Now I avoid scheduling early-morning meetings when I travel west to east and drink Sleepytime tea with a melatonin tablet on the first night of arrival. It has no effect on airplane headaches but reduces the chance that inconsistent sleep patterns will trigger a migraine attack the next day.

"Sleep routine is critically important for migraine sufferers. [Inconsistent sleep is] quite damaging ... for a person with migraine it can actually provoke more headaches" explained Toronto headache specialist Christine Lay, MD, in our " Migraine Again Podcast" interview .

If you can't avoid red-eye flights, which are common for cross-oceanic trips, wear comfortable clothes and pack a neck pillow, comfy socks, eye mask, and earplugs. Skip the in-flight movie, too. Dr. Lay advised: "Avoid light-emitting screens for a couple of hours before bedtime."

Step 2 — Stock Your Carry-On

To prepare yourself for a possible in-flight airplane headache, pack the medication your doctor recommends (such as ibuprofen or triptans) and an empty reusable screw-top ice pack that will go through security. Those will come in handy if you happen to have a migraine attack as well.

If you are prone to migraine attacks, you'll want to stock your carry-on with sunglasses, eye masks, earplugs, or noise-canceling earphones (worth every penny!), a healthy snack, and an empty water bottle you can fill before boarding and after security. Since I can get nauseated from strong odors, I also pack a lavender stick and anti-nausea medication.

Many of these items are available to purchase in the terminal if you forget them at home.

Step 3 — Know What to Eat and Avoid Preflight

The day before you fly is the time to start avoiding migraine-triggering foods and drinks like alcohol , processed foods with MSG and nitrites, and anything else you're sensitive to. Veteran cross-country flyer Kristin Chenoweth spends her time jetting between New York and Los Angeles for stage and screen work. In her 2019 Migraine World Summit live event interview, she offered a personal tip that's helped her avoid a headache while flying: "Pound the water, people!"

Managing hydration levels cannot be understated. Drinking plenty of water the day before the flight, during flight, and after you land is recommended by frequent travelers and physicians. Staying well hydrated could go a long way in preventing a headache while flying.

Moawad, Heidi. Airplane Headaches: What the Research Says. Neurology Times. 2018 February

Step 4 — Settle In and Manage Your Ride

Now you've chosen a conveniently timed flight, packed your carry-on carefully, and pounded the water before boarding. It's time to settle in with everything easily accessible at your feet.

To manage your ride, you'll want to avoid sleeping in flight unless you're changing time zones and you need to adjust. "Naps aren't advisable for people with migraine," advised Lay in her interview.

Turbulence is something you simply cannot anticipate but which can elevate migraine-triggering anxiety in addition to making you queasy. If this is a common issue for you, ask your doctor for the best anti-nausea solution for you or drink a beverage that can help ease your nausea quickly . Some anti-nausea medications can also help alleviate a migraine attack if taken early in your attack.

If you're not nauseous and feel like eating, choose one of the healthier options offered by the airline. Look for nutrient-rich foods with magnesium, omega-3s, and riboflavin that are not only good for you but also can help prevent migraine attacks.

Should you still struggle with in-flight headaches or migraine attacks after trying these four steps, see your doctor to brainstorm solutions.

Do you ever get headaches when flying? Does plane travel trigger a migraine attack for you? Share your prevention tips on Tippi .

Paula dumas.

Paula Dumas is the founder of Migraine Again. She is a producer and cohost of the Migraine World Summit, president of the World Health Education Foundation, and a member of the International Headache Society Global Patient Advocacy Committee.

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How to Prevent Headaches After Air Travel

Last Updated: January 29, 2024 References

This article was medically reviewed by Erik Kramer, DO, MPH . Dr. Erik Kramer is a Board-Certified Primary Care Physician at the University of Colorado. With over 15 years of experience, his clinical interests include obesity and weight management, diabetes care, and preventive care, as well as embracing a holistic approach to primary care. He received his Doctorate in Osteopathic Medicine (D.O.) from the Touro University Nevada College of Osteopathic Medicine and completed his residency at Central Maine Medical Center. Dr. Kramer is a Diplomate of the American Board of Obesity Medicine. There are 8 references cited in this article, which can be found at the bottom of the page. This article has been viewed 146,756 times.

Many travelers suffer from flight-related headaches. This can be due to altitude changes, jet lag, or exposure to irritants in airports or airplanes. Flight-induced headaches are different from the sinus pressure you sometimes experience during a flight due to pressure changes, which usually resolves once you land. [1] X Trustworthy Source PubMed Central Journal archive from the U.S. National Institutes of Health Go to source In contrast to flight-related sinus problems, these headaches often start at landing and can be very intense, usually with throbbing pain that’s localized to one side of your head. While they often go away on their own within 1 hour, you’ll likely want to minimize the pain or avoid it altogether. There are a variety of ways to lessen the severity of headaches after flight, and you should take action before, during, and after boarding a plane.

Using Medication

• In a recent study, hikers preparing for a high-altitude journey were given doses of ibuprofen in the 24 hours prior to their journey. A little over 40% of hikers who took ibuprofen developed altitude-related headaches and nausea. In the control group, where hikers did not take ibuprofen, almost 70% experienced headaches, nausea, and other symptoms. [2] X Research source
• If you're going to be flying, try taking 600 milligrams of ibuprofen sometime during the 24 hours leading up to the flight. Ibuprofen can be purchased at most drug stores and supermarkets and comes under a variety of names, such as Advil or Motrin. [3] X Research source

• You will need a prescription for acetazolamide. Talk to your doctor about your headaches during flying and ask them if they think the medication would be safe for you.
• Acetazolamide is prescribed in different doses with different instructions depending on why you're taking it and your medical history. Follow the instructions on your prescription and do not hesitate to ask a doctor or pharmacists if you have any questions. [5] X Research source
• Acetazolamide can cause nausea, dizziness, and loss of appetite. These are normal side effects that should pass. If you experience more serious side effects, like fever, rash, or blood in your urine, stop using the medication and talk to your doctor. [6] X Research source

Taking Precautions

• Altitude changes can prompt changes in your oxygen levels, causing your head's blood vessels to compensate by contracting and expanding. This change in your blood vessels can trigger a migraine. [7] X Research source
• Booking a non-stop flight can be difficult and costly. However, see if you live within driving distance of a location that provides non-stop flights to your end location. It might be worth it to take a road trip to an airport and take a non-stop flight from there if your migraines or headaches are particularly severe.

• Aircrafts only have a humidity level of 15%, which is on par with some of the driest climates on earth. Make sure you bring a water bottle on the plane and stay hydrated prior to boarding.
• Remember, drinks are not usually offered on a plane until well after take-off. Bringing your own water on board will make it easier for you to stay hydrated while you wait for in-flight service.
• If you forgot your water bottle and are feeling thirsty as the plane takes off, it's fine to ask the flight attendant for a water bottle before the plane takes off.

• Purchase high-fiber and high-protein snacks, like nuts, dried fruits, and granola bars. Put them in your carry-on bag. Avoid salty or overly sugary snacks, which can worsen dehydration.

• Alcohol is one of the biggest triggers for migraines. It also contributes to dehydration that can exacerbate jet lag and cause headaches.
• Red wine, in particular, is known to cause headaches if drunk in excess. Consuming a glass or two of red wine before or after boarding could lead to a headache after flight.
• If you really want a preflight alcoholic beverage, stick to white wine as it's less likely to cause headaches.

• Herbal supplements, like melatonin, can be purchased at drug stores and supermarkets. In small doses, they can promote sleep. Many people also take Dramamine while flying as it reduces nausea. It also causes drowsiness and may help you sleep through a long flight.
• Test any medications you're trying at home before a fight. If they have any adverse side effects for you, you want to know ahead of time.
• Bring an in-flight pillow to avoid straining your neck while flying.

• Familiarize yourself with the routines of flying and airplane noises before leaving for the airport. Anxiety is often rooted in the unexpected or unknown, so having as much information as you can beforehand can reduce fear. [11] X Research source
• Keep a picture of your destination on hand. If you start to become anxious during the flight, reminding yourself what you have to look forward to can help ease that anxiety.
• If your fear of flying is particularly bad, talk to a doctor or therapist about an anti-anxiety medication you can take as needed before flight.

Recovering after the Flight

• It might not be a good idea to drive right away. Take a cab home from the airport or have a trusted friend pick you up.
• Do not expose yourself to stimulants that can normally induce headaches. Caffeine, loud music, and alcohol should be avoided in the hours after a flight until you've readjusted.

• Most flight-related headaches go away within 30-60 minutes after they start. If your headache lasts longer than that, talk to your doctor.

Expert Q&A

You might also like.

• ↑ https://www.ncbi.nlm.nih.gov/books/NBK470207/
• ↑ http://healthland.time.com/2012/03/20/ibuprofen-can-prevent-altitude-sickness/
• ↑ https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682756.html
• ↑ https://migrainetrust.org/understand-migraine/types-of-migraine/other-headache-disorders/high-altitude-headache/
• ↑ https://www.cntraveler.com/stories/2016-04-29/how-to-avoid-headaches-on-planes
• ↑ http://www.everydayhealth.com/headache-and-migraine/taming-migraines-while-traveling.aspx
• ↑ https://www.health.harvard.edu/blog/alcohol-and-headaches-2018102615222
• ↑ https://patient.info/news-and-features/how-to-manage-flight-anxiety

About This Article

Medical Disclaimer

The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment.

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To avoid getting a headache after air travel, take ibuprofen like Advil before your flight since the medication can help prevent headaches. While on your flight, drink lots of water so you don’t get a headache from dehydration. You should also avoid drinking alcohol right before or during your flight since that can lead to dehydration and trigger a headache. Some headaches from air travel are caused by jet lag, so try and sleep on the plane so you feel rested when you land. After you land, get some fresh air as soon as you can to alleviate any jet lag. For more advice from our Medical co-author, including how to stay calm during air travel so you don’t get a headache from stress, read on! Did this summary help you? Yes No

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The Maya Train Will Get You to All of Yucatán’s Best Spots. But Not Yet.

In December, the train began running on its first route through Mexico’s Yucatán Peninsula. On a five-day journey a few months later, the author encountered enthusiasm, and scheduling hiccups.

By Elisabeth Malkin

Elisabeth Malkin has been visiting the Yucatán Peninsula for three decades.

I stepped off the platform at the gleaming new Maxcanú train station, eager to see the magnificent Maya archaeological site of Uxmal. All I needed was a taxi to take me there, a trip of about 30 miles away.

There are no taxis, said the stationmaster, as we stood on the polished limestone floors of the high-ceilinged station, which was cool and breezy despite the brilliant late-morning sun outside. And I was the third person in two weeks to get off at Maxcanú expecting to reach Uxmal, he said.

I was midway through a five-day trip to explore the brand-new Maya Train and several of its destinations in the Yucatán Peninsula of Mexico . Designed to run 965 miles (1,554 kilometers) around a loop of 34 stations when completed, the train will whisk passengers in cool comfort through colonial cities, archaeological sites, splashy resorts and tropical forests.

Now I was stunned. Wrangling a taxi has never been a problem in Mexico. But the drivers gathered in the main square of Maxcanú offered only beat-up vans that hopscotch through small towns, where I might or might not find a taxi to Uxmal. The next van was leaving in 45 minutes.

Yucatán’s layers of history have long held me spellbound. During earlier car trips, I have clambered up deserted Maya temples and palaces, stepped into the cool naves of massive 16th-century churches and visited restored haciendas, testaments of the ostentation — and hardship — of the peninsula’s 19th-century plantation economy. Traveling by train, I thought, would allow me to steep myself in more of that history.

But as I found in Maxcanú, a train won’t necessarily get you to where you want to go.

During my February trip, I traveled on the only route then available, an east-west leg that opened in December and runs from Cancún to Mérida, and then south through the port city of Campeche to the Maya site of Palenque (a short route between Cancún and Playa del Carmen opened last month, with three trains a day). I encountered scheduling confusion, unfinished stations and a dearth of trains — just two operating daily each way between Cancún and Campeche, and only one to Palenque. Overnight sleepers and special dining trains seem years away.

President Andrés Manuel López Obrador considers the Maya Train his showcase development project, and wants to inaugurate the rest of the train before he leaves office on October 1. Based on my experience, that goal seems elusive.

A $29-billion route through the jungle

I started my journey in Cancún, where in the pre-dawn gloom the station hovered like a glowing spaceship. An attendant scanned the ticket I had bought online and a half-dozen more pointed me toward my tourist-class car, which was about a quarter full. I planned to go to Campeche, about 300 miles away, stopping once each day. At 120 kilometers (about 75 miles) an hour, the train covers the route in about six hours, the same as a car. (When construction is complete, the train’s speed should increase to 160 kilometers an hour.)

The car’s wide windows looked out at a wall of low jungle. The blue-green seats were comfortable and there was ample space between the rows. I bought a very good cappuccino at the snack bar, but declined the plastic-wrapped sandwiches. The rest of the merchandise was fruit cups, milk boxes and junk food.

The train will ultimately cost much more than the $29 billion budgeted so far, and it’s not the first time ambitious planners have alighted on the region. Cancún was once a tiny fishing village, selected half a century ago as a tourist hub. Last year 10 million international tourists flew into its airport, more than the airports of Mexico City, Los Cabos and Puerto Vallarta combined.

But uncontrolled growth has stressed the Caribbean coast’s fragile environment. The Maya Train, scientists warn , will push those problems south, threatening the area’s water supply, its unique system of underground limestone caves and its vast nature reserves.

Mr. López Obrador has charged ahead, handing the train over to the military , and arguing that it will spread Cancún’s wealth and attract new visitors. Mexico received more than 42 million overseas tourists last year and they spent almost $31 billion .

Local governments see an opportunity. “The train will allow people to disperse throughout the peninsula,” said Michelle Fridman, the tourism secretary for Yucatán state, which promotes dozens of attractions far beyond highlights like Mérida and Chichén Itzá .

Now that the train is operating, transport companies will begin to connect stations with lesser-known sites nearby, she said.

It’s fair to ask whether the train is the most effective way to develop the peninsula’s tourism. Tour companies already run trips to many sites from major cities, which are well served by buses. Driving a rental car through most of the area is considered safe , according to U.S. State Department travel guidance .

Route of Mexico’s Maya Train

Canceled trip.

It took two hours (and one time-zone change) to reach Valladolid, a colonial city of handsome streets and ancient churches, where I bought the rest of my tickets at the station. A tourist-class ticket from Cancún to Valladolid costs 472 pesos (around $28) for foreigners and 355 pesos (around $21) for Mexicans. First class, with wider seats, costs 755.50 pesos and 566.50 pesos, and discounts are available for older travelers and residents of the five states along the train’s route. (A first-class bus from downtown Cancún to Valladolid costs between 222 and 344 pesos, depending on the time of day, and takes half an hour longer.)

It was impossible to run the new Maya Train tracks into dense city centers and the Valladolid station, like the rest, was outside the urban core. A waiting bus took disembarking passengers downtown, a 15-minute ride for 35 pesos.

That day I toured Ek Balam , the site of a ninth-century Maya kingdom that is dominated by a 100-foot palace distinguished by a facade of carvings depicting winged warriors, stylized animal features and geometric patterns bordered by giant fangs. Admission to the site includes entry to the X-Canché cenote, one of thousands of limestone sinkholes that were sacred to the Maya.

Later that afternoon, I was wandering through the Museum of Ethnic Clothing, a private collection of traditional dress, embroidery and hats, when a WhatsApp message from the ticket office blinked on my phone. My train scheduled for the following day was canceled.

I decided to deal with the problem in the morning and enjoy the city. As I wandered past the antique shops and boutique hotels of the elegant Calzada de los Frailes, it was clear that Valladolid’s tourism, and the infrastructure to handle it, was well established. The Maya Train is simply an alternative way to reach a city that tourists discovered years ago.

‘We’re on the Tren Maya!’

In the morning, I found that my train had not been canceled, but the station for which I had a ticket, Tixkokob, was closed. I got off instead one stop earlier at Izamal, known for its ocher streets and the giant Franciscan convent of San Antonio de Padua, built atop the ruins of a pyramid.

During the 90-minute ride, I heard widespread enthusiasm among fellow travelers who expressed a willingness to give the train time to work out the kinks. “We’re an experiment,” said Oliva Escobedo Ochoa, 64, who was vacationing from her home in central Mexico.

Leticia Iliassich, 57, who is Mexican, was traveling with her Croatian husband along with relatives from Mexico and Croatia. They had initially been scheduled on an earlier train to Mérida that had been canceled. “We knew that it was a new project,” she said. “We don’t mind.”

The group had already sent a video to friends declaring, “We’re on the Tren Maya!”

At the Izamal station I hitched a 15-minute ride into the town center with a man who had asked me to take his photo alongside the train and his father. From there I negotiated a taxi to Hacienda San Lorenzo Aké, a working hacienda that still turns the fiber from an agave plant called henequén into coarse rope. Global demand for henequén, known as Yucatán’s “green gold,” brought fantastic wealth to the region in the mid-19th century, speckling the peninsula with more than 1,000 haciendas. ( Many are now sumptuous hotels.)

Where geometry, nature and the divine merge

It was during my third day that I found myself stuck in Maxcanú, after a 90-minute train ride from Izamal. The stationmaster, an army captain, offered me a ride to Uxmal, just as he had to the stranded tourists before me.

Eying Uxmal’s 4 p.m. final ticket sale, I accepted.

My situation made it clear just how distant the Maya Train’s promises are for tourists seeking to explore more of Yucatán. In time, that will change, said Ms. Fridman, the tourism secretary. “The idea is to have more hotels along the train line,” she said. “That will happen little by little.”

But Uxmal , among the most stunning of the Maya sites, made up for the inconvenience. Uxmal’s grand buildings are faced with intricate decorative masks as well as friezes in which geometry, nature and the divine merge. New plaques at each structure offer detailed information in English and Spanish, part of the government’s investment in improving displays at Maya sites for the train project.

Most tourists either take day trips by car or bus to Uxmal from Mérida or stay at one of three nearby hotels. As I finished dinner at my hotel, the dining room began to fill up: 47 Polish tourists had arrived.

Panama hats and a cramped van

My plan for the day was to go by taxi to Bécal, a town where Panama hats are woven in limestone caves to keep the fibers soft, and then pick up the afternoon train in nearby Calkiní for the port city of Campeche.

But I spent so much time watching the hat-making demonstration and then fitting my new hat and buying gifts that we set off with little time to reach the station. To my chagrin, I missed the train, the last one of the day.

On Calkiní’s central square, I found a van that was leaving for Campeche. Cost: 65 pesos. Time: about 1 hour and 20 minutes, similar to what I would have spent on the train. Of course, I was trapped in a cramped seat and had to listen to the driver’s choice of sentimental ballads, but I was dropped off in downtown Campeche, close to my hotel.

The next day, I toured the Museum of Maya Archaeology , an expertly curated collection that included haunting jade funeral masks, glyphs and delicate ceramic figures.

José Madrigal, 45, an engineer from Fremont, Calif., was trying to make Maya pottery interesting for his twin sons. The boys had just turned 5 and their birthday present had been a ride on the Maya Train. “They love trains,” Mr. Madrigal said. Then the family moved on, keeping up a brisk clip through the museum. They had another train to catch.

Should you take the train?

Yes, if you are traveling between larger stations. The train also offers a way to get to Palenque, which is harder to reach and has roads with security concerns. Travelers can stow bicycles on board.

To see train times, check the destinations on the website . You cannot buy tickets online more than a week in advance. But when you finally board, the ride is smooth — and the coffee is excellent.

Follow New York Times Travel on Instagram and sign up for our weekly Travel Dispatch newsletter to get expert tips on traveling smarter and inspiration for your next vacation. Dreaming up a future getaway or just armchair traveling? Check out our 52 Places to Go in 2024 .

Open Up Your World

Considering a trip, or just some armchair traveling here are some ideas..

52 Places:  Why do we travel? For food, culture, adventure, natural beauty? Our 2024 list has all those elements, and more .

Mumbai:  Spend 36 hours in this fast-changing Indian city  by exploring ancient caves, catching a concert in a former textile mill and feasting on mangoes.

Kyoto:  The Japanese city’s dry gardens offer spots for quiet contemplation  in an increasingly overtouristed destination.

Iceland:  The country markets itself as a destination to see the northern lights. But they can be elusive, as one writer recently found .

Texas:  Canoeing the Rio Grande near Big Bend National Park can be magical. But as the river dries, it’s getting harder to find where a boat will actually float .

Ask Amy: Should we take a flight with our 1-year-old or miss a family function to avoid the travel headache?

• Published: Apr. 24, 2024, 2:00 p.m.

Amy Dickinson TNS

• Amy Dickinson

DEAR AMY: My sister will earn her Ph.D. out-of-state this summer.

My wife and I have a one-year-old and a three-year-old.

Bringing the whole family would be too much for the one-year-old to handle.

I’d like to bring our older child, who is close with the graduating aunt.

My wife doesn’t support the older child going with me because she wants to be there for that child’s first airplane flight.

She acknowledges that this is a selfish desire.

Should we go as a family, despite the headaches that will come from flying with a baby, or should I go solo?

– Harried Husband

DEAR HARRIED: I have to admit that as someone who has flown – a lot – with my daughter when she was a baby and a toddler, and subsequently with many other children of varying ages, I don’t see flying with a three-year-old as being the important and unmissable milestone your wife seems to perceive it to be.

(I still have flashbacks of running from one end of the Dallas airport to the other with my daughter, repeatedly dropping our carry-on luggage and assorted backpacks as we went.)

If the trip to your sister’s graduation is a direct flight of three hours or less, I would take the whole gang. If the trip requires a complicated connection, I would suggest you go solo.

(You can email Amy Dickinson at [email protected] or send a letter to Ask Amy, P.O. Box 194, Freeville, NY 13068. You can also follow her on Twitter @askingamy or Facebook .)

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