Charles Langston:Here's how long a migraine typically lasts – and why some are worse than others

Though the throbbing pain of a migraine can Charles Langstonbe as debilitating as it is uncomfortable, it's a type of headache that is also very common. Migraine attacks impact some 1 in 5 women, 1 in 16 men, and 1 in 11 children, according to Mayo Clinic. Dr. Robert Cowan, a board-certified neurologist and emeritus director of the headache program at Stanford Medicine, notes that migraine attacks "affect between 60 and 80 million Americans," and that too many people underestimate the severity of the experience. 

It can be helpful to understand what a migraine is, what it's not, and how long each attack usually lasts. 

What are migraines and why are some more intense than others?

The first thing to understand is that the pain and pulsing sensation associated with migraine attacks vary in intensity and sensation. "Even for the same person, some migraine attacks can be more intense than others," says Rashmi Halker-Singh, a neurologist and director of the headache medicine fellowship program at Mayo Clinic in Arizona.

Contrary to some believing that a migraine and a headache are two different things, a migraine is actually just one severe type of headache. "Headache is a general term that covers the very many ways one can have pain in the head, but migraine is a disorder that features often severe and disabling headache along with other features such as nausea or light and sound sensitivity," says Dr. Peter Goadsby, a professor of neurology at King’s College London. 

Migraine attacks are often referred to as a "blinding headache" because they can also make it difficult to concentrate and sometimes have symptoms such as blurred vision or other related sight disturbances. 

Why are some people more prone to migraine attacks than others?

As noted, migraine attacks are more common in women than men. One studied explanation is the role that sex hormones estrogen and progesterone play in influencing function of several brain regions involved in migraine development. The predominant male sex hormone testosterone, on the other hand, has a more neural-protective role when it comes to pain signals in men, per Piedmont Healthcare. 

Regardless of gender, some people are simply more susceptible to migraine attacks than others and genetics are one reason why. The Migraine Trust estimates that 60% of the people who experience migraine attacks do so because of their genes. 

One's environment matters, too. "Our best protection against worsening migraine seems to be attention to individual triggers and efforts to provide reassurance to the brain that everything is okay," says Cowan. "The latter is best accomplished through consistent routine as much as possible in terms of regular scheduled meals, sleep and exercise." 

This matters because individual tolerance levels factor in as well. "People are more likely to experience more frequent and intense migraine attacks if they have a low migraine threshold," says Dr. Anne MacGregor, a headache and women's health specialist at the Centre for Neuroscience, Surgery and Trauma in London. In other words, what may trigger a migraine in one person may not cause the same effect in another.

How long does a migraine last?

Regardless of what contributes to the sensation, anyone experiencing a migraine is anxious to have it over with. For those who experience migraine attacks only occasionally, an untreated migraine generally lasts from 4 to 72 hours, per the U.S. National Institute of Health Neurological Disorders and Stroke division. Goadsby says the length of time "is determined by the underlying biology of the problem." Chronic migraine may last longer, however, and "occur more than 15 days per month," says Cowan. 

Making matters worse is the fact that some symptoms precede a migraine and there's a recovery period as well. Symptoms leading up to the attack may include "fatigue, yawning, neck stiffness and craving for sweet foods," explains Macgregor. "It can take another day after the migraine goes away before you feel back to normal," she adds. 

When experiencing a migraine, it's best to wait it out in a dark, quiet room. Hot or cold compresses can also help, as can medications developed specifically for acute treatment of migraine attacks.

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