How long should I keep a headache diary before I see a doctor?

Most clinicians like to see at least four to eight weeks — long enough to catch a few attacks and any monthly pattern, including one full menstrual cycle if that's relevant. If your appointment is sooner, bring whatever you have. Two weeks of honest notes still beats trying to remember at the desk.

What should I write down during an attack?

As little as you need to. The time it started, a pain score out of ten, and where it hurts is a complete entry. Triggers, medication, and notes can wait until you feel human again. A half entry is still a useful entry.

Do I need an app, or is paper fine?

Paper works, and a free template is a fine place to start. An app helps once you have a few weeks of data, because it can total your attacks, count medication days, and turn months of entries into one page for your doctor without you doing the arithmetic during a migraine.

How to keep a headache diary (and what to log)

A headache diary is the least glamorous thing your neurologist will ever ask you for, and one of the most useful. It is not a test you can fail. It is a quiet record of what your head actually did — kept in the moment, not reconstructed from memory at the clinic desk a month later.

Keeping one well is mostly about keeping it light. The diary that gets filled in is the one that asks little of you on a bad day. Here is what to log, how often, and how to turn it into something a doctor can read in under a minute.

Why keep a headache diary

Memory is a poor witness to pain. By the time you sit down with a doctor, last month’s attacks have blurred into “a lot, I think.” A diary replaces that with numbers: how many attacks, how bad, how long, and how often you reached for medication.

That record does three jobs. It helps with diagnosis — the pattern of your attacks is part of how migraine is told apart from other headaches. It helps you spot triggers over time, which no single attack can reveal. And it quietly flags medication overuse, the slow trap where acute painkillers taken too often start causing headaches of their own.

Major headache organisations — the American Migraine Foundation, the Mayo Clinic, and The Migraine Trust — all recommend keeping one, and many neurologists will ask you to bring a diary to your first appointment.

What to log

You do not need every field every time. Think of it as a short list you can fill in, not a form you must.

The essentials

These five take seconds and carry most of the clinical weight:

Onset — the date and time the attack began.
Pain level — a single score from 0 to 10, at its worst.
Location — one temple, both, frontal, behind an eye, occipital.
Duration — how long it lasted, even roughly.
Type — migraine, tension-type, or something that felt different.

Symptoms

A line on what came with the pain: nausea, sensitivity to light or sound, aura (the visual or sensory warning some people get), dizziness. These details matter more to a specialist than the pain score alone.

Medication

What you took, the dose, and the time. Note whether it worked, and how long it took. This is the single most useful column for a neurologist, and the one that reveals overuse before it becomes a problem.

Possible triggers

A skipped meal, short or broken sleep, stress, bright or flickering light, weather, screens, dehydration, your menstrual cycle. Don’t agonise over it — just jot what’s plausible. Patterns only appear later, across many entries. We cover that in migraine trigger tracking.

The bare minimum on a bad day

When you can barely look at the screen, log three things: pain level, location, time. That’s it. You can add the rest when the worst has passed — or never. A short entry kept in the moment beats a detailed one you never write. (More on this in what to log during an attack.)

How often, and for how long

Log every attack, on the day it happens. The value of a diary is that it’s contemporaneous — filled in while the memory is fresh, not backfilled.

Keep it for at least four to eight weeks before a first appointment. That window usually catches several attacks, any weekly rhythm, and — if it’s relevant for you — a full menstrual cycle. If your appointment is sooner, bring whatever you have.

Paper or an app?

Paper is honest and free, and a printable template is a perfectly good way to start. Its limit shows up later: at the appointment, you and the doctor end up counting attacks and tallying medication days by hand, during the ten minutes you have.

An app earns its place once you’ve logged a few weeks. It can total your attacks, count acute-medication days, surface correlations, and — the part that matters in the room — export the whole period as one clean page. Migrainely is built for exactly this, with a quick-log mode and a neurologist-export PDF, and a low-light design so the screen is bearable mid-attack.

Bringing it to your doctor

The goal isn’t a thick logbook. It’s a summary your doctor can read in under a minute: how many attacks this month, average severity, how many days you took acute medication, and your most frequent triggers. If you’re preparing for a specific appointment, see how to track your migraines for your neurologist for what to bring and how to present it.

A few common mistakes

Logging from memory. Entries written days later drift. Capture the attack the day it happens, even if only the three essentials.
Over-engineering it. A diary you dread is a diary you abandon. Keep it light.
Skipping the medication column. It’s the most clinically useful field and the one that catches overuse early.
Recording only the bad ones. Mild attacks and good stretches are data too — they’re how a pattern takes shape.

This article is for general information and is not medical advice. Migrainely is a log, not a diagnostic tool. Speak to a doctor or neurologist about your migraines.