A headache diary is the least glamorous thing your GP 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 surgery a month later.

The NHS and NICE both advise keeping one, and patients are often asked to bring a diary to a neurology appointment. Keeping it well is mostly about keeping it light. Here is what to log, how often, and how to turn it into something a clinician 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 your GP, 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 headache, the slow trap where acute painkillers taken too often start causing headaches of their own.

The NHS and NICE both recommend keeping a headache diary, and The Migraine Trust offers practical guidance on what to record.

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 missed 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 an 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 clinician 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 GP or neurologist

The goal isn’t a thick logbook. It’s a summary a clinician 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 the migraine diary 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.