Migraine Pressure Drop: What hPa, Flying and Altitude Mean for You

By Laurine NicolettiNovember 4, 202612 min

Your weather app says the pressure is dropping, and your head already feels like it knows. Maybe you suspect a migraine pressure drop is behind your attacks. Or you're about to board a flight, or head up to a ski resort, and you're wondering whether the change in air pressure will set off an attack. The numbers on the app (1009 hPa, 998 hPa) don't help much if nobody explains what they mean.

A migraine pressure drop is a fall in atmospheric pressure that some people notice just before or during an attack. The research is real but mixed: a drop seems to matter for some people, rarely acts alone, and no single hPa number works as a universal "danger line". This article explains how to read hPa, what studies found about thresholds, and what happens on planes, in the mountains and before storms. If you want the bigger picture first, our guide to migraine triggers is a good place to start.

In short

One hPa value on its own tells you very little: what matters is how the pressure changes compared with what your body is used to.
A small Japanese study found that drops of about 6 to 10 hPa below the standard 1013 hPa were linked to the most attacks, but it was small and the results vary a lot between studies.
On planes, the typical "airplane headache" is a short, sharp pain mostly during landing, and it seems to be a separate thing from the cabin's low oxygen and pressure.
In the mountains, low oxygen is probably more important than pressure alone, and a diary is the best way to find out whether you are sensitive.

What does a value in hPa actually mean?

An hPa (hectopascal) is simply the unit that weather services use to measure air pressure, and 1013 hPa is the standard reference value at sea level. In the Japanese study we look at below, researchers used 1013 hPa as the standard atmospheric pressure to describe how far the pressure had dropped when attacks started.

In everyday weather, pressure moves up and down around that value. A reading of 1020 hPa usually goes with settled, calm weather, while 1000 hPa or lower usually goes with clouds, wind and rain. That's why a low number often shows up the day before a storm.

Two things are worth knowing when you read your app:

Sea-level pressure vs. local pressure. Weather forecasts usually adjust readings to sea level so places can be compared. Your phone's built-in barometer may show the real local pressure, which is lower if you live high up.
The number matters less than the change. 1005 hPa could be normal for one region and a big drop in another. That's why people tend to look at the change over hours or days rather than the raw value.

Slow or sudden change: what matters most?

Many people with migraine feel that a sudden pressure change is worse than a slow one, but this is a common hypothesis, not a proven rule. Researchers have not agreed on a clear speed limit that applies to everyone.

It makes intuitive sense. A drop of 6 hPa over three days is not the same as 6 hPa in a few hours, just as the body copes better with a slow change in temperature than a sudden one. Many migraine communities and apps repeat this idea. But the studies we have mostly look at pressure on the day of an attack or the day before, not at the exact speed of change, so we can't give a firm number.

What studies do point to is that weather rarely works alone. Mayo Clinic notes that weather changes, including barometric pressure, may trigger migraine in some people, and can also worsen a headache that other triggers have already started. A 2024 review in Current Pain and Headache Reports concludes that recent studies are inconsistent, and that weather combined with other factors seems to matter more than weather alone.

So a pressure drop on a day when you also slept badly, skipped a meal and felt stressed may count for more than the same drop on a calm, well-rested day. Our article on how pressure and migraine are linked goes deeper into the science.

What do studies say about thresholds in hPa?

The most-quoted figure comes from a small Japanese study: attacks were most frequent when pressure was 6 to 10 hPa below the standard 1013 hPa. In this study of 34 people with migraine, who kept a headache diary, the researchers found that migraine occurred most often at pressures of about 1003 to 1007 hPa.

Some details from that study:

About 73% of people with migraine with aura and 75% of those with migraine without aura had attacks linked to a pressure decrease, compared with about 21% of people with tension-type headache.
Attacks were most common in the 1003 to 1007 hPa range, not in the very lowest pressures.
It was small, based in Japan (where typhoons are common), and it relied on diaries, so it can't tell us what happens for everyone.

Other research is less clear. In a study from a US headache clinic, only about half of the 77 patients turned out to be sensitive to weather at all, even though more of them believed they were. Barometric pressure was the cause for a smaller share (13% in the report), and temperature and humidity changes mattered too.

What can you take from this?

Some people do seem sensitive to pressure changes, and a drop of a few hPa may be enough for them.
Others notice nothing, even with big swings.
There is no proven universal threshold, so any "if it drops by X hPa, you will get a migraine" claim goes beyond the evidence.

Migraine on a plane: is cabin pressure to blame?

A headache on a flight is most often a short, sharp pain during landing, and it may have little to do with your usual migraine. This is called "headache attributed to airplane travel" or airplane headache. A systematic review of 39 papers and 275 patients found that 1 to 8.3% of air travelers get it, with more than 90% of cases happening during landing.

Typical features are:

A very strong, stabbing pain on one side, often around the forehead or eye.
A short duration, usually less than 30 minutes.
Pain only in relation to flights, not at other times.

The leading explanation in that review is sinus barotrauma: the pressure inside your sinuses doesn't keep up with the quickly changing cabin pressure, which may irritate nerves in the area. This is one reason a stuffy nose or a cold can make it worse. Doctors sometimes confuse it with sinus headache, so it's worth explaining the pattern if you speak to one.

Do people with migraine get it more? That's not clear. One study summarized by Atlas of Science did not find that having migraine increased the chance of airplane headache. Still, a long flight can bring other triggers on its own: poor sleep, dehydration, skipped meals, stress and screens. If flying regularly brings on severe pain, talk to your doctor about what might help, rather than guessing.

One more point: modern cabins are not kept at sea-level pressure. The FAA requires that cabin pressure altitude be no more than 8,000 feet (about 2,400 m) at the plane's maximum operating altitude, so during cruise you're effectively at moderate mountain altitude. That's a slow, steady shift, different from the quick changes at take-off and landing.

If you also feel dizzy or unsteady when pressure changes, our article on vestibular migraine may help you make sense of it.

Migraine in the mountains: altitude, pressure and oxygen

Going up high can trigger headaches, but pressure is probably not the only reason: less available oxygen seems to play a key role. As you climb, both the air pressure and the amount of oxygen you breathe in fall together, so they are hard to separate in real life.

Researchers tried to separate them. In a prospective trial in Cephalalgia, 77 healthy volunteers with no history of migraine were exposed to simulated altitude of 4,500 m by lowering the oxygen in the air they breathed, without changing the air pressure. Headaches developed, and in subgroups 8% to 15% had headaches that met the criteria for migraine-like attacks. The authors concluded that lack of oxygen can trigger these headaches and may be involved in migraine itself.

What this means in practice:

A headache at altitude isn't always "your migraine". Acute mountain sickness also causes headaches, and the two can overlap.
Going up gradually, rather than all at once, gives your body time to adjust. This is general travel advice, and your doctor can tell you what is suitable in your case, especially if you take regular medication.
Other triggers add up on trips: early starts, cold, dry air, bright snow glare, less sleep and less water.

If you plan a trip to high altitude, mention it to your doctor beforehand, and keep a note of how you feel so you can compare it with future trips.

Storms and low pressure: why the attack sometimes comes before the rain

An attack that starts before the storm is plausible, because pressure often starts falling hours before the clouds and rain arrive. That's the moment some people feel the first signs, while the sky still looks fine.

Another possibility is that the early signs are already part of the attack. Yawning, tiredness, mood changes and neck stiffness can appear hours or a day before the pain, so you may blame the weather for something your brain had already started. This doesn't mean you're imagining things: the weather may well play a part, just not always the one we assume.

Storms also bring other things that can matter, like humidity, wind, temperature swings and changing light. As Mayo Clinic notes, windy or stormy weather and temperature extremes are among the weather factors some people report. The mechanism is still uncertain, so be wary of anyone who presents it as settled.

How can you tell if you're sensitive to pressure?

The most reliable way is to compare your own attacks with the pressure on those days over a few months. Memory is not enough: we tend to remember the attack that came with a storm, and forget the ones that came with clear skies, as well as the stormy days without any attack.

Here is a simple method:

Note every attack, with the date, start time, intensity and duration. Our guide on what to write in a migraine diary lists what's most useful.
Add the pressure for that day, ideally the value in the hours before the attack, and how it changed compared with the previous day.
Also note other possible triggers (sleep, stress, food, screens, your cycle), because weather rarely acts alone.
Look for a pattern after at least two or three months. One or two coincidences prove nothing. What you want to see is something that repeats.
Check the days without an attack too. If pressure dropped on many days when you felt fine, it's probably not your main trigger.

The broader process is covered in how to identify your migraine triggers, and once you have a few months of notes, reading your diary patterns shows you how to spot trends in timing, duration and intensity. Mayo Clinic also suggests keeping a headache diary and monitoring the weather if you suspect weather triggers.

What to take away

A migraine pressure drop is a real trigger for some people, but not for everyone, and no single hPa number applies to all. One small study found attacks were most common with pressure about 6 to 10 hPa below 1013 hPa, while larger or more recent reviews describe the evidence as inconsistent.

On planes, short and intense pain during landing has its own name and mechanism. In the mountains, lack of oxygen is probably a bigger part of the story than pressure alone. In both cases, other triggers (sleep, stress, hydration) usually add to the effect.

You don't have to avoid every storm or trip. The practical step is to observe, note and compare, then take your findings to your doctor, who can help you decide what to do about your attacks and any treatment.

Frequently asked questions

How many hPa does the pressure have to drop to trigger a migraine?

There's no proven number. A small Japanese study of 34 patients found attacks were most common at 6 to 10 hPa below the standard 1013 hPa, but other studies found weaker or no links, and sensitivity varies from person to person.

Is high or low pressure worse for migraine?

Low or falling pressure is the one most studied and most reported. A 2024 review notes that some patients seem susceptible to low barometric pressure while others are susceptible to high pressure, so your own diary is the best guide.

Can flying cause a migraine?

Flying can be linked to a short, stabbing headache during landing (airplane headache), which affects 1 to 8.3% of travelers according to a systematic review. A full migraine on a trip may also come from other triggers like poor sleep, dehydration or stress.

Why do I get a migraine in the mountains?

Altitude brings less oxygen as well as lower pressure, and a trial with healthy volunteers found that low oxygen alone could trigger migraine-like headaches in some of them. Headache at altitude can also be a sign of altitude sickness, so tell your doctor about your plans and how you feel.

Sources

Written by Laurine Nicoletti, founder of Mellow, who has lived with migraine since she was 21. Learn more · How we write our articles

October 6, 202610 min

Birth Control and Migraine: What Studies Say and When to Talk to Your Doctor

Birth control and migraine: what studies say about hormones, aura and stroke risk, what is still uncertain, and questions to ask your doctor.

June 13, 202612 min

Migraine and Screens: Is Blue Light Really to Blame?

What the studies really say about screens, blue light, filter glasses, and migraine. A method to identify if your screens are actually triggering your attacks.

May 13, 202610 min

Weekend Migraines: Why Attacks Hit When You Finally Relax

Let-down effect, cortisol drop, sleeping in, caffeine withdrawal: why your migraines hit on weekends or vacations, and how to prevent them.

All “Triggers” articles