Question for migraine sufferers

I've read a few theories on this which seem to come down to our sensitivity to barometric changes, particularly impacting the vestibular system and but sinus cavities and other air filled spaces in your head to some degree too.

Your sense of balance is mostly driven by the vestibular system, which is your inner ear. It's three semi-circular, fluid filled canals that your brain is using inputs from to sense and calculate your position three dimensional space - basically an x, y and z axis. The movement of the fluid in the canals is picked up by sensory hairs, which give extremely precise information about the location of your head. [You also pull in information from other sources - visual cues, sensations from joints and muscles etc, but the primary source is your vestibular system.]

Your middle ear is filled with air (well a controlled mix of gasses similar to air which is actually a mix of air let in through the eustachian tube and from gas exchange with your body). When there's a change in air pressure, your middle ear's internal pressure can be significantly different to the atmospheric pressure which places pressure on structures as the gas expands. Likewise, if there's a sudden increase in atmospheric pressure, these pockets of gas can compress until they equalises through that valve in your Eustachian tube or through gas exchange, and that can give a strange sensation in your hearing, but it can also impact your sense of balance or cause other sensory impacts, due to physical pressure placed on the structure of your inner ear.

You can even get small bubbles of gas in your inner ear, which can cause issues like this too. They can be there temporarily and are reabsorbed after a while, or they can be there all the time.

The other aspect is that you've gas filled spaces i.e. your sinuses, but also little bubble like pockets of gas in bone and spaces in your head generally, all of those are impacted by pressure changes in the atmosphere, so you can pick those up as headaches and possibly odd sensory input which can trigger migraine like events.

Your brain can sometimes interpret false inputs in very odd ways i.e. they can make you feel physically sick (that's what motion sickness is). Basically your vestibular system is telling your brain that your body is moving in odd directions, and your eyes and muscles are telling it they're not. It doesn't fit the model it has of how movement should work, so, the response is confusion and you feel sick / dizzy, as it's totally outside the parameters of what your body's evolved to do (e.g. not be attached to a machine that's moving in chaotic ways). It's also why you can learn your way past it - e.g. by focusing on the horizon and ensuring that you're giving it the correct inputs.

So, the sense of feeling pressure changes in the air is very real.

It's also why some people get sudden headaches ahead of thunderstorms. That isn't a myth. It's your ears and head working like a barometer and detecting the rapid changes in air pressure.

Things like going outside and fixing your vision on a distant point with a clear view of the horizon can help. As it gives your brain a reference that tells it things are not moving.

Taking a comfortably hot steamy shower could also help a lot as it can help clear mucus from your sinuses and nose, which helps get your Eustachian tubes working and equalises pressure.

Keeping adequately hydrated - keeps mucous production from getting too thick.

Minimising exposure to pollen (if you're allergic to it only) e.g. using an air filter in your bedroom at night, not sleeping in rooms with very pollen producing plants, giving the house a hoover with a HEPA filter vacuum cleaner or mopping the floors and generally keeping dust down, and checking with your GP or pharmacy about allergy medications and so on is useful too.

If you've an on-going issue with this, there would be no harm in getting your ears checked by an audiologist or ENT.

If you've bad migraines though, you should definitely get them investigated by a doctor as they can have many underlying causes that are worth eliminating.

Your inner ear can detect absolutely tiny changes.

It can also fill with more fluid as the air pressure drops.

There's significant ENT research done on this btw showing direct correlation between atmospheric pressure and humidity and attacks of Ménière's disease (more commonly referred to as vertigo).

https://journals.lww.com/otology-neurotology/fulltext/2017/02000/the_weather_and_m_ni_re_s_disease__a_longitudinal.11.aspx

The middle ear pressure changes also don't necessarily change in response to immediate change in atmospheric pressure. Your middle ear is a small, usually sealed pocket of gas with a tube with a valve that connects to the atmosphere via your throat (just behind your upper pallet basically). Your inner ear and other head spaces containing gas i.e. in bones, are entirely sealed.

The atmospheric pressure can change more slowly, but the pressure in your ear doesn't equalise immediately, it builds. So it can create swelling, responses from fluids filling spaces (during low pressure). Or in the case of your middle ear, it will suddenly shift when the valve is triggered by swallowing. A % of people don't have the most effective eustachian tubes or may have valves that don't respond very well / get stuck so the pressure just builds.

Some people's ears will pop and crack on a small hill, or even on a train going through a tunnel.

The tiny trapped bubbles of gas elsewhere are often VERY tightly sealed with little or no leeway for expansion, so a change in pressure is extremely perceptible if it causes pressure on something sensitive. They can expand slightly or shift suddenly and so on.

Some of these issues aren't necessarily how the system has evolved to operate, but rather they're minor glitches that are present in a small % of the population.

If you take a pressure change impacting your inner ear directly e.g. a trapped bubble of gas, there shouldn't be gas present there, but it is sometimes there and it can cause chaotic inputs to nerves.

You're talking absolutely tiny bubbles and EXTREMELY sensitive sensory systems, capable of picking up absolutely tiny changes in pressure or movement within their systems, which will be interpreted by your brain as very significant changes as they're being caused by something directly interacting with a sensory organ's internal workings, in a way that isn't normal.

Then if you throw random sensory input into a system like that, the impacts can be quite odd. Instead of just being a single error, your brain can just interpret them very strangely and it can trigger other sensations.

It's not quite like a computer system that's just narrowly and literally looking at inputs, nor is it a simple barometer. Rather, you're looking at changing atmospheric pressure interacting with complex, dynamic systems with small spaces containing gases and fluids.

Your brain also feeds everything into an extremely complex model, where one input can end up convolving with a whole load of other things and resulting in a perception of something completely different. So, throw something like a vestibular sensor into a chaotic input and you can end up seeing a colour, or feeling a sensation on your nose or something. It can be quite odd.

Have a look at some of the experiments on colour perception sometime, for example, and you'll get a sense of how our reality is very much a model. If you throw the inputs out even a bit on some obscure aspect of it, it can result in some very strange sensations until the model adjusts.

At the most basic level you can play around with some of that to create illusions, but it can have some very real impacts when someone's got a neurological issue or something creating a false signal somewhere.

These systems can and do glitch. So, it's just important to recognise when they are glitching and be able to see glitches for what they are, rather than something scary.

Serious migraine i.e. with visual disturbances, auras, etc absolutely should be investigated. It's important to rule out any serious issues. They can be caused by cardiovascular issues, neurological issues, blood sugar issues or even tumours and so on, so definitely do not ignore them.

The same applies to sensory phenomena like tinnitus. It can be some random glitch issues, or it can be something serious.

With any issue like this, ALWAYS talk to a doctor and don't just assume it's nothing until you know it is! Mostly they can rule out anything dangerous quite quickly.