A headache diary records what happened on headache days and, when useful, on headache-free days. The format can be paper or digital. What matters is that you can keep using it and bring a clear summary to an appointment.
Quick answer
A useful diary records headache days, duration, intensity, symptoms, medication use and impact on daily life. Daily entries can be more reliable than recalling an entire month later. In one migraine study, four-week recall underestimated headache days by 1.7 to 3.4 days compared with a daily electronic diary.
An app can total entries and prepare a report automatically. Paper needs no account, battery or software. Neither format diagnoses a headache disorder or proves that a suspected trigger caused an attack.
If you want more background, read what a headache diary is, how to prepare a report for your doctor and what to look for in a migraine tracker.
What to record
Start with a short set of fields:
- whether you had a headache that day
- start time and, if known, end time
- pain intensity on the same scale each time
- symptoms such as nausea, aura, light sensitivity or sound sensitivity
- acute medication, dose and time taken
- effect on work, school, sleep or other activities
You can also record sleep, meals, menstruation, stress or weather when you have a specific question about them. Treat these as context. A diary can show that two things occurred together, but that is not proof of cause.
Do not wait for a perfect entry. A short record made regularly is easier to compare than a detailed form you stop using after a few days.
Digital and paper diaries compared
Research does not show that every electronic diary is better than every paper diary. A review of electronic headache diaries found generally high completion, and two included randomized studies reported better completion than paper controls. The studies used different devices and methods, so those results do not guarantee that a particular app will suit you.
A digital diary may suit you if
- you usually have your phone nearby
- you want automatic dates, totals or charts
- you need a PDF or CSV report for an appointment
- reminders help you complete entries
Paper may suit you if
- writing by hand is faster or calmer for you
- you do not want health information in an app
- you need a format that works without a phone or battery
- a simple monthly grid is enough
Paper is private only if you store it safely. An app is private only if its storage, analytics, account and sharing practices match what its privacy policy says. Use this health-app privacy checklist when comparing the details.
What an app can and cannot tell you
An app can count headache days, display changes over time and group medication entries. It may also calculate associations between logged circumstances and headache days. Those associations need cautious interpretation. In a 90-day prospective diary study, many common candidate triggers had weak or noisy relationships with migraine risk.
A tracker cannot confirm a diagnosis, decide which medicine is safe, or replace a clinical assessment. New neurological symptoms, a sudden extremely painful headache, fever with headache, headache after an injury or a clearly changed pattern need medical attention rather than more tracking.
Preparing information for a clinician
Choose a date range that answers the clinical question, often the period since the previous appointment. A concise report should make headache days, migraine-like days, acute medication days, typical duration, intensity, associated symptoms and functional impact easy to find.
Daily electronic records can differ substantially from estimates given during an interview. In a prospective headache-clinic study, self-estimated monthly migraine days, other headache days and acute medication days all differed from diary-based counts. The diary supported the assessment, but the physician's interview and examination remained the diagnostic standard.
HeadYogi records headache episodes on iPhone and can export PDF and CSV reports. Its data is stored on the device or in the user's private iCloud account, without advertisements, third-party trackers or sale of user data. Check HeadYogi's features and how it works to decide whether that setup fits your needs.
A simple way to start
Pick one format and use the same core fields for two to four weeks. Review missing days before interpreting any totals. Then bring the summary to your clinician and ask which details would be most useful to keep recording.
Sources
- Comparing prospective headache diary and retrospective four-week headache questionnaire over 20 weeks: Secondary data analysis from a randomized controlled trial (2020; PMCID: PMC9060397)
- E-diary use in clinical headache practice: a prospective observational study (2021; PMCID: PMC8504420)
- A qualitative review of electronic headache diaries (2013; PMCID: PMC3673932)
- Development and validation of a migraine prediction model based on daily trigger exposures (2020; PMCID: PMC9645460)
The useful choice is the diary you can complete honestly and review with the person treating your headaches.