What lifestyle modifications can I suggest to patients to help manage vestibular migraine symptoms?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 17 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

To help patients manage vestibular migraine symptoms through lifestyle modifications, suggest the following:

  • Identify and avoid migraine triggers: Common triggers include stress, lack of sleep, certain foods, dehydration, and hormonal changes. Encouraging patients to keep a headache and vertigo diary can help identify personal triggers to avoid .
  • Maintain regular sleep patterns: Consistent sleep hygiene can reduce migraine frequency and severity .
  • Manage stress: Stress reduction techniques such as relaxation exercises, mindfulness, or cognitive behavioural therapy may help reduce vestibular migraine episodes .
  • Encourage regular physical activity: Moderate exercise can improve overall well-being and may reduce migraine frequency, but patients should avoid sudden head movements that might provoke vertigo .
  • Limit alcohol and caffeine intake: Both substances can trigger migraines and vertigo symptoms and should be consumed cautiously .
  • Hydration and diet: Advise maintaining adequate hydration and a balanced diet, avoiding known dietary triggers such as aged cheeses, processed meats, and artificial sweeteners .
  • Safety advice: Patients should be cautioned about activities that may pose risks during vertigo episodes, such as driving or operating machinery, and advised to inform the DVLA if they experience disabling dizziness .

While direct evidence for lifestyle modifications specifically in vestibular migraine is limited, these recommendations align with standard migraine management principles and expert opinion suggesting similar treatment approaches for migrainous vertigo . Recent otolaryngology literature supports these lifestyle strategies as part of a comprehensive management plan for vestibular migraine, emphasizing trigger avoidance and stress management as key components .

Educational content only. Always verify information and use clinical judgement.