Why headaches worsen in Ramadan—and practical steps that help. Long Description (500–1000 characters): Migraine and headaches often worsen during Ramadan, especially in the first days. Research links this to caffeine withdrawal, dehydration, sleep disruption, and changes in meal timing. This blog explains the difference between migraine and “fasting headache” using ICHD-3 criteria and summarizes the strongest Ramadan-specific findings: early-Ramadan spikes, common day-1 withdrawal headaches, and post-iftar headaches often associated with fried foods and coffee. You’ll learn practical, Ramadan-friendly prevention steps—gradual caffeine tapering, strategic hydration between iftar and suhoor, sleep protection, and gentler iftar routines—plus guidance on when online care is appropriate and when urgent evaluation is needed. Book a consultation to create a personalized Ramadan migraine plan.

Medical disclaimer: This blog is for educational purposes only. It is not a substitute for medical advice, diagnosis, or treatment, and it is not for emergency care. If you have a sudden “worst headache,” new weakness/numbness, trouble speaking/seeing, fainting, confusion, fever with stiff neck, or a new severe headache in pregnancy, seek urgent care immediately.

Author: Dr. Diellza Rabushaj

1. Why Ramadan Can Trigger Headache or Migraine

Fasting in Ramadan is spiritually meaningful—and physically different from your usual routine. You’re not only changing what you consume, but also when you sleep, hydrate, and take caffeine. Ramadan studies repeatedly show that headaches and migraine can increase during this transition, especially early in the month. [1–3]

1.1 Migraine vs “fasting headache”

Not all headaches during Ramadan are the same. The International Classification of Headache Disorders (ICHD-3) distinguishes:

• Headache attributed to fasting (a secondary headache linked to fasting), and
• Migraine where fasting acts as a trigger (still classified as migraine, not “fasting headache”). [11]

This matters because the “best fix” depends on whether you’re dealing with migraine, caffeine withdrawal, or a fasting-attributed headache pattern. [11,12]

1.2 The pattern many people notice: early-week spike

A common experience is: the first days are the hardest, then things improve. A prospective Ramadan migraine study found the frequency often increases mainly in the first 10 days, with many people reporting attacks right at the start of Ramadan. [3] This “early-Ramadan effect” shows up across multiple papers and fits the idea of the body adapting to a new rhythm. [3–5]

2. What Ramadan Studies Actually Show

2.1 Migraine often worsens during Ramadan

Ramadan-specific migraine studies consistently report more migraine days (and often more medication-use days) during Ramadan compared with the month before or after. [1–3] In one diary cross-over design, migraine days increased during Ramadan compared with the following month, and the authors highlighted dehydration and caffeine withdrawal as key contributors. [1]

2.2 The first days matter most

Older and newer work suggests day-1 and the first few days are a “high-risk window.” A classic study described a strong day-1 headache effect and linked it most strongly to caffeine withdrawal. [4] A large later study among caffeine users also found a high prevalence of caffeine-withdrawal headache on the first day of Ramadan, with higher baseline caffeine intake associated with greater risk. [5]

2.3 Post-iftar headaches are a real subtype

Not everyone gets headaches during fasting hours. Some get headaches after breaking the fast. A large Saudi study reported post-iftar headaches in a substantial proportion of respondents (about 19.6%), and commonly reported triggers included fried foods and coffee. [6]

3. The Main Causes Identified in Ramadan Research

Think of migraine and headache like a smoke alarm: it’s not always “one cause,” but a stack of small triggers that lowers your threshold. Ramadan can stack several at once: caffeine changes + dehydration + sleep disruption + large meals. Multiple Ramadan studies point to these as repeat contributors. [1–3,6]

3.1 Caffeine withdrawal

If you regularly drink coffee/tea/energy drinks, stopping suddenly can trigger headache quickly. The classic “first-of-Ramadan” headache paper highlighted caffeine withdrawal as the strongest exogenous factor. [4] The large 2023 Ramadan study similarly found a strong relationship between baseline caffeine patterns and day-1 withdrawal headache. [5]
ICHD-3 provides diagnostic criteria for caffeine-withdrawal headache, supporting the timing-based link between stopping caffeine and developing headache. [12]

Why it feels intense: withdrawal often hits right when you’re also dehydrated and sleep-shifted—so the trigger stack is bigger. [2,4,5]

3.2 Dehydration

Across Ramadan migraine cohorts, dehydration is repeatedly emphasized as a contributor to worsening migraine or headache. [1,2] In the Kuwait study, dehydration (along with sleep/meal changes) was a major predictor of migraine worsening during Ramadan. [2]

3.3 Sleep disruption and schedule shifts

Sleep change is one of the most consistent predictors of Ramadan migraine worsening. [2] Late nights, early suhoor, changed meal timing, and fragmented sleep can all lower the migraine threshold—especially in the first week. [2,3]

3.4 Food and drink triggers after iftar

The post-iftar headache study reported associations with certain common patterns—especially fried foods and coffee after breaking the fast. [6] For some people, a large iftar can act like a “sudden switch” that triggers headache (big meal + caffeine + rapid routine change). [6]

3.5 Is “low sugar” always the reason?

Many people blame “low blood sugar,” but fasting headache literature suggests mechanisms are mixed: caffeine withdrawal and metabolic factors can both play roles, and true hypoglycemia is not necessarily the main driver for everyone. [7] That’s one reason why caffeine tapering + hydration + sleep protection can help even when you’re eating enough at suhoor/iftar. [2,4,7]

4. What Helps Most

The goal isn’t “perfect fasting”—it’s reducing the trigger stack so your brain stays below its headache threshold. The strongest Ramadan-specific evidence supports focusing on caffeine, hydration, sleep, and meal timing. [1–6]

4.1 2–3 weeks before Ramadan

Taper caffeine gradually (don’t stop overnight). This is repeatedly supported by the day-1 headache evidence and caffeine-withdrawal criteria. [4,5,12]
Practical taper ideas (non-medical):

• Reduce cups slowly (e.g., down by ½–1 cup every few days)
• Switch one serving to lower caffeine (tea) before stopping
• Keep the morning routine consistent while tapering

Start “Ramadan sleep practice” early. Because sleep change predicts worsening, even small improvements before Ramadan can reduce early-week spikes. [2,3]

4.2 Suhoor strategies

Skipping suhoor can make fasting harder and may increase the stress load for headache-prone people (especially when combined with poor sleep). [2,3]
A migraine-friendlier suhoor pattern often means:

• Balanced plate (protein + fiber + slower carbs)
• Steady fluids (not all at once)
• Avoiding known personal triggers (for some: very salty foods; for others: certain sweets)

(These are practical strategies aligned with the main predictors identified in Ramadan cohorts—sleep/meal timing and dehydration—rather than claiming one “magic food.”) [2]

4.3 During the fasting hours

If headaches usually appear late afternoon, it may be the moment when dehydration + sleep debt + withdrawal peaks together. [2,4,5] Helpful approaches supported by the identified predictors include:

• Minimize heat exposure where possible (dehydration risk) [2]
• Reduce trigger stacking (hard exercise + little sleep + caffeine cut) [2,4,5]
• Keep your schedule as consistent as you can (sleep timing stability) [2,3]

4.4 Iftar and post-iftar strategies

If you’re prone to post-iftar headaches, the Saudi data suggests watching for fried foods and coffee timing. [6] Many people do better with:

• A gentle break of the fast (water + small portion)
• A pause, then a fuller meal later
• Delaying coffee or reducing the amount if it’s a known trigger [6]

4.5 Sleep protection (including taraweeh nights)

Because sleep disruption predicts worse Ramadan migraine outcomes, protect total sleep time wherever you can. [2] If nights are late due to taraweeh or family gatherings, consider:

• A consistent wind-down routine
• A planned nap if it improves total sleep time
• Avoiding “sleep compression” every night for the first week (when attacks often spike). [2,3]

5. Medication Planning Without Guesswork

5.1 Why planning before Ramadan matters

In the Kuwait study, not adjusting the treatment plan beforehand was associated with poorer fasting tolerance and breaking the fast. [2] Planning can include:

• Identifying your biggest trigger (caffeine withdrawal vs dehydration vs sleep)
• Discussing safe timing of prescribed medications around iftar/suhoor
• Creating a “first-week plan,” since early-Ramadan is often hardest. [2,3]

5.2 Preventive paracetamol: what the trial suggests

A randomized open-label trial evaluating paracetamol to prevent fasting headache in the first week of Ramadan reported mixed results, meaning it is not a universal fix. [10] It’s best treated as a discussion point with a clinician, not a self-protocol—especially if you have liver disease or take other medications. [10]

6. When Online Advice Is Appropriate vs When In-Person Care Is Safer

6.1 Online-appropriate

Online consultation is often appropriate when:

• You have a known migraine history and Ramadan predictably worsens it [1–3]
• You want a plan for caffeine tapering, hydration timing, sleep protection, and medication scheduling [2,4–6]
• You get post-iftar headaches and want help identifying triggers and routines [6]

6.2 Red flags

Seek urgent care if you have:

• Sudden severe “worst headache”
• New weakness/numbness, trouble speaking, facial droop
• Fainting, confusion, seizure
• Fever with stiff neck
• New severe headache in pregnancy
  These require urgent assessment rather than routine online management.

7. How Doctors365.org Works

7.1 Steps: browse → pick time → confirm & pay → secure visit → summary

• Browse doctors by specialty (migraine often starts with neurology)
• Pick a time that suits your Ramadan schedule
• Confirm & pay
• Attend a secure online visit
• Receive a clear medical summary and next steps (and prescriptions when appropriate under local rules)

CTA: Browse neurology appointments here: /doctors/neurology/all/

8. Benefits of Using Doctors365 for Ramadan Migraine

8.1 Convenience, privacy, and less strain while fasting

When you’re fasting, traveling to clinics can feel harder—especially during the first week when migraine often spikes. [3–5] Online visits can help you:

• Get advice from home
• Adjust plans quickly (hydration, caffeine taper, sleep schedule)
• Avoid extra physical strain during fasting hours [2,3]

8.2 Faster plan adjustments in the “early-Ramadan spike”

Because early Ramadan is a high-risk period for headache/migraine in multiple studies, quick access to advice can make a meaningful difference in comfort and consistency. [3–5]

9. Quality & Trust

9.1 What to look for in online migraine care

For migraine/headache care—especially around fasting—choose services that provide:

• Clear clinician credentials
• A written plan (prevention + what to do if an attack happens)
• Follow-up guidance when symptoms change

9.2 Privacy and security basics

For any medical platform, prioritize privacy: use secure logins, avoid sharing sensitive details in public spaces, and keep your visit summaries stored safely.

10. Doctors365 Specialists to Consider

Because Ramadan migraine often involves multiple triggers, a few specialties can be especially helpful:

10.1 Neurology

For diagnosis confirmation (migraine vs other headache), treatment planning, and prevention strategy aligned with Ramadan patterns. [1–3,11]
Browse: /doctors/neurology/all/

10.2 Internal medicine

Helpful if dehydration risk, other medical conditions, or medication timing concerns are part of your situation. [2]
Browse: /doctors/internal-medicine/all/

10.3 Nutrition support

Useful for suhoor/iftar strategies and post-iftar trigger patterns reported in Ramadan headache research. [6]
Browse: /doctors/nutrition/all/

If you provide your Doctors365 doctor list, I can add 3–5 named specialists exactly as listed on your site (no guessing).

11. Pricing & Availability

11.1 What usually affects cost

Pricing commonly varies by:

• Specialty (e.g., neurology vs general medicine)
• Appointment length
• Doctor availability/time slots

11.2 Best times to book in Ramadan

Many people prefer appointments:

• After iftar (hydrated and fed)
• Before suhoor (if mornings are calmer)
• Before Ramadan begins to reduce early-week spikes supported in the data [3–5]

12. Practical Checklist Before Your Online Consultation

12.1 What to track for 7 days

Tracking helps your clinician match your pattern to what Ramadan studies show:

• Headache days and timing (during fast vs post-iftar) [3,6]
• Sleep duration and bedtime/wake time [2,3]
• Caffeine intake and taper attempts [4,5,12]
• Hydration between iftar and suhoor [2]
• Iftar triggers (fried foods, coffee timing) [6]

12.2 What to prepare

• Your current medicines and supplements
• Any chronic conditions (especially diabetes, kidney/liver conditions)
• What helped or worsened headaches in previous Ramadans [1–3]

13. FAQs

13.1 Why is my headache worst on the first day of Ramadan?

The strongest Ramadan-specific evidence points to caffeine withdrawal as a major driver of day-1 headache, especially in regular caffeine users. [4,5,12]

13.2 Why do my migraines calm down later in the month?

A prospective Ramadan study found attacks often spike early (first days) and then improve later, consistent with adaptation to new sleep/meal timing. [3]

13.3 I get headaches after iftar—what should I watch for?

Post-iftar headaches have been associated with fried foods and coffee in a large study. Smaller, gentler iftar patterns may help some people. [6]

13.4 Is it always “low sugar” causing my fasting headache?

Not always. Fasting headache literature suggests multiple mechanisms, including caffeine withdrawal and other metabolic factors, and hypoglycemia is not the only explanation. [7]

13.5 What’s the single best prevention step before Ramadan?

If you use caffeine regularly, gradual caffeine tapering before Ramadan has some of the clearest support from Ramadan-specific research and ICHD-3 withdrawal criteria. [4,5,12]

14. References (Vancouver)

1. Abu-Salameh I, Plakht Y, Ifergane G. Migraine exacerbation during Ramadan fasting. J Headache Pain. 2010;11(6):513-7. doi:10.1007/s10194-010-0242-z.
2. Al-Hashel JY, Abokalawa F, Toma R, Algubari A, Ahmed SF. Worsening of migraine headache with fasting Ramadan. Clin Neurol Neurosurg. 2021;209:106899. doi:10.1016/j.clineuro.2021.106899.
3. Ragab AH, Kishk NA, Hassan A, Yacoub O, El Ghoneimy L, Elmazny A, et al. Changes in migraine characteristics over 30 days of Ramadan fasting: A prospective study. Headache. 2021;61(10):1493-8. doi:10.1111/head.14231.
4. Awada A, Al Jumah M. The first-of-Ramadan headache. Headache. 1999;39(7):490-3. doi:10.1046/j.1526-4610.1999.3907490.x.
5. Magdy R, El Desouky ED, Hammad EMH, Salem MR, Mahfouz NA, Fathy W, et al. Prevalence, characteristics, and factors associated with caffeine-withdrawal headache during the first day of Ramadan. Headache. 2023;63(3):360-7. doi:10.1111/head.14483.
6. AlAmri A, AlMuaigel M, AlSheikh M, Zeeshan M, Suwayyid W, AlShamrani F. Postprandial fasting related headache during Ramadan in Saudi Arabia: A cross-sectional study. Cephalalgia. 2021;41(11-12):1201-7. doi:10.1177/03331024211017915.
7. Torelli P, Evangelista A, Bini A, Castellini P, Lambru G, Manzoni GC. Fasting headache: a review of the literature and new hypotheses. Headache. 2009;49(5):744-52. doi:10.1111/j.1526-4610.2009.01390.x.
8. Ebbert PT, Natbony LR. Fasting and headache. Curr Pain Headache Rep. 2025;29(1):67. doi:10.1007/s11916-024-01326-3.
9. Alwhaibi A, Alasmari F, Almutairi F, Assiri MA, Aldawsari FS, Aloyayd ST, et al. Effect of fasting-induced headache on calcitonin gene related peptide (CGRP) and other clinical biomarkers on the first day of Ramadan: sub-analysis from a randomized open label clinical trial. J Headache Pain. 2024;25(1):181. doi:10.1186/s10194-024-01886-0.
10. Almohammed OA, Alsanea S, Albishi N, AlMuhareb L, AlMotawa R, Alrasheed S, et al. Evaluating the use of paracetamol to prevent fasting headache during the first week of Ramadan: a randomized, open-label, clinical trial. Headache. 2024;64(10):1285-97. doi:10.1111/head.14828.
11. International Headache Society. The International Classification of Headache Disorders, 3rd edition (ICHD-3): 10.5 Headache attributed to fasting [Internet]. Accessed 2026 Feb 20.
12. International Headache Society. The International Classification of Headache Disorders, 3rd edition (ICHD-3): 8.3.1 Caffeine-withdrawal headache [Internet]. Accessed 2026 Feb 20.

Written by Diellza Rabushaj, Medical Writer & Researcher.