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Explore My Wider Patterns

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Migraine • Explore • Notice • Connect

Explore My Wider Patterns

Migraine does not always occur on its own. It can sit within a wider pattern involving pain, autonomic symptoms, sensory sensitivity, sleep, energy and capacity, connective tissue, immune or inflammatory symptoms, mood and neurodevelopmental differences.

This page can help you step back from migraine itself and explore what else may be happening around it.

Explore My Pattern Migraine & ALPIMS
Migraine can be part of a wider picture

What else seems to happen around your migraine?

For some people, migraine is one of several things that tend to travel together.

You may notice dizziness, fatigue, gut symptoms, widespread pain, poor sleep, sensory overload, joint problems, allergy-type symptoms, difficulty thinking or changes in your capacity.

Some of these experiences may be part of migraine itself. Some may be associated conditions. Others may be separate problems that interact with migraine or make it harder to manage.

You do not need to work out which is which before you begin. ALPIMS can help you look at the wider pattern.

Start with migraine — then look around it.

Instead of asking only “What causes my migraine?”, you can also ask “What tends to happen with it?”, “What makes the whole pattern worse?” and “What might help more than one part of the picture?”

Understand Migraine Migraine & ALPIMS
A simple starting point

What tends to happen together?

Think about your migraine days, symptom flares or periods when your capacity becomes smaller.

What changes first? Is it head pain, fatigue, dizziness, sensory tolerance, mood, sleep, digestion or something else?
What joins in? Do other symptoms tend to appear before, during or after migraine or another flare?
What makes things worse? Activity, poor sleep, illness, standing, sensory input, stress, heat, food or hormonal change?
What makes things easier? Rest, quiet, lying down, sleep, food, hydration, medication, reduced demands or sensory support?
What happens afterwards? Do you recover quickly, or do fatigue, sensory symptoms, brain fog or other difficulties remain afterwards?
What keeps repeating? A repeating cluster may be worth exploring even when you do not yet know why it happens.
Migraine across the ALPIMS domains

Which areas sound familiar?

Open any domain that seems relevant. The question is not simply whether you have these symptoms, but whether they form part of the wider pattern occurring around migraine and your health more generally.

Anxiety & Autonomic
Around your migraine or symptom flares, do you also notice dizziness, heart-rate changes, nausea, temperature problems or difficulty being upright?
Dizziness or light-headedness
Fast or pounding heart
Feeling faint when upright
Temperature regulation problems
Sweating changes
Nausea or digestive changes
Shakiness or internal trembling
Anxiety or panic-like body sensations
Poor tolerance of standing
Vasomotor / non-allergic rhinitis

Possible areas to explore can include migraine-related autonomic symptoms, POTS, dysautonomia, orthostatic intolerance, anxiety and other causes of autonomic-type symptoms.

Explore Anxiety & Autonomic — Coming Soon
Laxity & Connective Tissue
Alongside migraine, do you have hypermobility, joint instability, neck pain, TMJ or recurrent musculoskeletal problems?
Flexible or hypermobile joints
Frequent sprains or strains
Joint instability
Neck pain
TMJ / jaw problems
Musculoskeletal pain
Joint clicking or subluxation
Poor proprioception

Possible areas to explore can include joint hypermobility, HSD, Ehlers-Danlos syndromes, TMJ and other musculoskeletal or connective-tissue conditions.

Explore Laxity & Connective Tissue — Coming Soon
Pain & Bodily Sensitivity
Is migraine one part of a broader pain pattern involving widespread, nerve, jaw, neck, pelvic, bladder or other pain?
Migraine or frequent headache
Widespread pain
Muscle pain
Burning or nerve-like pain
Jaw or facial pain
Pelvic or bladder pain
Back or neck pain
Pain from normally mild input

Possible areas to explore include migraine, fibromyalgia, persistent pain, neuropathic pain, TMJ, pelvic pain, interstitial cystitis and other pain conditions.

Explore Pain & Bodily Sensitivity — Coming Soon
Immune & Inflammatory
Do allergy-type symptoms, MCAS, illness, post-viral symptoms, foods or environmental exposures seem to interact with your migraine or wider symptom pattern?
Allergy-type symptoms
Rhinitis or nasal symptoms
Asthma or airway symptoms
Skin flushing or itching
Gut symptoms
Post-viral symptoms
Food-related symptoms
Environmental sensitivity
Chemical or fragrance sensitivity
Inflammatory or autoimmune illness

Possible areas to explore can include allergy, MCAS, post-viral illness, ME/CFS, Long COVID, gastrointestinal conditions, autoimmune disease and environmental sensitivity.

Explore Immune & Inflammatory — Coming Soon
Mood & Mental Health
How do migraine, chronic symptoms, uncertainty, trauma, anxiety, mood and the demands of managing illness interact?
Anxiety
Low mood
Trauma responses
Panic
Emotional overwhelm
Burnout
Fear around symptoms
Grief or adjustment to illness

Emotional and psychological wellbeing deserves support without assuming that migraine or other physical symptoms are psychological in origin.

Explore Mood & Mental Health — Coming Soon
Sensory & Neurodevelopmental
Is sensory sensitivity mainly present around migraine, or do light, sound, smell, touch, executive-function or regulation differences continue between attacks?
Light sensitivity
Sound sensitivity
Smell sensitivity
Touch or clothing sensitivity
Misophonia
Visual disturbances
Executive function difficulties
Difficulty switching tasks
Autistic traits or autism
ADHD traits or ADHD
Sensory overload
Shutdown or overwhelm

Possible areas to explore include migraine-related sensory sensitivity, autism, ADHD, misophonia, hyperacusis, visual snow, sensory processing differences and executive function.

Explore Sensory & Neurodevelopmental — Coming Soon
Look beyond migraine

What might be travelling alongside migraine?

Migraine can overlap with several different ALPIMS patterns. These do not necessarily have one cause, and having migraine does not mean you have any of these conditions.

But recognising the wider pattern can help you decide what deserves a closer look.

ME/CFS & Post-Viral Illness Post-exertional malaise, sleep, cognition, pain, sensory symptoms and autonomic difficulties may add substantially to the migraine picture.
MCAS & Allergy-Type Patterns Skin, gut, respiratory, cardiovascular and other symptoms may occur alongside migraine and may need their own assessment.
Hypermobility Joint and connective-tissue differences may intersect with pain, musculoskeletal problems, autonomic symptoms and capacity.
Autism & ADHD Sensory processing, executive function, regulation, communication and everyday demands may affect how migraine is experienced and managed.
Hormonal Change Menstruation, perimenopause and menopause can interact with migraine, sleep, temperature, mood, pain and sensory tolerance.
Sleep Poor sleep can affect migraine, pain, mood, cognition, sensory tolerance and functional capacity.
Environmental Sensitivity Smells, chemicals, temperature, allergens or other environmental exposures may interact with migraine, airway symptoms and sensory sensitivity.
Gut & Nutrition Nausea, IBS, food tolerance, appetite, hydration and medication absorption can all affect migraine management and the wider picture.
Pain & Body Sensitivity Migraine may coexist with widespread pain, TMJ, neuropathic pain, pelvic pain or other persistent pain conditions.
Explore Migraine & ALPIMS
Put the pieces together

Which pattern sounds most like you?

These are not diagnoses. They are different ways of looking at what may be happening around migraine and your wider health picture.

Tap a box to explore. Use the × to close it again.

Everything worsens together Migraine, fatigue, sensory tolerance, cognition and other symptoms seem to flare at the same time.

Everything worsens together

When several symptoms repeatedly rise and fall together, it may be useful to look for shared triggers or factors affecting several systems at once.

Try noticing sleep, illness, activity, migraine, sensory load, hormonal change, upright activity and other changes around the flare.
Tracking Patterns — Coming Soon
Activity makes me worse later I may manage an activity but migraine or other symptoms become significantly worse afterwards.

Activity makes me worse later

A delayed and prolonged worsening after physical, cognitive, emotional or sensory exertion deserves particular attention.

The timing, severity and duration of the response matter.

If the wider pattern resembles post-exertional malaise, standard advice to simply increase activity may need careful adaptation.
Adapt What May Help
Being upright is difficult Standing, showering, heat or prolonged upright activity seems to worsen migraine or other symptoms.

Being upright is difficult

Notice whether upright activity is associated with dizziness, palpitations, weakness, nausea, headache, brain fog or feeling faint.

Migraine itself can involve dizziness and autonomic symptoms, but persistent difficulty with being upright can also have other causes worth discussing with a healthcare professional.
Orthostatic Symptoms — Coming Soon
My senses become unbearable Light, sound, smell, movement or touch become much harder to tolerate.

My senses become unbearable

Sensory sensitivity can be an important part of migraine. It is also useful to notice whether sensory differences remain when migraine is relatively quiet.

Migraine, autism, ADHD, hyperacusis, misophonia and other conditions can produce different but overlapping sensory experiences.
Understanding Sensory Patterns — Coming Soon
My environment affects me Smells, chemicals, temperature, noise or other environmental factors seem to trigger migraine or other symptoms.

My environment affects me

Environmental triggers can be relevant for several different reasons.

Smell sensitivity can occur as part of migraine, while allergens may cause allergic symptoms and irritants may affect the nose, airway or larynx.

ALPIMS can acknowledge the pattern without assuming that every environmental reaction has the same mechanism.
Environmental Sensitivity — Coming Soon
My body has a smaller budget Migraine is one of several things using more energy or capacity than I have available.

My body has a smaller budget

Migraine, pain, poor sleep, autonomic symptoms, sensory processing, illness and cognitive demands can all consume capacity.

Sometimes the useful question is not simply “What condition is causing this?” but also:

What is using my capacity, and what could reduce the load?
Adapt What May Help
My symptoms changed with hormones Migraine, sleep, pain, mood or sensory tolerance changed around menstruation, perimenopause or menopause.

My symptoms changed with hormones

Hormonal change can influence migraine and several other aspects of health at the same time.

This can make an existing multisystem pattern look different during menstruation, perimenopause or menopause.

It can be useful to consider when symptoms changed rather than looking only at what symptoms are present today.
Hormones & Wider Patterns — Coming Soon
I have many separate diagnoses Migraine is only one part of a long and complicated health history.

I have many separate diagnoses

The diagnoses may genuinely be separate. But mapping them across the ALPIMS domains can make interactions easier to see.

This may also help identify supports that benefit several parts of the picture.

The aim is not to replace established diagnoses with one grand explanation. It is to make the overall picture easier to understand and manage.
Migraine & ALPIMS
I don’t know where to start There are too many symptoms, treatments and things I am supposed to manage.

I don’t know where to start

You do not have to work through every domain or solve every condition.

Migraine may still be a useful place to start, particularly if it is a major contributor to pain, sensory load, nausea, disrupted sleep or reduced capacity.

Try asking:

What is hardest right now?
What is using the most capacity?
Is migraine a major part of that load?
What might make today a little easier?
Understand Migraine Adapt What May Help
From migraine to the wider pattern

Why does the wider pattern matter?

The aim is not to turn one migraine diagnosis into a long list of diagnoses. It is to make management fit the whole person.

Some symptoms may be migraine Migraine can involve much more than head pain, including sensory, gastrointestinal, cognitive, vestibular and autonomic symptoms.
Some conditions may coexist A person may also have another condition such as POTS, hypermobility, ME/CFS, MCAS, persistent pain, autism or ADHD.
Some problems may amplify others Poor sleep, pain, sensory overload, illness or reduced capacity may make the overall pattern harder to manage.
Some supports may help across domains A useful intervention may sometimes reduce several sources of load rather than targeting only one symptom.
Management may need adapting Advice that works for one person with migraine may need adjustment when someone also has post-exertional malaise, dysautonomia, sensory differences or other conditions.
You can still start with migraine Treating migraine appropriately can remain an important part of the plan while the wider pattern is explored.
Explore Migraine & ALPIMS Adapt What May Help
Keep the interpretation careful

Finding a pattern is a starting point — not a diagnosis

A pattern may be useful

It can help you notice repeating symptom clusters, possible triggers, areas that deserve assessment and supports that may help across several parts of life.

A pattern does not prove a cause

Two symptoms occurring together does not necessarily mean one caused the other or that they share the same biological mechanism.

Conditions can overlap

One person can have several genuine conditions at the same time. Symptoms may also interact and increase the overall burden.

Not everything is migraine

Migraine can explain many symptoms, but new or persistent symptoms should not automatically be attributed to migraine. Other medical explanations may need consideration.

Where would you like to go next?

Use the pattern to choose your next step

You might return to migraine itself, explore how migraine connects with the wider ALPIMS picture, or look at how support and management can be adapted to what else is happening.

Understand Migraine Migraine & ALPIMS Adapt What May Help

General information only. This page is designed to help organise symptoms, experiences and questions. It is not a diagnostic tool and cannot determine why symptoms are occurring. Associations and overlapping patterns do not necessarily establish causation. New, severe, rapidly changing or concerning symptoms should be assessed by an appropriate health professional.

Explore • Notice • Connect

Explore My Wider Patterns

Sometimes one symptom or diagnosis does not explain the whole picture. This page can help you step back, notice patterns across different areas of health and life, and decide what might be useful to explore next.

Start Exploring Look at Wider Patterns
Start with what you notice

You don’t need to know what is causing everything

You may simply know that several things seem to happen together.

Perhaps pain becomes worse when you are exhausted. Maybe standing makes you dizzy. Noise becomes unbearable when you have a migraine. Your gut, sleep and energy may all deteriorate at the same time.

Looking at the wider pattern can sometimes be more useful than trying to understand every symptom separately.

The aim is not to collect diagnoses.

It is to notice connections, recognise areas that may need support, and make it easier to decide what to explore with your healthcare team.

A simple starting point

What tends to happen together?

Think about difficult days, flare-ups or periods when your capacity becomes smaller.

What changes first? Pain? Fatigue? Dizziness? Sensory tolerance? Mood? Sleep? Digestion?
What joins in? Notice whether symptoms from other parts of the body tend to appear at the same time.
What makes things worse? Activity, poor sleep, illness, standing, sensory input, stress, heat, food or hormonal change?
What makes things easier? Rest, quiet, lying down, sleep, food, hydration, medication, reduced demands or sensory support?
What happens afterwards? Do you recover quickly, or do symptoms remain worse for hours or days?
What keeps repeating? A repeating cluster may be worth exploring even when you do not yet know why it happens.
The ALPIMS domains

Which areas sound familiar?

Open any domain that seems relevant. You do not need to fit neatly into one domain — many people have patterns that cross several.

Anxiety & Autonomic
Do symptoms change with standing, exertion, temperature, stress, meals or changes in your body’s state?
Dizziness or light-headedness
Fast or pounding heart
Feeling faint when upright
Temperature regulation problems
Sweating changes
Nausea or digestive changes
Shakiness or internal trembling
Anxiety or panic-like body sensations
Poor tolerance of standing
Vasomotor / non-allergic rhinitis

Possible areas to explore can include migraine-related autonomic symptoms, POTS, dysautonomia, orthostatic intolerance, anxiety and other causes of autonomic-type symptoms.

Explore Anxiety & Autonomic — Coming Soon
Laxity & Connective Tissue
Does your body seem unusually flexible, unstable, injury-prone or mechanically sensitive?
Flexible or hypermobile joints
Frequent sprains or strains
Joint instability
Neck pain
TMJ / jaw problems
Musculoskeletal pain
Joint clicking or subluxation
Poor proprioception

Possible areas to explore can include joint hypermobility, HSD, Ehlers-Danlos syndromes, TMJ and other musculoskeletal or connective-tissue conditions.

Explore Laxity & Connective Tissue — Coming Soon
Pain & Bodily Sensitivity
Is pain occurring in several places, persisting beyond an initial injury, or becoming easier to trigger?
Migraine or frequent headache
Widespread pain
Muscle pain
Burning or nerve-like pain
Jaw / facial pain
Pelvic or bladder pain
Back or neck pain
Pain from normally mild input

Possible areas to explore include migraine, fibromyalgia, persistent pain, neuropathic pain, TMJ, pelvic pain, interstitial cystitis and other pain conditions.

Explore Pain & Bodily Sensitivity — Coming Soon
Immune & Inflammatory
Do illness, allergens, foods, environmental exposures or post-viral changes seem to be part of your pattern?
Allergy-type symptoms
Rhinitis or nasal symptoms
Asthma or airway symptoms
Skin flushing or itching
Gut symptoms
Post-viral symptoms
Food-related symptoms
Environmental sensitivity
Chemical / fragrance sensitivity
Inflammatory or autoimmune illness

Possible areas to explore can include allergy, MCAS, post-viral illness, ME/CFS, Long COVID, gastrointestinal conditions, autoimmune disease and environmental sensitivity.

Explore Immune & Inflammatory — Coming Soon
Mood & Mental Health
How are chronic symptoms, uncertainty, past experiences and everyday demands affecting your emotional wellbeing?
Anxiety
Low mood
Trauma responses
Panic
Emotional overwhelm
Burnout
Fear around symptoms
Grief or adjustment to illness

Emotional and psychological wellbeing deserves support without assuming physical symptoms are psychological in origin.

Explore Mood & Mental Health — Coming Soon
Sensory & Neurodevelopmental
Does your nervous system seem to process sensory, cognitive or everyday demands differently?
Light sensitivity
Sound sensitivity
Smell sensitivity
Touch or clothing sensitivity
Misophonia
Visual disturbances
Executive function difficulties
Difficulty switching tasks
Autistic traits or autism
ADHD traits or ADHD
Sensory overload
Shutdown or overwhelm

Possible areas to explore include migraine-related sensory sensitivity, autism, ADHD, misophonia, hyperacusis, visual snow, sensory processing differences and executive function.

Explore Sensory & Neurodevelopmental — Coming Soon
Look across the domains

Some important patterns do not stay in one box

These can affect several ALPIMS domains at the same time. They may be particularly useful to notice when trying to understand a complicated health picture.

Migraine May involve pain, sensory changes, nausea, autonomic symptoms, cognition, sleep and functional capacity.
ME/CFS & Post-Viral Illness Can involve post-exertional malaise, sleep, cognition, pain, sensory symptoms and autonomic dysfunction.
MCAS & Allergy-Type Patterns Symptoms may involve skin, gut, respiratory, cardiovascular and other body systems.
Hypermobility May intersect with pain, musculoskeletal problems, autonomic symptoms and functional capacity.
Autism & ADHD May affect sensory processing, executive function, regulation, communication and the demands of everyday life.
Hormonal Change Menstruation, perimenopause and menopause can interact with migraine, sleep, temperature, mood and other symptoms.
Sleep Poor sleep can affect pain, migraine, mood, cognition, sensory tolerance and capacity.
Environmental Sensitivity Smells, chemicals or other environmental exposures may interact with migraine, airway symptoms, sensory sensitivity and other symptom patterns.
Gut & Nutrition Nausea, IBS, food tolerance, appetite, hydration and medication absorption can affect the wider picture.
Put the pieces together

Which pattern sounds most like you?

These are not diagnoses. They are different ways of looking at what may be happening. Tap a box to explore.

Everything worsens together Pain, fatigue, sensory tolerance, cognition and other symptoms seem to flare at the same time.

Everything worsens together

When several symptoms repeatedly rise and fall together, it may be useful to look for shared triggers or factors affecting several systems at once.

Try noticing sleep, illness, activity, migraine, sensory load, hormonal change, upright activity and other changes around the flare.
Tracking Patterns — Coming Soon
Activity makes me worse later I may manage the activity but become significantly worse afterwards.

Activity makes me worse later

A delayed and prolonged worsening after physical, cognitive, emotional or sensory exertion deserves particular attention.

The timing, severity and duration of the response matter.

If the pattern resembles post-exertional malaise, standard advice to simply increase activity may need careful reconsideration with an appropriate clinician.
Post-Exertional Patterns — Coming Soon
Being upright is difficult Standing, showering, heat or prolonged upright activity makes symptoms worse.

Being upright is difficult

Notice whether upright activity is associated with dizziness, palpitations, weakness, nausea, headache, brain fog or feeling faint.

This pattern can be useful to discuss with a healthcare professional because several different conditions can cause orthostatic symptoms.
Orthostatic Symptoms — Coming Soon
My senses become unbearable Light, sound, smell, movement or touch can become much harder to tolerate.

My senses become unbearable

Look at whether sensory sensitivity is constant or changes with migraine, fatigue, illness, stress, sleep or overload.

Migraine, autism, ADHD, hyperacusis, misophonia and other conditions can produce different but overlapping sensory experiences.
Understanding Sensory Patterns — Coming Soon
My environment affects me Smells, chemicals, temperature, noise or other environmental factors seem to trigger symptoms.

My environment affects me

Environmental triggers can be relevant for several different reasons.

For example, smell sensitivity can occur with migraine, while allergens may cause allergic symptoms and irritants may affect the nose, airway or larynx.

ALPIMS does not need to assume that every environmental reaction has the same mechanism in order to take the experience seriously.
Environmental Sensitivity — Coming Soon
My body has a smaller budget Ordinary life seems to require more energy or capacity than I have available.

My body has a smaller budget

Pain, migraine, poor sleep, autonomic symptoms, sensory processing, illness and cognitive demands can all consume capacity.

Sometimes the useful question is not simply “What condition is causing this?” but also:

What is using my capacity, and what could reduce the load?
Understanding Capacity — Coming Soon
My symptoms changed with hormones Migraine, sleep, pain, mood or sensory tolerance changed around menstruation, perimenopause or menopause.

My symptoms changed with hormones

Hormonal change can influence several aspects of health at once and may make an existing multisystem pattern look different over time.

It can be useful to consider when symptoms changed rather than looking only at what symptoms are present today.
Hormones & Wider Patterns — Coming Soon
I have many separate diagnoses My health history feels like a long list of unrelated conditions.

I have many separate diagnoses

The diagnoses may genuinely be separate. But mapping them across the ALPIMS domains can make interactions easier to see.

This can also help identify supports that may benefit several parts of the picture.

The aim is not to replace established diagnoses with one grand explanation. It is to make the overall picture easier to understand and manage.
Map My Conditions — Coming Soon
I don’t know where to start There are too many symptoms, treatments and things I am supposed to manage.

I don’t know where to start

You do not have to work through every domain or solve every condition.

A reasonable starting point may be the problem that is currently causing the greatest difficulty, or a change that could reduce load across several areas.

Try asking:

What is hardest right now?
What is using the most capacity?
What might make today a little easier?
What Is Hard Right Now? — Coming Soon
Keep the interpretation careful

Finding a pattern is a starting point — not a diagnosis

A pattern may be useful

It can help you notice repeating symptom clusters, possible triggers, areas that deserve assessment and supports that may help across several parts of life.

A pattern does not prove a cause

Two symptoms occurring together does not necessarily mean one caused the other or that they share the same biological mechanism.

Conditions can overlap

One person can have several genuine conditions at the same time. Symptoms may also interact and amplify the overall burden.

Common things still matter

A complicated health history should not prevent ordinary medical causes, medication effects, nutritional issues, sleep problems or new conditions from being considered.

Choose your next step

You can start wherever makes sense today

You might explore the ALPIMS domains, look more closely at a condition or experience, work out what your body may need right now, or move directly to practical support.

Explore Conditions & Experiences Explore the ALPIMS Domains Could Your Body Need Something? What May Help?

General information only. This page is designed to help organise symptoms, experiences and questions. It is not a diagnostic tool and cannot determine why symptoms are occurring. New, severe, rapidly changing or concerning symptoms should be assessed by an appropriate health professional.