MIGRAINE & ALPIMS
Migraine: looking at the wider picture
Migraine is a neurological condition that can involve headache, nausea, dizziness, sensory sensitivity, fatigue and brain fog. Some people also experience aura.
About 1 in 7 people worldwide live with migraine. [1]
In ALPIMS, migraine fits mainly within Pain & Bodily Sensitivity. Its symptoms and associated conditions can also connect with the other domains.
ALPIMS is a framework for exploring overlaps, not a diagnosis. These connections can help you identify support needs and questions for your clinician. They do not mean every symptom has the same cause.
The figures below describe different groups. They cannot be added together or used to predict an individual’s diagnoses. An association does not prove that one condition causes another.
Explore the six ALPIMS domains
Open any coloured panel to see the connection, evidence and resources.
Anxiety & Autonomic
Migraine can coexist with anxiety and autonomic conditions such as postural orthostatic tachycardia syndrome (POTS). Dizziness, nausea and reduced capacity may overlap, while the underlying causes and treatments can differ.
How common? A meta-analysis estimated migraine in 36.8% of people with POTS. The confidence interval was very wide (2.9–70.7%), so this is an uncertain estimate. [2]
What may help?
Discuss symptoms related to standing, heat or faintness with your clinician. A migraine plan and an individual autonomic care plan may both be needed.
Laxity & Connective Tissue
Migraine is frequently reported in hypermobile Ehlers–Danlos syndrome (hEDS) and hypermobility spectrum disorders (HSD). Other headache causes also need consideration.
How common? One specialist-clinic study reported migraine in 42.5% of patients with hEDS/HSD, including 13.8% with chronic migraine. Clinic figures may not represent everyone with hypermobility. [3]
What may help?
Tell your clinician about hypermobility and whether your headache changes markedly when upright or lying down. Support should reflect your joint comfort and capacity.
Pain & Bodily Sensitivity
Migraine can coexist with fibromyalgia and other persistent pain conditions. The combined effects of pain, fatigue and sensitivity can make daily activities harder.
How common? In one survey of people with fibromyalgia, 55.8% of respondents screened positive for migraine. A positive screening result is not the same as a confirmed diagnosis. [4]
What may help?
Bring the wider pain picture to your clinician. Plan rest and daily tasks around your capacity, alongside migraine treatment.
Immune & Inflammatory
Migraine has reported associations with asthma, allergic rhinitis and eczema. MCAS is also discussed in migraine research, but the extent of its overlap is less securely quantified.
What does research show? A large cohort found approximately 28–45% higher rates of developing migraine in people with these allergic conditions compared with controls. This is a relative increase, not the percentage who have migraine. [5]
What may help?
Seek assessment for allergy symptoms alongside migraine care. Smell sensitivity alone does not establish allergy or MCAS. [6]
Mood & Mental Health
Depression and anxiety commonly coexist with migraine. Relationships may work in both directions, and living with disabling migraine can add emotional strain.
How common? There is no single reliable percentage for all people with migraine. Estimates vary by population, migraine frequency and diagnostic method. [7]
What may help?
Support emotional wellbeing alongside migraine care. Having anxiety or depression does not mean migraine symptoms are imagined or purely psychological.
Sensory & Neurodevelopmental
Light, sound and smell sensitivity can occur as part of migraine. ADHD and visual snow syndrome have documented associations; evidence concerning autism is still developing.
What does research show? A meta-analysis found 2.22 times the odds of migraine in children with ADHD. This is an odds ratio, not a prevalence percentage. [8]
Visual snow can coexist with migraine but is a distinct condition. Reliable migraine prevalence figures for autism, misophonia and hyperacusis remain limited. [9] [10]
What may help?
Adapt lighting, sound, screens and routines to your needs. Discuss persistent visual or sound symptoms rather than assuming they are all migraine.
Start with one useful support
You do not need to investigate every domain. Start with what is affecting daily life most, and discuss persistent or changing symptoms with your clinician.
Regular meals, a consistent sleep routine and a manageable sensory environment may support migraine care. Choose adjustments that fit your health and capacity. Healthdirect explains treatment and prevention ↗
Rest Reduce Load Pacing & CapacityResources & references
Practical information: External links open in a new tab.
- Healthdirect Australia: symptoms, treatment and when to seek care ↗
- Migraine Australia: information and support ↗
- NHS: migraine information ↗
- Stovner et al. (2022). Global prevalence of headache: estimated migraine prevalence 14%. ↗
- Ray et al. (2022). Headache disorders in POTS: systematic review and meta-analysis. ↗
- Headache disorders in Ehlers–Danlos syndromes and HSD (2024): review reporting clinic prevalence findings. ↗
- Frequency of Migraine Headaches in Patients With Fibromyalgia (2015). ↗
- Atopic Disorders and Their Risks of Migraine (2023): nationwide cohort study. ↗
- Blitshteyn (2023). Dysautonomia, HSD and MCAS as migraine comorbidities. ↗
- Migraine and psychiatric comorbidities (2025): narrative review. ↗
- Headache in ADHD as comorbidity and medication side effect: systematic review and meta-analysis. ↗
- Puledda et al. (2020). Visual snow syndrome: description of 1,100 cases. ↗
- Autism and Migraine: An Unexplored Association? (2020). ↗
General information only. This page does not diagnose conditions or replace personalised medical advice. A sudden severe headache or new weakness, confusion or speech difficulty needs urgent medical assessment. In Australia, call 000 for an emergency.