Abstract
Objective: To determine the frequency of triggering factors in migraine patients and identify the most frequent triggering factors.
Methodology: This cross-sectional study was conducted at the Department of Neurology, Rabia Moon Memorial Institute of Neurosciences, Karachi, Pakistan, from April to September 2024. It included 255 patients with migraine. Data on demographics and common migraine triggers were recorded. Participants completed the PHQ-9 (Patient Health Questionnaire-9) to assess depression severity and the DSM-5 Level 2 sleep disturbance questionnaire to evaluate sleep problems. Data were analyzed using descriptive statistics and Chi-square tests to determine the associations between migraine triggers and the severity of sleep disturbance, with significance set at p≤0.05.
Results: Among 255 participants (mean age 31±9.3 years; 79.2% female), the most frequent migraine triggers were sleep disturbance (40%), sunlight exposure (32.1%), and emotional stress (25.9%). The mean PHQ-9 score was 6.5±4.0, with most participants experiencing minimal to mild depressive symptoms. Chi-square analysis revealed significant associations between sleep disturbance, sunlight exposure, and emotional stress with higher sleep disturbance severity (p<0.05).
Conclusion: In our study population, migraine was most strongly associated with physiological triggers (sleep disturbance, emotional stress) and environmental triggers (sunlight exposure), while minimal to mild depression was common. These findings emphasize the importance of assessing and managing sleep quality and psychosocial factors in migraine care.

Key words: Migraine, triggering factors, sleep disturbance, DSM-5.