Wanting the dark is a diagnostic feature, not a preference.

WHAT COMES WITH IT · LIGHT AND SOUND

Sensitivity to light and sound during a headache is one of the criteria that define migraine, especially alongside nausea. When it lasts between attacks, it usually means frequent attacks or an overuse layer.

Wanting a dark, quiet room is not a preference during an attack. It is a diagnostic feature. When it lingers between attacks, it means something else again.

During an attack

Photophobia and phonophobia (light and sound sensitivity) are core diagnostic features of migraine. The criteria require either both of them, or nausea. They are not squeamishness. The point where ordinary light and sound start to hurt truly drops. That is why a normally lit kitchen becomes unbearable.

The mechanism runs through links between the retina and trigeminal pain pathways. That is why light can make head pain measurably worse, not just unpleasant.

When it does not switch off

Light sensitivity that lingers on clear days marks a nervous system that is not getting back to baseline. That is typical of high-frequency and chronic migraine. It is common in medication overuse. It is a reason to look at the two counts, not a reason for more sunglasses.

Which leads to the trap: wearing sunglasses indoors all the time. Keeping the eyes used to the dark lowers the threshold further. So the eyes get more sensitive and the glasses feel more needed. It is a loop that feeds itself. The way out is a step-by-step return to normal indoor light, not more protection.

The practical part

During attacks, dark and quiet are real treatment. Do not apologize for them. Between attacks, the aim is normal light. That also protects the sleep timing that sets next-day sensitivity. Two whole-body drivers keep interictal sensitivity high: sleep debt and the inflammatory terrain. The third is a setting nobody chooses. Think open-plan lighting, a warehouse, a screen-lit night shift.

Frequently asked questions

Is light sensitivity always migraine?

It is a core migraine feature, but not only found in migraine. With fever and a stiff neck it is an emergency. With a red painful eye it is an eye problem.

Should I wear sunglasses indoors?

During an attack, whatever helps. All the time between attacks, no. It lowers the threshold further and makes the problem worse.

Why am I sensitive even without a headache?

That points to frequent attacks or medication overuse, not to your eyes. So start with the counts.

Do tinted lenses help?

Some people report benefit from specific tints. But the evidence is limited. And tints do not address frequency, which is the number that matters.

Read on

• Migraine
• Nausea
• Chronic migraine
• Medication overuse
• Emergencies