From the Guidelines
Individuals with a history of migraine headaches should approach scuba diving with caution and consult with both a neurologist and a diving medicine specialist before participating. The British Thoracic Society guidelines on respiratory aspects of fitness for diving 1 provide a foundation for understanding the physiological stresses of diving, which can include increased work of breathing, cold stress, and changes in gas pressures. These factors can potentially trigger migraine attacks in susceptible individuals. Migraines can pose significant risks during diving, as pressure changes, stress, and other diving conditions may trigger attacks underwater, which could lead to dangerous situations including disorientation, vomiting (particularly hazardous with a regulator), and impaired judgment.
Key considerations for individuals with migraines who wish to dive include:
- Avoiding known migraine triggers before diving
- Ensuring they are well-hydrated and well-rested
- Not having had a recent migraine
- Carrying appropriate rescue medications if approved by their physician
- Considering preventive medications under medical supervision for frequent migraines
The physiological basis for concern includes the potential for barotrauma, altered gas exchange, and vasoconstriction or vasodilation effects that could worsen during pressure changes experienced while diving. Given the potential risks, a thorough medical evaluation and clearance by specialists are essential to minimize risks and ensure safety for both the individual with migraines and their diving companions.
From the Research
Risks Associated with Migraine Headaches and Scuba Diving
- Individuals with a history of migraine headaches may face increased risks when participating in scuba diving, including the potential for decompression sickness and arterial gas embolism 2, 3.
- Migraine with aura (MWA) may be a particular concern, as it can increase the risk of neurological complications during diving 2.
- Headache in divers can be caused by a variety of factors, including hyperbaric exposure, carbon dioxide accumulation, and cold stimulus 3, 4.
Considerations for Divers with Migraine Headaches
- Divers with a history of migraine headaches should be aware of the potential risks and take steps to mitigate them, such as avoiding dives that may trigger migraine attacks 4.
- A careful medical history and neurological examination are essential to assess the risks and determine whether diving is safe for individuals with migraine headaches 3.
- In some cases, migraine headaches may be triggered by the physical exertion or stress associated with scuba diving, highlighting the need for divers to be aware of their physical limitations and take regular breaks 5.
Medical Guidance and Recommendations
- Medical professionals should provide guidance and recommendations for individuals with migraine headaches who wish to participate in scuba diving, taking into account the individual's medical history and the potential risks associated with diving 6.
- While there is no absolute contraindication for diving with migraine headaches, individuals should be aware of the potential risks and take steps to minimize them, such as diving to shallow depths and avoiding triggers 6, 4.