How to Track Migraines in Apple Health (and Its Limits)

Apple Health will record a headache, and most people who own an iPhone have no idea it is in there. It takes four taps, costs nothing, and syncs across your own devices without an extra account.

It is also missing three of the fields a headache appointment runs on, and it is worth knowing which before you spend two years building a record in it.

The tap path

Open Health, then Browse at the bottom right. Choose Symptoms, then Headache. Tap Add Data.

You get a severity — Not Present, Mild, Moderate or Severe — and a date and time that defaults to now but can be edited, including an end time once the attack has finished. That is the record.

Two things make it less annoying day to day. Tap the star on the Headache screen to add it to Favourites, which puts it on the Summary tab rather than four levels down. And the Shortcuts app can log a headache directly, which is worth setting up if you want it on the Home Screen or triggered by voice — during an attack, the difference between four taps and one is not trivial.

What it actually stores

A severity band, a start, and an end. Nothing else. That isn’t a gap in the interface hiding something richer underneath — Apple’s own HealthKit documentation for the headache type describes it as a category sample carrying a severity value and a time range, which is the whole of what any app reading or writing that record can see.

That is a genuinely useful skeleton. Twelve months of it gives you dates, and dates give you a count, which is more than most people have when they walk into an appointment. If your alternative is nothing, this is not a bad place to start.

It is also worth being clear about what the severity band is doing. Four levels is a coarser scale than the zero-to-ten most diaries use, which cuts both ways: coarse scales drift less over time, and the common failure where a 7 in January quietly becomes a 5 by June is harder to fall into when there are only three levels above absent. What you lose is the ability to see a preventive move you from consistent eights to consistent fives, because both are “Severe” and then “Moderate” with nothing in between.

The three fields it has no place for

What you took, and at what time. There is no way to attach a medication to an attack. Health can record medications you have set up as a schedule, but the link between this attack and the tablet you took forty minutes into it does not exist, and that gap is the single most decision-relevant fact in a migraine diary. It is what separates a drug that failed from a drug taken too late, which is the distinction judging whether a migraine medication is working is built around.

What it stopped you doing. No notes field on the symptom entry. “Left work at two” and “worked through it badly” both record as Moderate, and the functional impact is what treatment intensity actually gets matched to.

A monthly day count. Health shows you entries, and leaves the counting to you. Nothing in it will tell you that last month held nine migraine days and eleven headache days, or that you took something on fourteen days — and those are the numbers that get asked for. Worse, the counting is not straightforward: an attack spanning Tuesday night into Wednesday afternoon is two migraine days rather than one entry, for reasons how many migraines a month counts as chronic works through with a full month counted both ways.

There is a fourth absence worth naming for anyone who suspects weather: no barometric-pressure reading is attached to the entry. That is the one variable memory cannot supply, and looking it up later is only ever as good as the time and place you can pin the attack to — so a record without it is a poor test of the question.

Making it work anyway

If you would rather stay inside Health than add anything, two habits close most of the gap.

Log the clear days too. There is no “no headache today” symptom, so use a repeating reminder and a note somewhere else — even a calendar with a letter on it. Without the clear days you have a list rather than a rate, and every threshold in headache medicine is a rate.

Keep the medication and impact on paper. A single index card by the bed with date, what you took, the time, and one line on what the attack cost you covers all three missing fields in about fifteen seconds. Health holds the dates, the card holds the rest, and you bring both to the appointment. The free printable diary is the tidier version of that card, laid out so the columns add up into the four figures at the end of the month.

That combination is genuinely fine. It is not elegant, and it is free.

When to use something else

Two situations make a dedicated tool worth it rather than a preference.

The first is an appointment where treatment is being decided, because you need four numbers on one page and Health will not produce them. Counting three months of entries by hand the night before is possible and reliably gets abandoned at eleven o’clock.

The second is weather. If falling pressure is your main suspect, it has to be stamped at the moment of logging or the column is worthless.

For the record, Migraine Journal does not read from or write to Apple Health at all. It keeps its own store, syncing through your private iCloud, so nothing you log there appears in Health and nothing in Health appears there. That is a real cost if you have been building a Health record already and want one timeline, and it is the honest reason someone might reasonably stay where they are. The same cost applies to any move between migraine apps, and it is usually larger than whatever feature you are moving for.

Whatever holds the record, it is a record rather than a diagnosis, and what it appears to show belongs in a conversation with your GP or neurologist rather than a decision you make from a chart. The rest of the tracking guides start from the same six fields regardless of what they are written in.