Imagine this: You’re at your desk on your computer in the middle of the work day and need to go online to do some research. You click on a relevant search result and are met by a flashy site filled with ads, motion graphics, and a video that starts playing on it’s own. It catches you off guard and overloads your visual cortex, and before you know it your vision starts to distort, flare, or leave partially. You recognize the telltale aura signs and know now that you have a very limited window to find a dark room before the pain sets in. For myself and the one billion other people in the world who suffer from migraines this is a situation we know all too well.
What is a Migraine?
So now I want to spend a little time talking more about Migraines as many of you are probably thinking “Isn’t that just a bad headache?”. Prior to experiencing them first hand, I’ll admit that that was my take on them. Misconceptions surrounding migraines are everywhere, and most people have a misunderstanding about what one actually entails. With that being said, I’m not a medical professional – so here is a brief overview from the Mayo Clinic.
“A migraine is a headache that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It’s often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for hours to days, and the pain can be so severe that it interferes with your daily activities.
For some people, a warning symptom known as an aura occurs before or with the headache. An aura can include visual disturbances, such as flashes of light or blind spots, or other disturbances, such as tingling on one side of the face or in an arm or leg and difficulty speaking.”Migraine – Mayo Clinic
As you can see, a migraine is not your everyday average headache. That being said, migraines are unique to the patient and some may not experience all of these symptoms, and respond differently to different treatments. Migraines today are still not exceptionally well understood even in the medical community, but recent breakthroughs have led to the development of better drugs and treatment plans.
Identifying Potential Technological Triggers
Now that we have a better understanding of what exactly a migraine is, I’d like to spend some time talking about triggers. Just as unique as the symptoms a migraine sufferer may experience from attack to attack, so are the triggers or causes. Some may be physiological changes or mechanical damage to the body while other triggers can be external or environmental – and those are the ones I would like to address today – specifically those brought on by the technology we rely on to communicate, create, and do business with today.
- Screens – Many of you are likely reading this article on a device with a screen – be that a cell phone, tablet, laptop, or desktop monitor. (If you are reading this with a screen reader – don’t worry, We’ll talk about that too!). One common migraine trigger is bright lights, which all displays are no doubt capable of. This in combination with poor web design, over animated UX, or flashy videos and advertisements that play on their own, can stress the visual cortex and trigger a migraine.
- Eyestrain – Long spans of time spent too close to a screen, reading small text, looking at small images, etc. all can take a toll on the muscles in and around your eyes can cause a migraine – especially if your screen is very bright.
- Poor Posture – If you hunch over a desk to look down at, or lift your neck to look up at monitors that aren’t at eye level, or stare sideways at your phone in bed, you might be applying stress to certain muscles and nerves that can trigger migraines.
- Sound – Just as with bright lights, loud sounds can trigger a migraine and our Internet is full of them! Constant pings from an e-mail or collaboration tool, autoplaying videos on the web, a faulty microphone in an online meeting, or an audio feedback loop from unmuted microphones, are all possible triggers for migraine that I have had first hand experience with. For those among us who use screen readers to consume or create media this can also be a challenge, as the screen reader can interrupt or be interrupted by other sounds playing, or cause confusion if the content they are navigating isn’t properly tagged.
- Stress – The world we live in today is one riddled with conflict – and we all have our opinions, feelings, and passions. The internet provides a constant stream of information and disinformation, and oftentimes serves it up unsolicited. This can be news of the ongoing pandemic, military conflicts old and new, economic turbulence, and the political warfare we have all witnessed across the globe. Social media puts our lives under extreme scrutiny to any and everyone who is interested, and bad actors take advantage of that to make you feel small and insignificant. This constant mental assault can absolutely trigger a migraine.
Please be advised that this list is not exhaustive and a myriad of other technological triggers exist out there.
What steps can I take to mitigate these triggers?
So, we have identified a few of the most common triggers when interacting with technology – but what can we do to mitigate the impact other than abandon technology and stay in our dark, soundproofed rooms? Good news! There are quite a few ways to combat these triggers, internal and external to our devices. First, I want to take time to see what we can do on our devices that could help.
- Adjust your display settings: All of the major computer operating systems have built in features to adjust your display, and most external displays have options to do it in their menus. The first one that comes to mind is lowering screen brightness and adjusting contrast to a level that feels more comfortable for you. You can also reduce motion in the operating system, and eliminate window transparency, to keep things a bit more static on the screen. You can also change your resolution settings to minimize eye strain.
- Lower the volume: Many of us keep the volume on our devices all the way up, which makes notifications or unexpected interruptions much more jarring. Unless you know you need audio, keep your volume low to lessen the impact of notifications or pesky auto-playing content.
- Software: There are thousands of browser extensions out there that can minimize auto playing content or visually intensive web pages, thus limiting your exposure to potential triggers. This however is not a suitable alternative to having a fully accessible website however. (Looking at you developers!)
- Usage tracking: Most major operating systems now also feature screen time monitoring. You can use these features to get an idea of how much screen time is too much screen time, and set windows of time where certain apps can’t be used.
Next on our list is external ways to minimize our triggers, be it behavioral or with the use of assistive technologies. There are some now that are commonly known, but I recently had the pleasure of attending the A11yPrinceton “Migraines and Digital Accessibility” meet-up, where John Jameson, the Digital Accessibility Developer at Princeton gave a wonderful talk about migraines and shared some great some great personal experiences and resources with the group, some of which i’ll be sharing in this article, in no particular order.
- Filters: Studies have shown that filtering light can have a positive effect on reducing strain. These include blue light filters for your display, or blue light glasses for your face. Blue light glasses have become fairly common and can often be found at your average department store, have been adopted by many of the designer eyeglass brands, and many companies even offer them in prescription lenses now as well. There are also rose filtered lenses available on the market that also help with eye strain, and new research into green light filtering lenses shows promise.
- Nerve stimulation: One item I’m seeing more frequently is a forehead worn nerve stimulation device. These devices use electrical pulses to stimulate the trigeminal nerve in the forehead to reduce the occurrence and intensity of migraine attacks.
- Ergonomics: Ergonomics can play a large role in the onset of a migraine, especially for someone like me, who started suffering from migraines due to mechanical damage in the cervical spine. Using a standing desk, a well designed chair, and keeping your monitors at eye level are all great ways to combat this, but maintaining correct posture when using these tools is also an important behavioral change one should strive to make. I once had a computer teacher in high school drone on and on about posture, and I only wish I’d have listened to her then.
- Take a break: Get up and walk around the room! Not only will you be giving your eyes a rest, your body will be appreciative of the movement. That being said, we don’t always have the luxury to get up and walk away from our work but there are other alternatives. One such alternative is the 20-20-20 rule, where for every 20 minutes of screen time, you stare at an object 20 feet away for 20 seconds. Studies have shown that this can reduce the strain on your eye muscles.
Once again, this list of suggestions is not comprehensive, and I’d encourage you to reach out with any personal experiences or tools that you find useful.
Migraine is not a simple condition, and neither is treatment or mitigation. But there are ways to fight back! Be it changing your posture, or a couple of system settings, I hope you were able to take away a few ideas you could use to help to minimize the impact migraine might have on your life or a loved ones. I also want to emphasize that none of the tips here are a replacement for accessible web design, and that is up to today’s creators to take these triggers into consideration during development. You can find the link to the A11yPrinceton Migraine Meet-up with John Jameson linked here, where he spends some more time on assistive technology solutions including live demonstrations. If you have any suggestions or personal stories with migraine to share, please don’t hesitate to reach out to me at firstname.lastname@example.org. Thanks for reading!