plane travel headaches

Get a Headache on the Plane? Know This Before Boarding

4 Simple Steps to Avoid Headaches While Flying

As if plane travel itself isn't enough of a headache, researchers have detected a distinctive pain pattern at 35,000 feet. If you notice a pattern of headaches while flying, you're not alone. As a Million Mile flyer whose advocacy work requires a lot of plane travel, I find it a personal challenge. Here's what I've learned about why an airplane headache happens. Discover what you can do to prevent a headache while flying — before you book your next trip.

Are Airplane Headaches a Real Thing?

Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018;8(Suppl 7):1–96

A headache when flying, also known as "headache attributed to airplane travel," can occur during takeoff and landing as the plane changes altitude.

Flying is also a migraine trigger for many. "In many headache clinics, people with migraine often report that their attacks are exacerbated by air travel ," said Andrew Charles, MD, director of the Goldberg Migraine Program at UCLA and president-elect of the American Headache Society. "The interesting question is whether it's the change in barometric pressure or the change in oxygenation that triggers pain. It is known experimentally that low oxygen levels are a migraine trigger, but there is also a notion that even if you didn't change oxygen levels, changing barometric pressure is also potentially a migraine trigger. It may, therefore, be either one of those, or both in combination, that are responsible for causing high altitude headache and migraine."

The Difference Between an Airplane Headache and a Migraine Attack

Even though headaches while flying are not always the same as migraine attacks, it can be difficult to tell the difference at first, especially when you're in pain and stressed. But, fundamentally, the cause and the symptoms of an airplane headache are different from those of migraine.

During a migraine attack, head pain is often just one of several symptoms . Your migraine head pain is more likely to be on one side of your head, behind your eye, and is caused by a genetic neurological response in the brain to your personal triggers.

7 Migraine Myths It’s Time to Toss in the Trash

Don’t Let Migraine Steal Your Summer: 7 Tips for Keeping a Cool Head

Migraines Not Going Away? How to Break Out of a Rut

Some of those biggest migraine triggers  include stress, dehydration, dry air, strong odors, alcohol, foods with nitrites — all things we can be exposed to during the air travel experience.

Airplane headaches can also be severe, one-sided, and are usually located behind the eye. The pain intensity can be great and the pain is often stabbing. Sounds like a migraine, right?

The difference is an airplane headache will worsen when the plane ascends or descends, and they typically resolve within 30 minutes of takeoff or landing. That makes airplane headaches much shorter than a typical migraine attack, which often lasts hours or even days.

Bui SBD, Gazerani P. Headache attributed to airplane travel: diagnosis, pathophysiology, and treatment - a systematic review. J Headache Pain. 2017;18:84.

Bui SBD, Petersen T, Poulsen JN, Gazerani P. Simulated airplane headache: a proxy towards identification of underlying mechanisms. J Headache Pain . 2017;18:9.3).

Mainardi F, Lisotto C, Maggioni F, Headache Attributed to airplane travel (‘airplane headache’): Clinical profile based on a large case series.  Cephalalgia , 2012; 32:8.

That's in contrast to migraine, which affects three times as many women as men.

Airline Accommodations to Help Prevent Headaches While Flying

While there's a lot we can do to prevent an airplane headache or a migraine attack while flying, airlines have a vested interest in making the flight experience less painful. After all, how many people want to fly an airline if they associate it with painful attacks?

Among the triggers within an airline's control: optimizing light, sound, and offensive odors; offering healthy food and drink options; supporting passenger hydration; offering ice bags, earplugs, and eye masks; stabilizing cabin pressure changes; and ensuring flight attendant training. Some airlines do a better job than others with healthy food options and walking the aisles with water cups every 30 to 60 minutes.

Still, cabin lighting, jet engine sound, and food odors cannot be individually controlled, as I experienced on a recent Delta cross-country flight. With no way to dim the cabin lights or diffuse the nauseating combination of hot chicken and the lavatory, it was pure misery.

Treating an Airplane Headache or In-Flight Migraine Attack

Doctors advise that an airplane headache is best treated with either a  nonsteroidal anti-inflammatory drug  or a triptan that you've packed in your carry-on bag. Obviously, airlines don't stock them. For years, I wouldn't take off without an injectable sumatriptan syringe in my carry-on for migraine attacks, often discreetly administered in an airplane bathroom. Today, sublingual medication or nasal sprays are good options when you need relief quickly.

Ice or heat, supplemental oxygen, water, blankets, and pillows can provide additional comfort in midair and are a flight attendant call button away.

Delva I, Delva M: Successful Treatment of Airplane Headache with Rizatriptan: Case Report. Case Rep Neurol 2021;13:375-379

4 Simple Steps to Avoid Headaches When Flying

Step 1 — schedule wisely.

While it may be tempting to choose that less expensive red-eye or 6 a.m. flight, it's possible you'll pay for it later. Sleep disruption may not affect an aviation headache, but it's a commonly reported trigger for migraine and could increase your odds of a headache while flying. The money you save on the cheaper flight could cost you more in pain medication and lost wages later.

Changing time zones is especially difficult, which I do often as I fly coast to coast and cross oceans to attend medical conferences and advocate for people with migraine. Now I avoid scheduling early-morning meetings when I travel west to east and drink Sleepytime tea with a melatonin tablet on the first night of arrival. It has no effect on airplane headaches but reduces the chance that inconsistent sleep patterns will trigger a migraine attack the next day.

"Sleep routine is critically important for migraine sufferers. [Inconsistent sleep is] quite damaging ... for a person with migraine it can actually provoke more headaches" explained Toronto headache specialist Christine Lay, MD, in our " Migraine Again Podcast" interview .

If you can't avoid red-eye flights, which are common for cross-oceanic trips, wear comfortable clothes and pack a neck pillow, comfy socks, eye mask, and earplugs. Skip the in-flight movie, too. Dr. Lay advised: "Avoid light-emitting screens for a couple of hours before bedtime."

Step 2 — Stock Your Carry-On

To prepare yourself for a possible in-flight airplane headache, pack the medication your doctor recommends (such as ibuprofen or triptans) and an empty reusable screw-top ice pack that will go through security. Those will come in handy if you happen to have a migraine attack as well.

If you are prone to migraine attacks, you'll want to stock your carry-on with sunglasses, eye masks, earplugs, or noise-canceling earphones (worth every penny!), a healthy snack, and an empty water bottle you can fill before boarding and after security. Since I can get nauseated from strong odors, I also pack a lavender stick and anti-nausea medication.

Many of these items are available to purchase in the terminal if you forget them at home.

Step 3 — Know What to Eat and Avoid Preflight

The day before you fly is the time to start avoiding migraine-triggering foods and drinks like alcohol , processed foods with MSG and nitrites, and anything else you're sensitive to. Veteran cross-country flyer Kristin Chenoweth spends her time jetting between New York and Los Angeles for stage and screen work. In her 2019 Migraine World Summit live event interview, she offered a personal tip that's helped her avoid a headache while flying: "Pound the water, people!"

Managing hydration levels cannot be understated. Drinking plenty of water the day before the flight, during flight, and after you land is recommended by frequent travelers and physicians. Staying well hydrated could go a long way in preventing a headache while flying.

Moawad, Heidi. Airplane Headaches: What the Research Says. Neurology Times. 2018 February

Step 4 — Settle In and Manage Your Ride

Now you've chosen a conveniently timed flight, packed your carry-on carefully, and pounded the water before boarding. It's time to settle in with everything easily accessible at your feet.

To manage your ride, you'll want to avoid sleeping in flight unless you're changing time zones and you need to adjust. "Naps aren't advisable for people with migraine," advised Lay in her interview.

Turbulence is something you simply cannot anticipate but which can elevate migraine-triggering anxiety in addition to making you queasy. If this is a common issue for you, ask your doctor for the best anti-nausea solution for you or drink a beverage that can help ease your nausea quickly . Some anti-nausea medications can also help alleviate a migraine attack if taken early in your attack.

If you're not nauseous and feel like eating, choose one of the healthier options offered by the airline. Look for nutrient-rich foods with magnesium, omega-3s, and riboflavin that are not only good for you but also can help prevent migraine attacks.

Should you still struggle with in-flight headaches or migraine attacks after trying these four steps, see your doctor to brainstorm solutions.

Do you ever get headaches when flying? Does plane travel trigger a migraine attack for you? Share your prevention tips on Tippi .

Paula dumas.

Paula Dumas is the founder of Migraine Again. She is a producer and cohost of the Migraine World Summit, president of the World Health Education Foundation, and a member of the International Headache Society Global Patient Advocacy Committee.

Sign up for our Newsletter to get weekly fresh content

• Future Leaders in Neurology

• Conferences
• Publications

Airplane Headaches: What the Research Says

There is a surprisingly low association between airplane headaches and other types of headaches. So what are the characteristics and how are they treated?

©GlebStock/Shutterstock

©Lightspring/Shutterstock

Airplane headaches (AHs) are brought on by airplane travel and afflict some travelers. For a number of reasons, it is difficult to assess how prevalent AHs are. It is possible that patients prone to AH may make lifestyle modifications-such as reducing the number and frequency of flights-to reduce the incidence of the headaches. And, because of the short duration relative to other types of headaches, it is likely that many people who experience AH do not mention it to their doctors.

AHs share several features. In addition to the obvious connection with air travel, they are generally associated with landing, tend to be very painful and throbbing, are usually unilateral, and often resolve after approximately 30 to 60 minutes.

The causative mechanism has not been well established. They are believed to be caused by one of several mechanisms related to physiological responses to the atmospheric pressure changes induced by air flight, including: reversible barotrauma, inflammation, or fluid pressure.

Characteristics of AH sufferers

Interestingly, large systemic studies point to a surprisingly low association between AHs and other diagnoses, such as migraine headaches, tension headaches, and chronic sinus allergies. 1 There is also no documented association between AHs and any adverse health risks.

Some patients are especially prone to AH. A study in Denmark 2 replicated the AH experience by asking volunteers to enter a pressure chamber, that was set to a similar environment as that of an airplane flight. The volunteers who regularly experienced AHs had the same symptoms when they entered a pressure chamber, while the volunteers who had never experienced AHs did not have symptoms when they entered the pressure chamber.

The study itself was performed for the purpose of identifying biomarkers for AHs. It turned out that the volunteers who had AH-like attacks also had measurable increases in their salivary prostaglandin levels, changes in cortisol levels, and mild changes in oxygen saturation, while the non-headache volunteers did not have these changes.

Treatment and prevention

The majority of AH sufferers do not regularly have headaches, so they do not typically carry headache medication with them when they are not traveling by air. This means that their physician must prescribe or recommend over-the-counter medication specifically for times of travel.

There are no well established or standardized approaches to treatment and prevention of AH. Due to the short duration of these events, medical therapy is generally used within a few hours of the flight. Use of anti-inflammatory medications, triptans, and steroid medications have all been found helpful, based on anecdotal accounts.

This article was originally published on January 25, 2018 and has since been updated.

References:

1. Bui SBD, Gazerani P. Headache attributed to airplane travel: diagnosis, pathophysiology, and treatment - a systematic review . J Headache Pain. 2017;18:84.

2. Bui SBD, Petersen T, Poulsen JN, Gazerani P. Simulated airplane headache: a proxy towards identification of underlying mechanisms . J Headache Pain . 2017;18:9.

This Week on NeurologyLive® — June 24, 2024

Sleeping Around the Podcast × NeurologyLive: Calcitonin Gene-Related Peptide in Sleep Research

This Week on NeurologyLive® — June 17, 2024

Episode 92: Highlights From the 2023 CMSC, SLEEP, AHS, and ATMRD Annual Meetings

FDA Action Update, May 2024: Approvals, Designations, and Labeling Update

This Week on NeurologyLive® — June 10, 2024

2 Commerce Drive Cranbury, NJ 08512

609-716-7777

Where to Buy

Offers & Coupons

For Professionals

Advil Tablets Drug Facts

Advil Liqui-Gels Drug Facts

Notice About Defective Peel-back Labels

Select Location and Language:

• United States of America (English)
• United States of America (Español)
• Canada (English)
• Canada (French)
• New Zealand (English)
• Brazil (Portuguese)
• Colombia (Español)
• Mexico (Español)
• France (French)
• Hungary (Hungarian)
• Australia (English)
• Netherlands (Dutch)
• Korea (Korean)
• Puerto Rico (Español)

• Cold, Sinus or Flu
• Children's Advil
• Product Comparison

Sleeping Issues

• Cold, Flu or Sinus
• Relief Finder
• Tips & Resources
• Children's Relief Finder
• Why Children's Advil

Combining Medications

• Advil & Pregnancy
• Potential Health Effects
• Pre-existing Health Conditions

Expiration, Disposal, and Storage

• Medicine Cabinet Checkup
• Can You Combine Ibuprofen and Acetaminophen?
• FAQs About Advil Pain | Advil
• Frequently Asked Questions About Advil PM Products
• Frequently Asked Questions About Advil Respiratory
• The Advil Pain Equity Project

Advil Tablets

Advil Dual Action

• Symptoms and Tips

3 Common Types of Headaches and What Causes Them

Read Article 3 Common Types of Headaches and What Causes Them

About Non-Prescription (Over the Counter) Sleep Aids

Read Article About Non-Prescription (Over the Counter) Sleep Aids

• Children and Infants

Children's Advil Suspension Grape

Infants' Advil Drops

Safety & Side Effects

Read Article Combining Medications

Read Article Expiration, Disposal, and Storage

• Sustainability

5 Tips to Avoid Headaches While Traveling

Traveling is usually an exciting occasion. Whether it’s for business or pleasure, visiting a different location can be a fun break from your daily life. However, getting a travel headache can make spending time on an airplane or elsewhere feel painstakingly long and uncomfortable. If you’re worried about getting a headache the next time you fly, arm yourself with these tips for a comfortable, symptom-free flight.

Why Do I Get a Headache Before or After Flying?

An airplane headache (AH) is a headache that develops while the plane is taking off or landing. The pain is usually felt at the front of the head and around the eye sockets. While the international headache society has recognized airplane headaches, not much is known about them and their triggers. 1

Some studies suggest that the cabin pressure changes in the airplane, which are more pronounced during takeoff and landing, affects the head and sinuses in a way that triggers a headache. 1 Another possible explanation for AHs is a fear of flying, which can cause stress and anxiety and subsequently trigger a headache. 2

Motion Sickness Headaches

Another possible cause of an airplane or travel headache is motion sickness. If you get motion sick on the plane, you could be susceptible to developing a vestibular migraine. A vestibular migraine usually includes normal migraine symptoms with additional vestibular symptoms, including dizziness, unsteadiness and a loss of balance, vertigo and motion sensitivity. 3

Other Types of Travel Pains

While headaches are a common type of pain associated with traveling, you may also feel pain or discomfort in other ways. Traveling involves long periods of sitting upright in planes or cars. If you aren’t maintaining good posture while sitting or sleeping, you may develop neck and back pain. 6 Carrying heavy bags can also strain your neck and cause discomfort. 6 If possible, try getting up and moving around often to stretch your muscles, as this can help prevent stiffness and pain. 6

How to Prevent a Travel Headache

The next time you travel, keep these tips in mind to prevent headaches and minimize common triggers.

1. Try Some Relaxation Techniques

If you’re a nervous flyer and you know that stress is one of your triggers, try some relaxation techniques while you’re on the plane. While you can’t exactly break out your yoga mat in the aisle, try some deep breathing from the comfort of your seat to help ease your nerves. 2 If you feel stressed on your trip, try some light stretching, meditation, yoga or tai chi. 2

2. Exercise or Stretch Before Your Flight

Exercise has proven benefits when it comes to preventing and treating headaches, so squeeze in a little light exercise or stretching before your flight. 2 At the very least, your legs will get a little breather before they’re stuck in a small airplane seat.

Just remember to warm up slowly and avoid overexerting yourself, as overly strenuous exercise can exacerbate headaches. 2 You can also use the gym at your hotel or even a mat or towel in your room if you need a break throughout your trip.

3. Avoid Altering Your Diet

Around 20% of headache sufferers can develop a headache from eating certain foods. 4 If you know which foods trigger headache symptoms for you, try to avoid those foods and stick to your usual food groups. In addition, prioritize eating a healthy diet that’s rich in fruits, veggies and whole grains, as these food groups can give you energy and potentially help keep your stress under control. 2 This can be a challenge when you’re travelling, so you might want to plan out your meals ahead of time or pack your own food for the plane (if allowed).

4. Pack Your Headache Essentials

If you expect to encounter headache triggers on your trip, pack your headache essentials in your suitcase or carry on. For example, you can pack medications, soothing items, cooling or heating packs, snacks, etc. to help make your flight more comfortable. 5 Things like an eye mask and ear plugs or noise cancelling headphones are great for cutting back on chatter, bright light and sensory overload. 5 They’re also a great addition if you want to sneak in a nap ! Lastly, don’t forget to pack an empty water bottle to refill before boarding, as planes can be extra dehydrating.

5. Take an Advil!

A comprehensive look at all the literature on airplane headaches agreed that taking an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) can help relieve an airplane headache. 1 Ibuprofen, the active ingredient in Advil, is classified as an NSAID and is available over the counter. You can also purchase Advil Dual Action , which comes with ibuprofen and acetaminophen for powerful pain relief. If you suffer from migraines, Advil Migraine is clinically proven to relieve migraine pain and related symptoms, including nausea and sensitivity to light and sound. Available in gels, capsules and tablets, Advil products are travel-friendly and the perfect addition to your carry on.

Source Citations:

• Headache attributed to airplane travel: diagnosis, pathophysiology, and treatment – a systematic review | The Journal of Headache and Pain | Full Text. https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-017-0788-0 . Accessed 8/29/22.
• Headaches: Reduce stress to prevent the pain - Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/tension-headache/in-depth/headaches/art-20046707 . Accessed 8/29/22.
• Vestibular Migraine | Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/vestibular-migraine . Accessed 8/29/22.
• Foods & Drinks That Can Cause Headaches: How to Diagnose & Avoid. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/9648-headaches-and-food . Accessed 8/29/22.
• 3 Tips For Traveling with Migraine this Post-COVID Summer. American Migraine Foundation. https://americanmigrainefoundation.org/resource-library/traveling-with-migraine-post-covid-summer/ . Accessed 8/29/22.
• Neck pain. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/neck-pain/symptoms-causes/syc-20375581 .  Accessed 10/12/22.

By clicking the link(s) above, you will be taken to an external website that is independently operated and not managed by Haleon. Haleon assumes no responsibility for the content on the website. If you do not wish to leave this website, do not click on the links above.

• Terms of Use
• Privacy Notice
• Washington Consumer Health Data Notice
• FSA HSA Eligibility

Follow Advil

Follow Children's Advil

Save over $70 with Haleon Huddle.

Haleon Huddle unlocks exclusive savings on brands including Advil, Sensodyne, Centrum and more.

*All fields required

I consent to the Haleon group of companies and brands (“Haleon”) collecting my Consumer Health Data. Continue reading... I understand that my Consumer Health Data may be used by Haleon as described in our Washington Consumer Health Data Notice , where I can find the categories of data collected, the purposes of collection, and with whom we may share your information. I understand that if I choose not to consent to Haleon’s collection of my Consumer Health Data, I may not be able to receive certain marketing or informational materials or other forms of communication directly from Haleon or participate in surveys and focus groups. I further understand that I may withdraw my consent at any time as described in the Haleon Washington Consumer Health Data Notice or the Haleon Privacy Notice .

I consent to the Haleon group of companies and brands (“Haleon”) sharing my Consumer Health Data with third parties continue reading... as described in the Washington Consumer Health Data Notice . I understand that I may withdraw my consent at any time as described in the Haleon Washington Consumer Health Data Notice or the Haleon Privacy Notice .

By Signing up for Advil newsletters, You are certifying you are 18 years of age and older.

Check your inbox for a confirmation email from Haleon Huddle to receive coupons!

Save over $70 with Haleon Huddle

Trade marks are owned by or licensed to the Haleon group of companies.

© 2020-2024 Haleon group of companies or its licensor. All rights reserved. The content of this website is intended for US audiences only.

PM-US-ADV-21-00474

• Search the site GO Please fill out this field.
• Newsletters
• Health Conditions A-Z
• Neurological Disorders

6 Reasons Why You Might Get Travel Headaches

For people who get migraines, vacation headaches are all too common—here's what might be at play.

Browsing through vacation photos can be a fun trip down memory lane. However, for some, recalling a vacation might bring back memories of migraines —headaches with neck pain, dizziness , and sound sensitivity.

Here are some of the precipitating factors for travel headaches. Health spoke with experts to understand six reasons why vacationing can literally be a headache for some people—and what you can do to keep them from making traveling more difficult.

What Is a Vacation Headache?

Headaches that occur while on vacation can result because you are finally relaxing and taking it easy with less stress , in a perceived less stressful environment. Headaches can, unfortunately, happen at any time, and getting them while traveling isn't as uncommon as you might think.

You might go on vacation to take a step away from the stress of your job or to renew your focus on your well-being. However, one outcome of a disruption to your usual daily routine is headaches.

Six Reasons You Have a Travel Headache

Headaches can happen for many reasons. Travel headaches can happen because of the travel itself or for reasons that are separate from traveling.

You Get a "Let-Down Headache"

You've just settled into a beach chair in the midst of a tranquil scene when you feel a migraine starting. Or maybe you're finally able to take that walk or hike following your college finals, and then your head starts to hurt. Perhaps you're meeting some friends for brunch after what seems like weeks of emergency room visits with your sick child when you feel that all too familiar head pain. You might even suddenly feel sick after finishing a stressful work project.

These headache phenomena are known as "let-down headaches."

"A let-down headache is a headache which occurs when there has been a drop in stress levels," Deena Kuruvilla, MD , neurologist, headache specialist, and director of the Westport Headache Institute, told Health . "Many patients with chronic or episodic migraines tell me that their headache frequency [was] really well controlled on preventive migraine treatments , but then boom, they go on vacation and experience an attack!"

There is evidence for and against this type of headache. The data could be mixed because this type of headache seems to be mainly a result of perceived stress. How you react to your perceived stress. such as drinking caffeine or alcohol and changing your sleeping patterns, seems to influence whether you have a "let-down headache."

Fortunately, to keep your relaxation from backfiring into a headache, there are options. To stabilize stress levels, especially prior to leaving for vacation, try:

• Clearly communicating your needs and feelings
• Getting more sleep
• Making lists to help prioritize what's important
• Managing time commitments
• Spending quality time with a partner or friend

These and other stress management activities can help avoid the spike-and-drop pattern that might trigger a migraine.

Lots of Smaller Stressors

The truth is not every aspect of vacation is stress-free bliss. From last-minute packing woes to the difficult in-laws you may be visiting, there are a number of reasons why you might need a vacation from your vacation. All of these can add up to stress headaches —literally and figuratively.

Remaining or becoming calm is easier said than done when you are stressed. However, self-care strategies for de-stressing are your best bet for preventing the onset of a headache. Try these suggestions to help guide you to a calmer place of well-being,

• Download a guided meditation to listen to in the car
• Give yourself quiet, unscheduled breaks throughout your trip
• Practice deep breathing exercises in the airport terminal

You’re Off Your Typical Sleep Schedule

When you're away from your own bed, sleep doesn't always come easily. "Migraine and sleep run hand in hand," said Dr. Kuruvilla, "[especially when] traveling across time zones [which] can throw off a person's circadian rhythm, [and] contribute to sleep disruption and migraine attacks."

You may want to have a melatonin supplement on hand to help. "Melatonin is a hormone that helps regulate the circadian rhythm," stated Dr. Kuruvilla. In addition, melatonin can offer migraine relief by reducing the intensity of the headache.

For better shuteye on vacation, practice healthy sleep hygiene:

• Discontinue the use of devices before heading to bed
• Keep a cool, dark bedroom
• Stick to your usual bedtime routine as much as possible

You're Dehydrated

It's hard to overstate the importance of staying hydrated to prevent a headache. "Even 1 to 2% of body water loss can increase your chances of developing headaches," dietitian Maryann Walsh, MFN, RD, CDE , told Health . "It's critical to get adequate water ."

While air travel alone can be dehydrating, the low humidity in a plane cabin isn't the only factor that can lead to vacation dehydration. Simply switching environments can bump you out of your usual healthy habits.

"Being out of your normal routine can lead to not hydrating as you normally would, especially if you are on a road trip or flight and you'd rather not have to stop or get up to use the restroom every hour," stated Walsh.

Then there's the ubiquitous vacation culprit: alcohol. "Because alcohol acts as a diuretic, it can further cause us to be dehydrated," indicated Walsh. "If we aren't drinking enough water before, in between, and after a day or night of cocktails, this can lead not only to a dreaded hangover but also headaches."

Follow these tips to stay hydrated:

• Drink electrolytes if you feel dehydrated or have been sweating a lot
• Drink more water than you normally would, especially if you're somewhere it's hot
• Keep a bottle of water in your travel bag and refill it throughout the day
• Keep the non-alcoholic beverages flowing alongside any alcoholic drinks

Diet Changes

Could that dinner you enjoyed at a restaurant send you reaching for the ibuprofen the next day? For some people, foods high in substances like tyramine, nitrates, sulfites, and artificial ingredients can trigger head pain. Common culprits include aged cheeses, cured and processed meats, pickled foods, and alcohol—all of which you'll frequently encounter in restaurant dining.

Travel can disrupt other individual diet choices you might normally make to live pain-free. "Some of us may have dietary headache triggers that we usually avoid in our daily lives but may not be able to avoid if there are sneaky ingredients we are consuming out at restaurants," said Walsh. If you know the foods that trigger your headaches, avoid eating them as best you can. You could also try eating more frequent, smaller meals and sticking with unprocessed, fresh foods.

There's also the impact of caffeine. Fluctuations in caffeine intake are known for tripping the headache wire. If vacation mode has you chilling out sans coffee—when you'd normally drink several cups a day—a headache can result. With that, keep your caffeine intake consistent and stick to your usual food intake if possible.

You’re at a Higher Altitude

As you make your way up winding roads for a mountain getaway and look forward to fresh air and cooler temps, the altitude change may cause headaches. Hypoxia occurs when the oxygen supply to your body is inadequate because of low blood flow or low oxygen in the air.

You don't have to be scaling Mount Everest for altitude to mess with your head. Even small elevation changes may lead to discomfort. "Studies have confirmed that all migraine-associated symptoms, headache frequency, and headache severity tend to worsen with increasing altitude," noted Dr. Kuruvilla. You may even experience a headache when you're on an airplane due to the sudden change in altitude.

The higher you go the more likely you are to experience hypoxia because your lungs and heart have to work harder to deliver oxygen, so your brain tissues may not get enough oxygen. To get relief from altitude headaches:

• Descend 1,000 to 3,300 feet
• Take ibuprofen
• Stay hydrated and take frequent breaks

A Quick Review

Going on a vacation may be a wanted break from your normal routine, but the changes to your routine may be what bring on headaches. Try to stick to your usual routine and habits as much as possible to keep the headaches at bay.

Stubberud A, Buse DC, Kristoffersen ES, Linde M, Tronvik E. Is there a causal relationship between stress and migraine? Current evidence and implications for management .  The Journal of Headache and Pain . 2021;22(1):155. doi:10.1186/s10194-021-01369-6

National Migraine Foundation. Stress and Migraine .

Long R, Zhu Y, Zhou S. Therapeutic role of melatonin in migraine prophylaxis: A systematic review .  Medicine . 2019;98(3):e14099. doi:10.1097/MD.0000000000014099

Zduńska A, Cegielska J, Domitrz I. The pathogenetic role of melatonin in migraine and its theoretic implications for pharmacotherapy: a brief overview of the research .  Nutrients . 2022;14(16):3335. doi:10.3390/nu14163335

American Migraine Foundation. Alcohol and Migraine .

MedlinPlus. Dehydration .

Center for Disease Control and Prevention. Water and Healthier Drinks .

National Headache Foundation. Low Tyramine Diet Guide .

American Migraine Foundation. Diet and Headache Control .

Sajadi-Ernazarova KR, Anderson J, Dhakal A, Hamilton RJ. Caffeine withdrawal . In:  StatPearls . StatPearls Publishing; 2023.

Bhutta BS, Alghoula F, Berim I. Hypoxia . In:  StatPearls . StatPearls Publishing; 2022.

Frank F, Kaltseis K, Filippi V, Broessner G. Hypoxia-related mechanisms inducing acute mountain sickness and migraine .  Front Physiol . 2022;13:994469. doi:10.3389%2Ffphys.2022.994469

American Migraine Foundation. Altitude, Acute Mountain Sickness and Headache .

Luks AM, Auerbach PS, Freer L, et al. Wilderness medical society clinical practice guidelines for the prevention and treatment of acute altitude illness: 2019 update .  Wilderness & Environmental Medicine . 2019;30(4):S3-S18. doi:10.1016/j.wem.2019.04.006

Related Articles

How to Avoid Headaches on Planes

By Mikaela Conley

There are enough metaphoric "headaches" when flying: missed connections, delays, long security lines . So the last thing you need is an actual airplane headache—a.k.a. "aviation headache"—which can be caused by the change in altitude as a plane ascends and descends, says Tesha Monteith, M.D., assistant professor of neurology at the University of Miami.

Why does this happen? Known as aerosinusitis, the inflammation in the paranasal sinus cavities (those are the air-filled spaces that stem from the sides of your nose to between your eyebrows) is caused by a difference in air pressures inside and outside the body. And that difference in pressure may cause blood vessels in the body to dilate, which can lead to head pain. Migraines can also be triggered during air travel due to a variety of factors, including stress, dehydration, dry recirculated air, strong odors, and weather changes.

So how can you avoid a throbbing head on your next flight? Follow these steps:

TAKE IBUPROFEN BEFORE YOU BOARD

If you know you're prone to aviation headaches, take a non-steroidal anti-inflammatory agent (i.e. ibuprofen) one to two hours before takeoff to get ahead of any inflammation or pain. Otherwise, board as usual, and if you do feel a headache coming on, waste no time popping a dose—which will hopefully prevent that throbbing feeling from getting worse. Suggestion: Keep a small bottle of ibuprofen with you in your carry-on ; that way, you know it's there if you need it (and you don't have to flag down a flight attendant to see if he or she has any pills in the galley).

SKIP TRIGGERING FOODS

Within 12-24 hours of your flight, pass on the red wine, aged cheeses, chocolate, and processed meats, all of which contain tyramine, a chemical compound that can signal pain pathways for those with a predisposition to headaches and migraines, says Dr. Monteith. Instead, try sticking to a natural plant-based diet just before and while you're traveling, which will not only help you avoid the potentially ache-inducing triggers, but also could also give you more energy so you don't feel sluggish before you board.

AVOID DARK ALCOHOLS AND SUGARY DRINKS

This one's a no-brainer: You already know to drink lots of water during flights to prevent dehydration. For the same reason, you should limit excessive amounts of coffee, alcoholic, and sugary drinks just before and during your flight. If you really need an adult beverage to calm your nerves, stick to clear liquors (like gin and vodka), which typically trigger less head discomfort than wine, beer, or fizzy cocktails. Why? Clear liquors contain fewer or no “congeners,” byproducts that form during fermentation that can be difficult for the body to break down. There is one exception to this rule, however: Some people find that caffeine helps ward off migraines, and so if you feel one coming on, a swig of coffee might help. (But still, keep chugging that water.)

WARD OFF MOTION SICKNESS

Turbulence can do more than mess with your nerves—it can also make you queasy, which can trigger a migraine. Keep motion sickness medication in your carry-on as well if you're sensitive to movement, and you might save yourself from a stomachache and headache.

PACK YOUR SLEEP GEAR

“Good sleep, possibly with the use of melatonin [if necessary], may be beneficial as alterations in sleep habit and jet lag can be migraine triggering, as well,” says Dr. Monteith. It certainly helps to get a proper rest the night before a flight, but for long hauls, it's just as important to sleep on the plane . Be sure, especially if you're flying a red-eye , to wear comfortable clothes and bring proper travel sleepwear—including an eye mask, ear plugs, and comfy socks—to have the best possible (and headache-free) trip.

Plus: Vote for your favorite hotels, cities, airlines, and more in the 2016 Readers’ Choice Awards survey .

Packing List

By signing up you agree to our User Agreement (including the class action waiver and arbitration provisions ), our Privacy Policy & Cookie Statement and to receive marketing and account-related emails from Traveller. You can unsubscribe at any time. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

• Conditionally
• Newsletter Signup

Health Conditions Chevron

Neurological Health Chevron

Migraine Chevron

How to Avoid Getting a Migraine Attack When You Fly

By Julia Ries

Medically reviewed by Alina Masters-Israilov, MD

When you have migraine , your brain is super sensitive to the outside world. The neurological condition can make you dizzy, nauseous, and hypersensitive to lights, smells, and sounds. 1 That means that your average plane ride might be a perfect storm of triggers: You’re often surrounded (quite literally) by questionable odors, screaming toddlers, and the occasional jolt of eye-stabbing sunshine.

Air travel sucks for just about everybody—but when you live with migraine, it can feel like absolute hell. However, there are ways to make it to your destination without ending up in a full-blown pain spiral, according to experts. Here are their top tips.

Pack your go-to meds.

For a lot of folks with migraine, taking medications as soon as the throbbing starts can often prevent it from getting worse. That’s why it’s a good idea to keep them in an easy-to-reach spot in your carry-on bag. This might include an over-the-counter nonsteroidal anti-inflammatory drug (NSAID), like ibuprofen, and a prescription triptan, which can often halt symptoms in under an hour—basically before the drink cart arrives.

Of course, you don’t need to wait for the aching to start; pain relievers can be used preventatively, Kristina Lopez, MD , a headache specialist at the WVU Rockefeller Neuroscience Institute, tells SELF. NSAIDs alone can be really effective, but you might need a triptan if you’ve got an extra-long travel day ahead or your symptoms feel unbearable on planes. You can have a dose of your go-to med 30 minutes before a flight, for example, or whenever you think you’re most likely to need it (like during takeoff and landing). In some cases, a doc can prescribe additional or more potent medications, like a “migraine cocktail,” which is basically a mixture of different treatments for particularly brutal attacks, Dr. Lopez notes.

It’s important to be aware that cabin pressure and altitude changes can also sometimes trigger an episode. So you might want to reach for meds as soon as you step onboard if those things have bothered you in the past, Nicholas Tzikas, MD, MPH , a Yale Medicine headache specialist and assistant professor of clinical neurology at Yale School of Medicine, tells SELF.

Block out awful noises and sensations.

The harsh lighting and loud sounds you often encounter on airplanes—a seatmate who likes to pass the time by shoving a window shade up and down (why?!), for example—can be pretty bothersome for a lot of people with this condition. 2 “Even if they don’t throw folks into a full-blown migraine attack, they may still have irritation,” says Dr. Lopez.

Because of this, Dr. Tzikas recommends stashing products in your carry-on bag that can diminish the intensity of annoying stimuli. Lindsey de los Santos, a 46-year-old teacher from Kansas City, Missouri, struggles with migraine symptoms when she travels. She keeps a “rescue kit” handy on every flight, which includes an eye mask (to block out bright overhead lighting) and ear plugs (to muffle the rumbling engine or a cranky baby). These types of tools can help you get through flights peacefully, Dr. Lopez says.

Eat before leaving for the airport—and pack a few snacks.

Skipping meals—or snacking in a way you normally wouldn’t back at home (which, let’s be honest, is 80% of air travel)—can also spur an attack, some research suggests. 3,4 When you rush to the airport for a morning flight and forgo your usual breakfast, for example, your blood sugar might dip, which is a common migraine trigger. 5 Dr. Tzikas recommends slipping a few protein-rich snacks into your carry-on to keep you full throughout your flight.

By Katie Camero

By Erica Sloan

By Jenna Ryu

Reach for whatever sounds delicious and convenient to you, but keep in mind that some packaged snacks can be more migraine-inducing than others. For example, you may want to avoid processed meat (like in the overpriced, dry, but also mysteriously soggy deli sandwiches you find at terminal convenience marts), Dr. Lopez notes, because they often contain nitrates, which are preservatives that may aggravate your symptoms. 6 Other people don’t do well with sugary treats, possibly due to a blood sugar spike, and then a crash. (Basically, the sudden physiological switch-up happening in your body can trigger you.)

Try to hydrate once you’re through security.

If you cut back on water when you fly—say, to avoid using the (sometimes gnarly, admittedly!) plane bathrooms—it’s time to rethink your game plan. Dehydration sometimes precedes a migraine attack, and some studies suggest that drinking water can cut your odds of them happening. 7,8 A lack of fluids can also increase your pain sensitivity, Dr. Lopez says, so any symptoms might feel even more miserable. 9

Plane cabins are notoriously dry, so you’ll need more than the dinky cup of water the flight attendant hands you to stay hydrated. Stash a refillable tumbler in your bag, or just splurge on the overpriced bottled water near your gate.

There isn’t a hard-set amount of water that can stave off an attack, but make sure your urine is clear(ish) or very light yellow—and, when in doubt, drink whenever you're thirsty .

Go easy on yourself.

It’s important to remember that some of this is simply out of your control; you do everything “right” and still feel like hell when your plane lands. If that happens, know that it’s okay to take a little time out to recover—even if that means missing the first round of margaritas at the resort’s bar.

Taking a beat to rest while everyone else enjoys the trip is crucial for de los Santos. She’s learned (perhaps the hard way) that she isn’t the reason air travel can be such a challenge, her migraine is—and she’s doing the best she can. “If you can accept that, it really reduces your stress level and creates less sense of worry,” she says.

• How to Deal With Migraines at Work, From People Who Get It
• 6 People Living With Migraine Share How They Prioritize Self-Care
• People Swear That Ice Caps Make Their Migraine Feel Better—Here’s What the Science Says
• Open Medicine , Migraine Management: Non-Pharmacological Points for Patients and Health Care Professionals
• Internal Medicine , Identification of Everyday Sounds Perceived as Noise by Migraine Patients
• Journal of Clinical Neuroscience , Nighttime Snacking, Stress, and Migraine Activity
• Nutrients , Migraine and Diet
• Genes (Basel) , Glucose-Related Traits and Risk of Migraine—A Potential Mechanism and Treatment Consideration
• mSystem s, Migraines Are Correlated with Higher Levels of Nitrate-, Nitrite-, and Nitric Oxide-Reducing Oral Microbes in the American Gut Project Cohort
• Journal of Clinical Neuroscience , Association of Drinking Water and Migraine Headache Severity
• Nutrition Reviews , Water, Hydration, and Health
• Journal of Clinical Medicine , The Importance of Nutrition as a Lifestyle Factor in Chronic Pain Management: A Narrative Review

SELF does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a substitute for medical advice, and you should not take any action before consulting with a healthcare professional.

• PRO Courses Guides New Tech Help Pro Expert Videos About wikiHow Pro Upgrade Sign In
• EDIT Edit this Article
• EXPLORE Tech Help Pro About Us Random Article Quizzes Request a New Article Community Dashboard This Or That Game Popular Categories Arts and Entertainment Artwork Books Movies Computers and Electronics Computers Phone Skills Technology Hacks Health Men's Health Mental Health Women's Health Relationships Dating Love Relationship Issues Hobbies and Crafts Crafts Drawing Games Education & Communication Communication Skills Personal Development Studying Personal Care and Style Fashion Hair Care Personal Hygiene Youth Personal Care School Stuff Dating All Categories Arts and Entertainment Finance and Business Home and Garden Relationship Quizzes Cars & Other Vehicles Food and Entertaining Personal Care and Style Sports and Fitness Computers and Electronics Health Pets and Animals Travel Education & Communication Hobbies and Crafts Philosophy and Religion Work World Family Life Holidays and Traditions Relationships Youth
• Browse Articles
• Learn Something New
• Quizzes Hot
• This Or That Game
• Train Your Brain
• Explore More
• Support wikiHow
• About wikiHow
• Log in / Sign up
• Nervous System Health

How to Prevent Headaches After Air Travel

Last Updated: January 29, 2024 References

This article was medically reviewed by Erik Kramer, DO, MPH . Dr. Erik Kramer is a Board-Certified Primary Care Physician at the University of Colorado. With over 15 years of experience, his clinical interests include obesity and weight management, diabetes care, and preventive care, as well as embracing a holistic approach to primary care. He received his Doctorate in Osteopathic Medicine (D.O.) from the Touro University Nevada College of Osteopathic Medicine and completed his residency at Central Maine Medical Center. Dr. Kramer is a Diplomate of the American Board of Obesity Medicine. There are 8 references cited in this article, which can be found at the bottom of the page. This article has been viewed 147,747 times.

Many travelers suffer from flight-related headaches. This can be due to altitude changes, jet lag, or exposure to irritants in airports or airplanes. Flight-induced headaches are different from the sinus pressure you sometimes experience during a flight due to pressure changes, which usually resolves once you land. [1] X Trustworthy Source PubMed Central Journal archive from the U.S. National Institutes of Health Go to source In contrast to flight-related sinus problems, these headaches often start at landing and can be very intense, usually with throbbing pain that’s localized to one side of your head. While they often go away on their own within 1 hour, you’ll likely want to minimize the pain or avoid it altogether. There are a variety of ways to lessen the severity of headaches after flight, and you should take action before, during, and after boarding a plane.

Using Medication

• In a recent study, hikers preparing for a high-altitude journey were given doses of ibuprofen in the 24 hours prior to their journey. A little over 40% of hikers who took ibuprofen developed altitude-related headaches and nausea. In the control group, where hikers did not take ibuprofen, almost 70% experienced headaches, nausea, and other symptoms. [2] X Research source
• If you're going to be flying, try taking 600 milligrams of ibuprofen sometime during the 24 hours leading up to the flight. Ibuprofen can be purchased at most drug stores and supermarkets and comes under a variety of names, such as Advil or Motrin. [3] X Research source

• You will need a prescription for acetazolamide. Talk to your doctor about your headaches during flying and ask them if they think the medication would be safe for you.
• Acetazolamide is prescribed in different doses with different instructions depending on why you're taking it and your medical history. Follow the instructions on your prescription and do not hesitate to ask a doctor or pharmacists if you have any questions. [5] X Research source
• Acetazolamide can cause nausea, dizziness, and loss of appetite. These are normal side effects that should pass. If you experience more serious side effects, like fever, rash, or blood in your urine, stop using the medication and talk to your doctor. [6] X Research source

Taking Precautions

• Altitude changes can prompt changes in your oxygen levels, causing your head's blood vessels to compensate by contracting and expanding. This change in your blood vessels can trigger a migraine. [7] X Research source
• Booking a non-stop flight can be difficult and costly. However, see if you live within driving distance of a location that provides non-stop flights to your end location. It might be worth it to take a road trip to an airport and take a non-stop flight from there if your migraines or headaches are particularly severe.

• Aircrafts only have a humidity level of 15%, which is on par with some of the driest climates on earth. Make sure you bring a water bottle on the plane and stay hydrated prior to boarding.
• Remember, drinks are not usually offered on a plane until well after take-off. Bringing your own water on board will make it easier for you to stay hydrated while you wait for in-flight service.
• If you forgot your water bottle and are feeling thirsty as the plane takes off, it's fine to ask the flight attendant for a water bottle before the plane takes off.

• Purchase high-fiber and high-protein snacks, like nuts, dried fruits, and granola bars. Put them in your carry-on bag. Avoid salty or overly sugary snacks, which can worsen dehydration.

• Alcohol is one of the biggest triggers for migraines. It also contributes to dehydration that can exacerbate jet lag and cause headaches.
• Red wine, in particular, is known to cause headaches if drunk in excess. Consuming a glass or two of red wine before or after boarding could lead to a headache after flight.
• If you really want a preflight alcoholic beverage, stick to white wine as it's less likely to cause headaches.

• Herbal supplements, like melatonin, can be purchased at drug stores and supermarkets. In small doses, they can promote sleep. Many people also take Dramamine while flying as it reduces nausea. It also causes drowsiness and may help you sleep through a long flight.
• Test any medications you're trying at home before a fight. If they have any adverse side effects for you, you want to know ahead of time.
• Bring an in-flight pillow to avoid straining your neck while flying.

• Familiarize yourself with the routines of flying and airplane noises before leaving for the airport. Anxiety is often rooted in the unexpected or unknown, so having as much information as you can beforehand can reduce fear. [11] X Research source
• Keep a picture of your destination on hand. If you start to become anxious during the flight, reminding yourself what you have to look forward to can help ease that anxiety.
• If your fear of flying is particularly bad, talk to a doctor or therapist about an anti-anxiety medication you can take as needed before flight.

Recovering after the Flight

• It might not be a good idea to drive right away. Take a cab home from the airport or have a trusted friend pick you up.
• Do not expose yourself to stimulants that can normally induce headaches. Caffeine, loud music, and alcohol should be avoided in the hours after a flight until you've readjusted.

• Most flight-related headaches go away within 30-60 minutes after they start. If your headache lasts longer than that, talk to your doctor.

Expert Q&A

You might also like.

• ↑ https://www.ncbi.nlm.nih.gov/books/NBK470207/
• ↑ http://healthland.time.com/2012/03/20/ibuprofen-can-prevent-altitude-sickness/
• ↑ https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682756.html
• ↑ https://migrainetrust.org/understand-migraine/types-of-migraine/other-headache-disorders/high-altitude-headache/
• ↑ https://www.cntraveler.com/stories/2016-04-29/how-to-avoid-headaches-on-planes
• ↑ http://www.everydayhealth.com/headache-and-migraine/taming-migraines-while-traveling.aspx
• ↑ https://www.health.harvard.edu/blog/alcohol-and-headaches-2018102615222
• ↑ https://patient.info/news-and-features/how-to-manage-flight-anxiety

About This Article

Medical Disclaimer

The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment.

Read More...

To avoid getting a headache after air travel, take ibuprofen like Advil before your flight since the medication can help prevent headaches. While on your flight, drink lots of water so you don’t get a headache from dehydration. You should also avoid drinking alcohol right before or during your flight since that can lead to dehydration and trigger a headache. Some headaches from air travel are caused by jet lag, so try and sleep on the plane so you feel rested when you land. After you land, get some fresh air as soon as you can to alleviate any jet lag. For more advice from our Medical co-author, including how to stay calm during air travel so you don’t get a headache from stress, read on! Did this summary help you? Yes No

• Send fan mail to authors

Reader Success Stories

Sabina Horak

Dec 30, 2016

Did this article help you?

Bernadette Raikar

Oct 24, 2016

Featured Articles

Trending Articles

Watch Articles

• Terms of Use
• Privacy Policy
• Do Not Sell or Share My Info
• Not Selling Info

Don’t miss out! Sign up for

wikiHow’s newsletter

Airplane headache: Why it occurs and how to stop it

Airplane headache!  Yep, it’s real. It’s also know as “high altitude headache”. But it doesn’t matter how you call it, it’s hurtful anyways.

I didn’t experience it but my boyfried did on our last trip to France. What was it like? A sharp pain in the sinuses, so strong it was scary as hell. So he felt it on our second flight landing in Paris from Munich.

It lasted for a good 3-4 hours . We never knew what was it until we read about it when we got back home a week after. My boyfriend felt the same sharp pain on our way back to Sofia, on the second flight again, when landing. It lasted less then.

So what have we learnt about airplane headache?

We are not experts but according to our own web research, High Altitude Headache occurs more often during landing. It develops within 24 hours after ascent and resolves within eight hours of descent.

It covers at least two of the following charasteristics: Bilaterial, Frontal or frontotemporal (at the front of the head in the region of the temples), Dull or pressing quality, Mild or moderate intensity, Aggravated by exertion, movement, straining, coughing, or bending.

Some info says that the symptoms rarely last more than one hour. The pain has been described as jabbing, stabbing, shooting, bursting, pressing, piercing and sharp in quality. As for why airplane headaches occur, scientists think it’s due to an imbalance between the air pressure in the cabin and those in the frontal sinuses.

The exact cause of airplane headaches remain unclear, but it’s likely due to several factors such as the shape of the sinuses, as well as the speed of the aircraft, cabin pressure, and even the maximum altitude reached.

How to prevent airplane headache

We read a lot about it and the most common ways to prevent airplane headache are:

• Stay hydrated before, during and after your flight;
• Chew gum – this would help while the cabin pressure is changing;
• Avoid alcohol (especially wine) and caffeine – these two can trigger the headache;
• Take sinus medications – some spray, nasal cream should help before the flight.

So have you ever experienced an airplane headache? What was it like the first time you had it?

Update (January 2018): Since that time we never experienced airplane headache again. Our flight routine now includes chewing gum as fast as possible on take off and landing, and staying hydrated during the flight. We noticed that a pain occurs when we have a mild cold so it better be treated before flying.

Get insurance when you travel:

Written by Maria Stoyanova

Travel blogger and tourism graduate from Bulgaria, working in the field of Digital Marketing and PR for travel brands.

Holiday like a local: 8 Essential Tips

A quick photo walk in sofia, bulgaria, latest comments.

Escape Hunter | November 5, 2014

One thing I had after flights (especially long-haul flights) was eye ache accompanied with headache. The jet noise can be bothering on long flights.

Dx | February 22, 2017

I had airplane headache every time the plane is landing, especially in the airports near the sea or big lakes. It starts from the left or right ear and move above to forefront or right in the eye. It is very paining, terrible. I feel like stop breathing.

Phil Bickel | November 29, 2021

Just had this happen, I’ve had three Thoracic surgeries and a compound fracture, but I’ve never experienced pain like this. Steep descent into Atlanta at a very high rate of speed, honestly felt more like crashing than landing. The Air brakes were extremely long and loud. The pain was above my left eyebrow, felt like my head was going to explode. My wife was freaking out.

Yes, I never want to go through that again.

Jay | October 3, 2022

Had this once landing in Turkey 2017. Plane dicended pretty quick had a sinus infection at the time. Felt like a sharp nail was hammered into my forhead. Had the sharpest most intense pain ever. Took a few hours to go after landing

Just came back from Punta Cana today and OMG it happened again. Again Had cold like symptoms possibly a sinus infection again. As I reached Gatwick on landing plane dropped pretty quick and POW had what felt like a 10inch nail railguned into my forhead behind my left eye. Struggled to balance the pressure. Tried chewing sweets, holding my nose and mouth closed to force air out ears. Could only pop ears on right side. Horrible experience, had a good read online today. Seems its a combination of plane speed, drop in altitude, canin pressure and having vulnerable sinuses due to cold or sinus infection. I’d recommend a decongestant before flight nasal spray, blowing tour nose a few times could help. Or just wait it out till you land and doors open. The pain will make you pray to a god or all of them for it to stop I know I did lol.

Hope this helps.

Anthony | March 20, 2023

Phil I literally just had the same happen to me landing in New York. Freaked me out especially since I’m flying alone.

Charlie S. | July 14, 2023

I was landing in Sardinia today and I had it, about an hour before landing I woke up to the feeling of being stabbed by needles in the forehead above my left eye, I then checked my phone to see any physical damage, as I honestly felt that my skin was tearing apart. For about 45mins to an hour it was excruciatingly painful, and then when I was driving from Olbia to Porto Cervo it was painfull to tough my head, though not the same as before. Within 2 hours I was sound. But when it hit I felt that my head was going to explode.

Roger Fitzgerald | February 11, 2023

I experienced this for the first time yesterday after a short flight from Sydney to Melbourne. With 4 minutes to arrival, I had this stabbing pain over my left eye which seemed to get worse if I put my hand over it. It was scary. My left eye watered and I thought when I wiped it dry that I would see blood on my hand….it was like something had popped in my forehead and was trying to force its way out. This morning, a good 12 hours after landing, there’s still a dull pain and I now know, from all the reading done on this, that I’m not the only one that this has happened to.

pankaj | June 11, 2023

That’s terrible to hear. hope you get a chance to try some remedies listed on this blog.

ian croker | April 15, 2017

pain is horriffic landing in bangkok last week i busted the blood vessells in both eyeys real scarey 6th day starting to come good

Maria Stoyanova | Author | January 18, 2018

That’s Awful! I hope you are better when flying now..

MIchal | January 22, 2018

Not sure this conversation is still being followed, but… I flew from Vienna to Frankfurt yesterday and as the plane started its descent I had a feeling as if someone was ripping the bone above my left eye out of my head … It was terrible and there was nothing I could do. I had a swollen eye, I could not sleep well and my eyes are still not OK (20 hours later). Although this was not the first occurence, it was by far the most severe. now I can’t wait for my return flight… and a week later I’m flying again… ugh… I’d rather drive.

Maria Stoyanova | Author | January 22, 2018

I’m sorry it was that bad. Try to research some ways to fight it or consult a doctor next time you fly. Wish you best!

Aeropain | June 7, 2022

I have the same sharp pains in the temple area and needles in back of the eye.

Only happened while descent, so i Lean forward and bend my head – brace position as if we gonna crash, works like magic. all the pressure stays in sinus levelled. try this on your next flight along with your other routines.

Carl Brown | March 27, 2021

I experienced it years ago and have been scared to fly again, the pain was so terrible I thought I may have to get help, I was at high altitude not near landing but I’m telling you was the most intense pain I believe I have ever experienced. I was just looking up the subject because I still wonder what it was to this day. Thank you for the info

DC | June 4, 2017

Yes, I just had my first airplane headache and it was likely one of the worst painful experience in my life. I didn’t know what was happening and why. I got a horrid sharp jabbing pain at my left brow/eye area. This happened while beginning the landing (SJC to SAN). It was a very short flight. I was fine until plane started to land. I am a somewhat healthy 60 yr old woman. I will say I had not flown in years, and last year (July 2016) I got a severe sinus infection. I never seem to totally recover to normal. Still experience congestion but no recurring infection. I go home tomorrow (SAN back to SJC) and I’m worried. I will take a decongestion, (12 hour acting) one hour before boarding. The pain is such a horrible one that I don’t know if I ever want to fly again after I get home!

Maria | Author | June 5, 2017

Hey! I’m sorry that happened to you too! It’s an awful feeling. One of the small tips we received was to chew a gum very fast when the plane is departing and landing. This will release the pressure a bit. Good luck!

DC | June 6, 2017

The decongestant worked! I took about one hour before flight. I also drank lots of water, and ate the peanuts they offer. I didn’t have gum.

Margaret | March 5, 2023

Many yrs ago I went to Ibiza flight there was great but coming back home on descent I had a horrific headache and felt like the pressure behind my eyes was so strong my eyes were going to pop out my head! The headache and pain lasted a week with the severe headache not going away, I couldn’t get my ears to pop I have never flown again I’m too frightened to experience it again

Elaine | June 27, 2023

Horrible jabbing pain through my forehead Wow coming down from altitude. I was so scared. Never experienced that pain before in my life. Makes me not even want to fly again

DC | June 7, 2017

The decongestant worked! I took one hour before flight. No headache and felt just fine during descent from 40k feet. I was also careful to drink lots of water.

Maria | Author | June 8, 2017

Great to hear! I’ll also keep that in mind though we didn’t had any other problems since that one. But you never know! Happy for you and thanks for the advice!

Anne Davison | December 29, 2022

I had a similar experience a couple of weeks ago…Flying to Gran Canaria..About 20 minutes before landing I started to get a pain in my head and behind my left eye..Gripping the top of my head to try to alleviate it..Gripped my husbands hand as tight as I could..Just praying for plane to land..I felt like my brain was exploding..Never had pain like it..headache where around the brain but this felt like it was inside my brain…I thought I’d had my chips! Headache lasted for hours after…Experienced it coming back but not as bad.

Jb | August 27, 2017

Never heard of it..until yesterday when I experienced it. I jumped up and said’ do you guys feel that’ and waited for oxygen masks to drop. Thank goodness people have shared this online. Thank you…I’m drinking water now…chewing gum and ready to take a nonsteroidal anti inflammatory drug..like ibuprofen…and nasal spray …as I am boarding to go home soon. Thanks for sharing may we never experience this again.

Hiba | November 20, 2017

22 yr old female who travels a lot. just recently starting to get airplane headaches – they usually last 40 or so minutes before landing and then intensify dueing landing. It’s an extremely sharp stabbing pain. I was worried i was popping some vessels in my brain the first time it happened because it was such a sharp pain I head never expierenced in the front area of my left side forehead and then the right eyebrow area. It stops as soon as we land. Was hoping to find something to help it, I’ll definitely try more water and gum.

Maria Stoyanova | Author | November 21, 2017

It sounds very scary. In our case the pain was also very very sharp and worrying. But it continued even half an hour after landing. Gumand water helps a lot to balance the pressure in they sinuses.

Shay | June 18, 2023

My brother and I both get them the only thing I haven’t tried yet cause I just found out about them today after my flight And getting a pressure migraine air plugs for the ears…… my brother swears by then…. The first time it happened to me I thought I was having an aneurysm. I didn’t know anything about these kind of headaches I have had migraines, but the one on the airplane that I get every time the plane is going down to land that is the worst migraines in my entire life… hope this helps.

Jay | December 3, 2017

Just had one a few hours ago. Felt like something burst above left eyebrow. Really painful And actually passed out. Scared a lot of PEOple on my flight! Including my pregnant wife!

Maria Stoyanova | Author | December 5, 2017

I was also scared when this happened to my friend. It was awful! But then we read about it and realized it was a thing… I’m glad it all passed away. We now know what to do when we travel by airplane

Pankaj C Pandit | March 14, 2019

I have been experiencing the pain often during landing and what i have started doing when it feel like its hitting you, immediately tilt your head backwards and look up until the pain resides.

Ronaldo Marcelo | May 27, 2023

Olá Bem nunca havia acontecido antes, depois de 17:30 minutos em um voo de São Paulo a Dubai, com o Boing já abrindo trem de pouso com cintos atrelados, senti uma compressão no centro da cabeça um dor muito forte e intensa, oarecia que meu cérebro iria sair do crânio, dir muita dor eu olhava as ósseas ao redor tidas estavam normais, a dor durou até o pouso do avião e depois desapareceu como do nada. Foi uma exoeruencia muito dolorida e estranha, pois a namorada tomou vinho e café e só eu tive essa experiência, eu já acredito no sobrenatural por estar em lugar de muita maldade estava co. Destino final para Israel fazendo confecção em Dubai.

Ashley | January 4, 2018

Thank you for sharing this! I have had about 4 airplane headaches in my life. (Oddly enough two of them happened in thailand and i noticed another commentor had one in thailand. I wonder if there’s something about air travel in thailand that triggers them) The last time i got one, i had a glass of wine before. now i definitely wont be drinking wine on a flight again! These are so terrifying. I honestly thought i was going to die last time. I’m getting on a plane tomorrow, sO i will try these tricks. Thanks!!

Maria Stoyanova | Author | January 5, 2018

I’m sorry to hear. I was so scared sitting next to my boyfriend when it happened. But chewing a gum really helps so you should try it. We do it on every plane and as fast as possible on take off and landing when the pressure is high. Good luck!

MERCY | January 18, 2018

I HAVE HAD A FEW OF THESE HORRIBLE PAINFUL EPISODES I DO NOT WISH THIS PAIN ON MY WORST ENEMY. IT IS A PAIN THAT FEELS LIKE MY EYEBALL IS GOING TO POP OUT I HEAR LIKE CRACKING NOISE IN MY HEAD ALL I CAN DO IS CRY, I CHEWED A WHOLE PACK OF GUM, I YAWNED THE WHOLE DESEND UGH HORRIBLE I TELL YOU… I ACTUALLY HAVE A TRIP 11 HOURS TO ISRAEL IN 2 WEEKS AND I REALLY DO NOT WANT TO GO BECAUSE OF THIS HORRIBLE PAIN I HATE TO TRAVEL BECUASE OF THIS EXCRUTIATING PAIN…. UGH SCARED TO GO THROUGH THIS AGAIN…. I WILL BE TRYING THE DECONGESTING MED AND CLEANING OF SINUSES TO SEE IF IT WORKS.

That is awful! I hope the meds work. The pain occurs differently in people, I haven’t had it that bad…

teadel | January 24, 2018

I AM GLAD TO KNOW THAT I AM NOT ALONE IN THIS. Had my third episode of the headache yesterday, during a 1hr flight. the pain was terrible (stabbing, shooting pains). I was chewing gum, just before the pain started; but i had to stop because of the pain. it started from the right ear and spread to my entire head and jaw, including my tongue. i felt like my breathing was going to stop. it occurred 19hrs ago and i still feel the discomfort. in addition, i feel kinda drowsy. guess it would get better. thank you for sharing your experience

Maria Stoyanova | Author | January 24, 2018

I am sorry to hear that! Sometimes, gum doesn’t help me too… Did you have some migraine or mild cold when you got on the plane?

teadel | January 25, 2018

Just recovered from mild cold. guess that could have responsible.

Maria Stoyanova | Author | January 25, 2018

It might be…

hello I took a flight to Dubai lasting 17:30 minutes, when the plane was flying over the airport to land, very low I started to feel a severe headache in my skull, it seemed that my brain was being ripped out of my skull, I looked at The sides and people were normal, as for coffee and wine, most people had taken it, I don’t know, I just know that my destination after the connection would be Tel Aviv Israel. I don’t believe it was something caused by the flight because I had traveled to Mexico Canada Portugal Spain France and Ukraine and nothing happened after that. I believe in the supernatural

Susan | January 30, 2018

My husband has had around 3 of them until i researched it. His last flight was one year ago and we did decongestants a few days before every day, 24 hours prior did advil and the morning of did advil, did nasal spray right before flight and prior to landing and finally drank two waters before flight and water during flight, He felt good. flying again next week and will do the same thing praying it works becuase to see him in this pain is so scary. i feel for you people that this happens to. Good Luck

Maria Stoyanova | Author | January 31, 2018

I am glad he was okay after those! I had my last flight a few days ago and I had a mild cold so I used nasal spray right before the flight. It helped and I didn’t had a pain. Good luck with your next flights

RObert | February 12, 2018

Hello folks, I’m also a victim of this unfortunate situation ! I Flew to N.Y and for the first time felt this super scary felling … than again fLying to CHicago and lastly to NOrth CaRolina, which has resulted in driving back home rather than flying. I tried all the remedies stated on prior post but nothing works! Any advice ??

Maria Stoyanova | Author | February 13, 2018

Maybe the best thing is to consult with a doctor?

I am no sinus expert but this simple trick has been working for me lately. During descent, whenever you feel that its going to hit, immediately tilt head backwards and look up and breathe through nose but can keep mouth open. Continue looking up until you think its safe.

angela miles | February 18, 2018

I am flying soon, and will get some decongestant, but my headaches have been happening well after the landing. on our last 3 holidays i’m getting headaches a few hours or a day after landing and they last from 15hours to 36hours. I’m trying to see if they are linked to the flight or I’m just headache prone. its not much fun for my partner.

Luz | April 1, 2018

It always happens to me when landing the last 20minutes. The pain is so bad i want to Cry. 1st time it happened i thou i was going to die. I will try the recomendaTIons Later.

Sued Murtaza Ali Rizvi | April 27, 2018

Great literature. I am doctor and specialist in internal medicine. I suffer every time I travel by air. 10 years ago I went to eye specialist for this flight headache problem he said it’s because of pressure difference and take chewing gum before takeoff and landing. Pain is severe even I hit my forehead with punches, terrible

Maria Stoyanova | Author | April 27, 2018

Sorry to hear you also experience this problem. For me, it’s worse if I have a mild cold when I fly. However, the pain was not as bad. Hope you don’t have any problems in the future.

Hemanshu | September 19, 2021

I have severe pain while landing especially 40 minutes before landing and my head and eyes pain so much that I feel that they will bust. Its untolerable. Especially the eyes and head. I have 14 hours flight next week. Is it correct that we should not consume any liquor in the flight

Lèboo | May 16, 2018

I have been flying between Johannesburg and Durban countless times but yesterday, as soon as the plane started it’s descent, I felt a very sharp pain just above my left eye and honestly, it was unbearable. It felt better after landing but did not completely go away. 12 hours later I still have episodes but not as intense. Also, my left nostril is now blocked and I can’t fall asleep from the pain invoice the eye

Ebin Abraham | May 18, 2018

I had this airplane headache twice . It was like something moving inside my head from my right eye to my forehead AND I realised Alcohol is triggering this horrible pain especially whiskey . I’m 25 years old .

HenryJR | June 21, 2018

I got my first Airplane headache 3 years ago. Before that, I never experienced it. The first time I felt it, I thought I got heart attack / stroke / something. I was panic. When the airplane decreased the altitude (mostly an hour / 30 mins before landing), I had pain around my left eye (above my eye brow). It felt like someone stabbed my left eye brow with needles and burning! I was dealing with this pain for 30 mins, and gradually gone after landing. It happened again on the second landing.

I did research on the internet about what I experienced, and seems like it is kinda rare (not alot of people experience this airplane headache).

I am still experiencing this, only on my left eye brow. Now, I always bring a nasal spray and use it an hour before landing. It helps alot. Sometime I don’t feel the pain during landing. Even if the pain occurred, it doesn’t hurt that much as before.

Maria Stoyanova | Author | June 21, 2018

Hey Henry, sorry to hear that you experienced it too. I only had minor pain due to mild colds. But I was also panicked when my friend had a strong one during landing. I am glad to hear that the nasal spray is working. It is a bit of relief.

Heet | August 27, 2018

When I experienced this terrible pain for the first time, I was clueless about the reason behind it, thought that something might have been wrong with me at that particular time, but then I started experiencing this frequently while travelling by air. This is not just related to air, the first time I experienced this pain was when I did scuba diving. So the change in pressure is definitely the biggest factor to cause this pain. I have also googled a lot but no strong biological reason has been found yet. I will try Chewing gum next time for sure, as being hydrated didn’t help me recently. Lets hope we get a permanent cure to this horrible pain.

Maria Stoyanova | Author | August 27, 2018

Hey Heet, sorry to hear you’ve experienced it so much. I hope next time it will be better.

Jay | August 27, 2018

This is definitely triggered by colds. I travel for work and as such fly regularly. never had this happen, although I used to get ear pains until I learned to hold my nose and gently pop my ears. Had a cold over the weekend and was flying back from Dallas to Atlanta when it hit suddenly. Think I passed out as well, but it felt better once we landed. Got it again since I was back on a flight a day or two later. This time once I tried blowing my nose, I could feel the pressure escape suddenly through my nostril and the pain immediately subsided. Little tip for those suffering this due to colds.

hannah | September 30, 2018

I suffered really bad from this kind of headache, first whilst descending into Kefalonia, and then the whole journey back to England. The pain was so severe I was close to screaming, and had to hold the palms of my hands into my eyeballs. I couldn’t stop crying.

I would have rather of been knocked out!

Gillian | October 4, 2018

Hi, i think i have it, now five days after flying. Flying back from Turkey on descending to Manchester Airport i got sharp pains shooting across my forehead lasting 2 hours, got home took painkillers. Next day still head ache took 2 pills eased off. Sunday and monday the same. Tuesday woke up at 6am with the same pain took pills didn’t go and took more pills eased off but still there all day. Wednesday today as been the same as Tuesday and still here at 22.23pm. More pills before bed. First time this as happened to me and on a short flight as well. I have done long flights , no problem. Maybe cause i am older? i don’t know. I wish it had only been for a couple of hours.

Jonard N. Dicdican | November 7, 2018

I observe that I always feel this sharp and throbbing pain every time the plain starts to descend. It usually starts in my neck, then the back of my air until my ears pop, and crawls unto my temple and in front of my forehead and eyebrows. I just flew hours ago and I still have the pain for 8 hours now. It becomes severe when I tilt my head and sneezes. I can’t work very well because the pain is still there. Thanks for this article. It might be useful for my next trips.

karen | December 2, 2018

About a month ago we flew from Johannesburg to Buenos Aires, first landed in Sao Paulo. The last 30 min of the flight,when the plane started descending I felt this severe pain above my left eye on my brow,. it was burning like hell..i thought i was having a stroke!!!! After landing it disappeared, but the area above my brow stayed tender to my touch. After 2 hours we flew to Buenos Aires. The exactly same thing happened when the plane started descending. This time I knew I was not about to die!! It also worsened in intensity, my left eye started watering as well and my nose started running. And when we landed it was over. It was one of the worst experiences in my life!! After a day or two I did some research..and read somewhere you have to chew gum.I wasnt looking forward to the flights back home. So I chew gum on all my 3 flights back home and thankfully it did not happen again!!!

Daniel | December 29, 2018

Glad I’m not alone. This has happened to me about 10 times. The best way to describe this is someone slowly dragging a knife across your forehead. You can feel it come up both sides of my neck, and waves of violent stabbing in my eyebrows. A few times were so excruciating I couldn’t even cry. I just put my hands to my face and accepted my death. The pain was a 10/10. Like cutting off your finger.

After that, I got these earplugs called “ear planes” and they stay in the entire flight. Hurt your ears a bit if the flight is long. But the pain is only a 7/10 after using them. Still feels like I’m being sadistically tortured as I’m sweating, but it’s the best I can do. Now it happens 50% of the time. I just can’t believe no one knows about this!!!

Pamela corbett | May 22, 2019

I flew from Liverpool to isle of man and as soon as I landed I got a headache , it feels like a brick on my head ,I’ve had it ever since, plus am scared of flying ,any suggestions

I don’t like flying but we flew from Liverpool to the isle of man ,as soon as we landed I started with a headache , it feels like pressure on the top of my head and still have it now 2 weeks later . I also suffer with sinusitus. Any suggestio

Kelvin | August 10, 2019

I started experiencing airplane headache about 5 years back. Prior to that I never had any problem on flights. The first time it happened, the flight was descending and preparing to land. I still remember the intensity and the sudden onset of extreme pain. I would rate it as 10/10 as well to the point of you feel like banging your head to distract from the pain in between your eyes. The intensity reduced once the plane landed however there is still residual dull pain (variable about 3-5/10) for the next couple of days and eventually gone. But it created the fear of flying due to not wanting to experiencing such pain again. It persisted a couple more times after that and pain meds didn’t help much. Later on I learnt how to scuba dive and they taught how to equalize your sinuses and eardrums as you descend into the water. I use the same technique to equalize my ear pressures and to date I have never experienced airplane headache again (fingers crossed!). To those who suffer from airplane headache, perhaps try this method and see if it works! Google around to learn about equalizing pressure. Chewing gum and swallowing your saliva are some of the simple techniques but read up on those used in scuba. It may work for you as well.

Maria Stoyanova | Author | August 25, 2019

Very good advice! Thank you for sharing.

Greg | September 14, 2019

I get them occasionally on landing, last about two minutes. So bad I usually give the person beside me a heads-up and not to be concerned when they see me distressed. I suffer from mild congestion and sinus problems anyway. I assume the low pressure at altitude let’s the gaps between the little bones and cartilage, or whatever make up the sinus area, increase and expand and fluid fills the gaps. Returning to high pressure at ground level begins to compress everything back to normal causing excruciating pain. Will try the tilted head trick. Not sure if cabin pressure at altitude varies between airlines? I presume maintaining a high pressure is more expensive for them.

Victor | October 3, 2019

Thank you for this post. I experienced this for the second time yesterday. It was as if there was something exploding in the left side of my head, there was sharp pain in the left eyeball, it felt as if it was about to pop, then it got teary. The pain was unbearable and diminished slowly. I might have appeared to others I just got emotional, but I wished there to be some medical help in the airport. But there wasn’t anybody to approach at that late hour.

Bryan Wrightson | October 3, 2019

I had my first airplane headache last year flying to Sardinia. I honestly thought I was going to die, the pain was so bad. Like a lightning strike in my brain. Coming home no problem, then two weeks ago flying to Greece I had another episode as the plane started to lose altitude and the pain was all on the right side of my head right down into my jaw. Pure agony. Thanks for your research Maria, Sounds like you’ve found the cause with the sinus solution. I’ll try everything and hope for the best! Ps. I have no after effects and the pain lasts only an hour or so.

Ali | October 7, 2019

I was on a flight from Dubai, to Manchester. Upon descent I had felt a slight tickle on my left eyebrow, until suddenly I felt like my life was going to end due to the severe stabbing pains I was experiencing. Crippling facial paralysis I could describe it as, with jabbing pains. I did not even think to try chewing gum, blowing nose, or using a nasal decongestant I thought I was having a brain aneurysm.

It is quite interesting how so many peoples stories are so similar, in terms of pain still lasting post-flight, as well as the locations on the face people have described where the pains start. I would like to mention however, stress may be a likely cause as I was having severe episodes of stress prior to my flight, as well as potentially not having a fully cleared up mild cold I contracted.

I will definetley ensure to try the gum trick, and blowing nose. I believe my other potential factor that caused this was poor neck posture, as well as sleeping as the plane was landing which was a terrible idea. I have really been put off from flying back home, but will ensure to have a friend or family with me next time I fly as I was alone, and thought I was about to die.

Vicky | October 26, 2019

I have this most terrible headache about 45 minutes into the flight. The pain is located on my left brow area and behind my eye, the pain is so severe I can barely speak and lasts until the plane starts to descend. My symptoms seem to be the same as other fellow sufferers have experienced on landing, but lasting the whole cruising altitude. I have had scans that show nothing abnormal and pain killers don’t touch it. Would be interested if anyone else is familiar with my symptoms. Really don’t want to give up travelling!

Jen | February 3, 2020

My husband, avid traveler since he was a very young child, just had his first airplane headache in December 2019 on the way from Orlando to Montreal. Same as many, it suddenly began as the plane began its descent. Over the left eyeball. He couldn’t even talk; could only hold his hand to his head and try to breath through it. By the time the plane landed he could talk again but the pain was still there for about another hour, but much reduced. We had a connecting flight from there and, upon landing in Vienna, he experienced a milder form of the headache again (although nothing at all like the first one). Luckily did not experience anything on our return flights at all. Thank you all for your advice and, like the others, for validating this is a “thing” that happens.

Dorcas Paul | February 10, 2020

I just stumbled on your article,i am about to catch a flight and the fear of experiencing the headache again got me researching.I had the headache for the first time on the 27th on December 2019, i had to experience it twice that day because i had a connecting flight. It was terrible, i felt like i was dying. The Pain i had moved from the back of my neck, into my head. I honestly thought that was my last day on earth.

Passion | March 23, 2021

I’m also here to share my experience with flight headaches. I have bad sinus problems but I remember before my flight to Houston I took allergy medication and was well hydrated. The return flight omg I thought my life was over. 30 mins before landing in Orlando I woke up from my nap and sneezed like 10x and right after my left and right ear was stuffed. I couldn’t hear anything but crackling…. oh but that’s not the worst part above my left eye it felt like a giant was crushing my scull or better yet like I was being stabbed with a knife slowly. My eyes was pouring with water and snot was pouring out of my nose. I had to take my palm of my had and press above my left eye. It lasted until I got of the flight. I had a headache all the way home. Went away and came back again. Now what I did notice reading other ppl comments was 1. I had a drink before the flight and had been drinking the whole time with hardly any H2O… so that was a big no! no! 2. No gum 3. I forgot to take my allergy medication I really do feel that having real bad sinus or even a cold plays a major part in what is happening. This was my first experience and I fly a lot. This headache literally scared my to death! I cried the whole time and had a panic attack. The pain I wouldn’t wish on my worse enemy. I’m really thankfully for the information I read and will try next time so hopefully fingers cross it works.

Teri Stover | April 17, 2021

I have had several of these airplane headaches. Always on the decent. Absolutely terrifying. I have found a formula that helps. I take 2 Aleve gel caps before boarding. They are good for 12 hours. About 2 hours before the decent begins I take migraine medicine, either Maxalt or Imitrex. One hour before landing I use a spray decongestant and chew gum. Hope this might help some one else. These headaches make you never want to fly again!

Raneca Lee | May 20, 2021

I am so happy to see this comment section. I always wondered why I’m the only one on the plane dying of this pain and everyone else is just fine. This has happened to me wayyyyy too many times . Almost every single time I fly. I’m lucky if it doesn’t happen. I’m definitely scarred by this. My last flight a week ago, I could feel the pain working up in my head but it stayed in my ears. It was excruciating. The time before, it began in my eye. But it always ends in my head. I describe it as something bursting in my head. It lasts up to 2-3 hours after I’ve landed usually. I’m going to try the nasal spray and decongestant. I pray this helps because I have a flight in a couple weeks and I’m absolutely not excited about flying due to this pain.

Alisa | May 27, 2021

It’s actually relieving to see this many comments with almost the same symptoms as me. In my years of flying this never happened to me. I was coming back from Las Vegas even on the flight there this didn’t happen. We got sat at the end of the plane and when it was descending I thought I was having a stroke. The left side of my face felt like it was drowsy and just melting and it felt like my brain was swelling up so big that my skull was going to explode. My left eye couldn’t stay open and had pressure on my eyelid that it was shutting and opening back up by itself. My scalp when I touched the left side of my head it stung like needles being shoved into it. I felt like screaming and I couldn’t breathe I hid my face so the person next to me didn’t get scared but it was probably the worst thing I felt in my life I felt like someone was stabbing the left side of my head repeatedly and pulling my hair out. I have a flight in two weeks to Cancun and I’m so scared I’m going to use these tips and go to the doctor to see what he can do about me not having to seat at the back of the plane. It’s the worst thing I’ve ever felt in my life. I would give up traveling because of this type of pain.

Jim | July 5, 2021

Hello. Thanks for this site.

Yesterday was the first time I experience an airplane headache. It is interesting how it seems to appear on the left side behind our near the eye on almost all who have posted. Mine was the same and it was the worst pain I ever felt. Like someone stabbing me in my temple through to the back of my eye on the left side.

This was the second flight I took that day. My first flight was from Detroit to New Orleans. Normal flight no problems. The second flight occurred 3 hours later after layover, from New Orleans to Tampa. Upon descent in Tampa is when it happened.

Thanks for posting this on your blog. I will try some of the suggestions like sinus medicine before a flight.

I hope I never have that happen again.

Mina | July 27, 2021

Hey hey, Thank you for all the information! I experienced this for the first time recently coming home from New Zealand only about two weeks ago. It felt like my brain was going to explode out of my ears, I couldn’t yawn or cry it was that bad.. genuinely accepted death, I just held my head and dealt with the the pain sweating and screaming inside 😐

When I was able to yawn eventually, I heard a very loud high pitched noise out of my left ear, cut my yawn halfway through because I got scared. My head was sore after the flight landed. I did chew gum, but at that stage in the pain I think it only distracted me a little bit and gave me hope that death was not going to take me mid-descent in a plane full of random people.

The plane did drop suddenly at one stage and I was a little bit sick, my nose was blocked so I think that’s maybe why I experienced it.. I will most definitely try the decongestants next time regardless of if I’ m sick because the pain was so horrible I’m afraid to experience it again.

Thank you for all the comments, I didn’t understand why it was happening or if it happened to other people, this has given me some peace of mind.

Thanks again ya’ll !

Brian C Free | August 3, 2021

I’ve experienced this 3 or 4 times in my life, but I believe that it never happened before I turned 40. I’ve been on hundreds of flights and can’t seem to find any pattern as to when it happens. Most recently, I was landing in LaGuardia (New York) on an early morning flight, hydrated, hadn’t had any alcohol, no allergies, cold, or sinus issues. Same as many others- stabbing behind the left eye and through the eyebrow. I imagine this is what a stoke feels like and it scares me every time. There was residual pain for several hours and I finally stopped at a drug store to get some acetaminophen, which helped. The flight back to Columbus, Ohio two days later was fine. Fortunately, the comments on this list seem to indicate that (1) I’m not unique in experiencing this and (2) it probably won’t lead to having a stroke or ruptured eyeball. I’ll be trying some of the suggested remedies in the future. It is scary to think that this could happen to pilots- it is unpredictable and completely disabling.

Betsy Hartsock | August 11, 2021

I have been flying all over the world for over 40+ years and just 2 months ago started to experience this piercing pain above my left eye. I thought to myself “is this what a blood clot is like”. It happened on 3 different flights only while in descent. I decided to google the issue and found this site. I am happy to know that I am not alone. I will try the recommendations posted.

Kcy | October 20, 2021

I felt a serious sharp pain while on the plane today, unfortunately the more I Rob it the more severe the pain was.

Anthony | January 13, 2022

Hi all. I’ve dealt with this for a few years now, on plane descent you get the sharp stabbing pain right in the middle of your forehead that starts making you panic.

I have found something that works for me to STOP IT EVERY TIME. The instant I start feeling the pain, I squeeze my nostrils with my hand to “plug” my nose and then try to blow through my nose while it is plugged. It relieves it instantly, and I think it has something to do with equalizing the pressure in your sinuses.

Hopefully this works for others!

George | February 4, 2022

This article has helped me a lot. I’m doing a 3 hour flight in 2 weeks and I’ve been getting increasingly nervous about this happening to me again. The first time was awfully scary.

It has a name: Aerosinusitis or Barosinusitis. There’s an article of prevention techniques here: https://chroniclesofwanderlustdotcom.wordpress.com/2015/01/08/aerosinusitis-how-to-prevent-it-from-ruining-your-travels/

And there’s some aviation ear plugs recommended here: https://www.amazon.co.uk/EarPlanes-Reusable-Earplugs-Tether-Pilots/dp/B01A5STDAO/ref=sr_1_5?keywords=earplanes&qid=1643928230&rdc=1&sr=8-5

Matt | April 24, 2022

It’s happened to me a few times. Very very painful sharp pain. Holding my nose and blowing out helped alleviate it for me.

Jill | June 6, 2022

This happens to me everyone time i fly home (Orlando) this past time, literally 15 minutes again was one of the worst times. SHARP, STABBING pains in both temples, across forehead, back of my skull, and down the sides of my neck. It’s like having needs stabbed into your head/face. All i could do was close my eyes, try to breath and pray the pain didn’t get worse. The pain was so bad i was seeing flashes while my eyes were closed. I was worried i was going to pass out. We have a tropical cyclone warning currently, I think that’s why it was so bad this time. It makes me hesitant to fly in the future.

Raymond | June 7, 2022

Mine happened just yesterday and that’s the reason i came to research about it before seeing this page. Although not the first time its happening to me but this recent one was far more severe than I have ever experienced. It felt like my head wanted to explode and the right side of my head was feeling like something its trying to pull the bones there, its such an excruciating pains that even this morning i am coughing out blood and my ears and still wobbling, with distant headache still hanging around. I really hope this gum tricks works and i also found out its worst when you seat close or at the wings of the plane.

wendy christiansen | August 3, 2022

My son first had one of these when he was 7 and was the scariest thing ever as a mom, as his eyes were rolling back in his head from the pain and thought he was going to passout or worse on the flight. He texted me today, at age 23, and said I had the same headache when I was a kid and it was so excruiating, unbearable. I didn’t realize it was a thing when he was little….now I do.

SArah | September 2, 2022

I am 50 and I have been travelling for many years also on long-haul flights and recently started having this. It is like a sudden stab in the face, it is so awful and scary. I talked to the flight attendant and she gave me the same advice, use nasal decongestant 1h before landing. I have noticed that when it happened I was sitting at the very back of the plane. Not sure if buying a front seat may help. I will try, I do hope these remedies work as it is scary.

Cynthia | September 7, 2022

I experienced my first airplane headache flying from Atlanta to Indiana. It was awful. It felt at first like an ice cream freeze and continued on to deep pain. It lasted Half of flight getting worse. The pain eased at the end of the flight but I had pressure for 24 hours after. I became nauseated . Thought I was having a stroke.

Marty | September 16, 2022

Oh my goodness, this happened to me this evening for the first time, it happened as we started to descend. It was so painful and can only describe it as a stabbing, burning intense pain on the left side of my forehead and left eyebrow. My eyebrow was forehead as so painful to touch, like the skin had been burned. I can only describe the pain as like something had burst under the skin. I thought my face would be bruised when I landed. It was the worst pain I’ve experienced in a long time. It lasted approx 20 mins and then eased off when I landed. I took some paracetamol but can still feel niggling after pain. I genuinely thought I may have been having a stroke or brain bleed. I’m glad I came across this article which seems to explain my symptoms. I’ve never experienced this before on a flight.

CJ | October 16, 2022

My first experience was when descending into the Bahamas. It felt like a blowtorch to my forehead, and I was so alarmed. I was attacking my forehead like I was being stung by bees. The intensity stopped when we landed but the pain lasted for two days after. Now I take allergy and decongestant meds about 1.5 hours before decent and chew gum. Never again…

Danica Ivanoski | November 3, 2022

I had no idea that other people experienced this…. I am 44 and this was the 1st time I have had this AH on a plane! I thought I was having a stroke and I will die before we landed! I suffer from migraines, but this was worse! Sharp pain in my left brow area and all left side of my face. Teeth, ear, cheek… It went away after we landed. But I think it was triggered by my congestion as well as 2 glasses of wine before the flight.

Eleazar | December 10, 2022

I had the same headache reall bad my head wanted to blow up coulntd even touch it….I thinck it has to do with a cold and stuffy nose that’s why it happens …

Any one was sick when it happend..

Mckent | December 11, 2022

I experienced my second time just yesterday, the first time I had it was 3 years ago. It was scary for me because I’m the type who doesn’t get migraines, so I didn’t know if it was a migraine or not, I thought I was having paralysis or stroke, or cardiac arrest. I tried calming down and monitoring my breathing and pulse. It was worse than the first time, It started near my right ear and spread through the backside of my head, I could feel the pain branching out into specific regions inside my head and the back neck area. My throat was dry and it was hard to gulp.

Tej | February 17, 2023

Pain was unbearable, it makes me want to never fly again! This great information and will keep your prevention treatment.

Petri | May 15, 2023

Thanks for this site and user comments.

I feel that I also have to share my own story.

I had flown dozens of times and never felt any pain when the plane landed. About 5 years ago I experienced a headache for the first time when the plane landed. Sometimes the pain was really bad and sometimes there was no pain at all.

Last week when the plane landed, the pain got so bad that I finally lost consciousness and woke up when the plane was on the ground (I was unconscious for about 5 minutes) When I woke up, I was drenched in sweat and couldn’t see anything for 10-15 minutes.

The experience was really scary and made me afraid to fly again.

I’m going to the doctor tomorrow to examine the matter.. I’ll get back to it if the doctor finds out something.

Melissa | July 25, 2023

I’m late to the plane pain party yall. Just wanted to say I experienced a very tramatic explosive pain experience when landing in NYC today. It is the second time I had pain landing but this time it was so bizarre. Just want to mention I have had 2 sinus surgeries in the past. I have chronic sinusitis and monthly infections as I have oddly shaped septum and deformed sinus cavities (it’s genetic from my father). Get this, the pain was in the back of my neck, shooting into my ear canals and then into my jaw hinges. Like extreme TMJ on steroids. I felt like my brain was being pulled out my ears and my neck muscles were being yanked outward like the oppositeof being strangled, like my neck was going to explode. I was crying and screaming in pain. I freaked everyone out. My husband was not sure what to do. I couldn’t even speak. Almost looked like I was having a stroke or seizure from the way I was contorting in agony. I know why this happened like this though. The pilot was not skilled at landing at all. He pretty much crash landed .. just extremely sloppy and way too quickly on the runway. My pain started 9min from touch down. About 7-8 min of agony. Was not fun and I won’t be flying frontier again.

Etienne M. | July 27, 2023

Hello! It’s been quite a while since I started having these terrible pains 10 to 15 minutes before landing and I couldn’t understand anything since all the other passengers around me don’t suffer as I do such that I was wondering what’s wrong in my body contitution!

After reading your experiences and remedies, I believe I am saved. The day before yesterday, I suffered too much from it when I was chewing one that we landed on Kalemie in the DRC, it is practically on the shores of Lake Tanganyika; and I had already noticed that some areas made me suffer a lot more than others. Now I understand that there is a connection with the sea and atmospheric pressure. I also understand that it could have a link with the problem of nasal congestion because if breathing through the nose is fluid, there will be pressure balance because the air will circulate well.

I’m going to try various tricks on the next flight in August.

Thanks for sharing the experience.

K | September 8, 2023

If this helps just 1 person, I’ll be happy!!

I’ve been suffering with this now for the last 11 years, after many years happily flying, I randomly started to get this debilitating, searing stabbing pain above my left eye (in my eyebrow) on a flight to Cyprus. My eye instantly poured and I immediately wiped, convinced I would see blood. I had no idea what was happening, it was terrifying, the pain quite literally takes your breath away. As much as I love flying, I’m now filled with anxiety weeks before upcoming flights in the fear that I’ll experience this again.

For the last few years, I have been taking 2x Nurofen Express tablets approx 1 hour before landing (or 1 hour before starting descent to be on the safe side). I find that the pain sets in for me anywhere between 20k & 10k feet, especially if the pilot descends rapidly. For the most part, this has worked well & has ensured I do not feel any pain. However, I have noticed that if I am congested or recently had cold/flu like symptoms that the Nurofen doesn’t work & I still get the pain.

I’ve just recently flown Tue 5th & Thu 7th Sept, after reading some of the comments on here suggesting decongestants, I thought I’d give that a go, as a few days before flying I’d started to feel some congestion setting in.

I went to Boots and purchased the Sudafed Sinus Pressure & Pain 200mg/30mg (Ibuprofen 200mg, Pseudoephedrine hydrochloride 30mg), it costs around £8 and is available OTC. I took 2 tablets per flight in total (1 tablet 1 hour before take off & 1 tablet 1 hour before descent). I am so pleased to say these tablets worked!! I was so worried with it being my first time trying them as opposed to my 90% trusty Nurofen, however because I’d been experiencing some cold like symptoms I needed to give this a try & I’m so glad I did.

Along with taking the tablets, I made sure to stay hydrated with plenty of water, I had chewing gum/hard mints when taking off and landing, and throughout the flight I was constantly swallowing to help alleviate some pressure from my ears.

I really hope some of this advice can be of use & thank you to everyone who have posted their recommendations, the decongestion ones are particularly great.

I can only hope that one day we have some sort of cure for this, it’s truly horrific & I’m sorry that anyone needs to experience this!

SATISH MITRUKA | September 21, 2023

Yesterday I was traveling a 2 hour flight to New Delhi.Before 20 minutes landing I had a severe pain above my left eyes.It seem a kind of Brain stroke,and tears rolled downed from both the eyes and the pain was un bearable.However I calmed myself but the pain was there whole day.Today morning their was blood in my cough.I have experienced same thing flying, just after flights resumed after Corona restriction.But,ENT at that time said it was due to wearing mask on flight.Request for proper remedy to it.

Shaz | October 17, 2023

I remember my horible experience 2019 flying on virgin australia from NEWZEALAND to MELBOURNE. my first time experiencing such a horrible pain. this was during take off, horrible painful, stabbing, felt like someone was trying to rip my brains out. for me, the pain was at the back of my head ( behind the ears to lower skull) so painful went for a good 5mins. the worst 5mins minutes of my life. to the point where i kinda screamed in low voice, luckily for my dad that was sitting next to me, he kinda had to full massage and put pressure on the lower back of my head. while i had both my hands covering and adding full pressure to the back of my ears. i was in tears, i was crying like i just the worst beating of my life. hate it. HIGH ANXITEY if i were to fly again….

Alex | October 23, 2023

Trigeminal neuralgia it is. Suffered a lot before I could find any relevant information. Paracetamol or some antispasmodics plus diuretic stuff help me with that.

LEAVE A COMMENT Cancel Reply

Save my name, email, and website in this browser for the next time I comment.

By using this form you agree with the storage and handling of your personal data by this website. For more information check our privacy policy *

• Privacy Overview
• Strictly Necessary Cookies

This website uses cookies so that we can provide you with the best user experience possible. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful.

Strictly Necessary Cookie should be enabled at all times so that we can save your preferences for cookie settings.

If you disable this cookie, we will not be able to save your preferences. This means that every time you visit this website you will need to enable or disable cookies again.

• Pre-Markets
• U.S. Markets
• Cryptocurrency
• Futures & Commodities
• Funds & ETFs
• Health & Science
• Real Estate
• Transportation
• Industrials

Small Business

Personal Finance

• Financial Advisors
• Options Action
• Buffett Archive
• Trader Talk
• Cybersecurity
• Social Media
• CNBC Disruptor 50
• White House
• Equity and Opportunity
• Business Day Shows
• Entertainment Shows
• Full Episodes
• Latest Video
• CEO Interviews
• CNBC Documentaries
• CNBC Podcasts
• Digital Originals
• Live TV Schedule
• Trust Portfolio
• Trade Alerts
• Meeting Videos
• Homestretch
• Jim's Columns
• Stock Screener
• Market Forecast
• Options Investing
• Chart Investing

Credit Cards

Credit Monitoring

Help for Low Credit Scores

All Credit Cards

Find the Credit Card for You

Best Credit Cards

Best Rewards Credit Cards

Best Travel Credit Cards

Best 0% APR Credit Cards

Best Balance Transfer Credit Cards

Best Cash Back Credit Cards

Best Credit Card Welcome Bonuses

Best Credit Cards to Build Credit

Find the Best Personal Loan for You

Best Personal Loans

Best Debt Consolidation Loans

Best Loans to Refinance Credit Card Debt

Best Loans with Fast Funding

Best Small Personal Loans

Best Large Personal Loans

Best Personal Loans to Apply Online

Best Student Loan Refinance

All Banking

Find the Savings Account for You

Best High Yield Savings Accounts

Best Big Bank Savings Accounts

Best Big Bank Checking Accounts

Best No Fee Checking Accounts

No Overdraft Fee Checking Accounts

Best Checking Account Bonuses

Best Money Market Accounts

Best Credit Unions

All Mortgages

Best Mortgages

Best Mortgages for Small Down Payment

Best Mortgages for No Down Payment

Best Mortgages with No Origination Fee

Best Mortgages for Average Credit Score

Adjustable Rate Mortgages

Affording a Mortgage

All Insurance

Best Life Insurance

Best Homeowners Insurance

Best Renters Insurance

Best Car Insurance

Travel Insurance

All Credit Monitoring

Best Credit Monitoring Services

Best Identity Theft Protection

How to Boost Your Credit Score

Credit Repair Services

All Personal Finance

Best Budgeting Apps

Best Expense Tracker Apps

Best Money Transfer Apps

Best Resale Apps and Sites

Buy Now Pay Later (BNPL) Apps

Best Debt Relief

All Small Business

Best Small Business Savings Accounts

Best Small Business Checking Accounts

Best Credit Cards for Small Business

Best Small Business Loans

Best Tax Software for Small Business

Filing For Free

Best Tax Software

Best Tax Software for Small Businesses

Tax Refunds

Tax Brackets

Tax By State

Tax Payment Plans

All Help for Low Credit Scores

Best Credit Cards for Bad Credit

Best Personal Loans for Bad Credit

Best Debt Consolidation Loans for Bad Credit

Personal Loans if You Don't Have Credit

Best Credit Cards for Building Credit

Personal Loans for 580 Credit Score or Lower

Personal Loans for 670 Credit Score or Lower

Best Mortgages for Bad Credit

Best Hardship Loans

All Investing

Best IRA Accounts

Best Roth IRA Accounts

Best Investing Apps

Best Free Stock Trading Platforms

Best Robo-Advisors

Index Funds

Mutual Funds

var mps=mps||{}; mps._queue=mps._queue||{}; mps._queue.gptloaded=mps._queue.gptloaded||[]; mps._queue.gptloaded.push(function() { (mps && mps.insertAd && mps.insertAd('#dart_wrapper_badgec', 'badgec')); }); Road Warrior

Suffer an 'airplane headache' when flying you're not alone.

Body scans, missed connections, fighting for overhead bin space, annoying passengers in flight — there are many things about flying that can make your head pound. But some researchers are documenting yet another kind of pain from air travel, which they call the "airplane headache."

In a paper published online in the journal Cephalalgia, Italian neurologists report on 75 people who suffer from what they describe as a "peculiar headache." It's peculiar because it tends to occur while on a plane and usually lasts less than 30 minutes. It also seems to mostly affect men, and it typically flares up during the flight's landing.

To gather up information about airplane headache, researchers gave people affected by them a written questionnaire. From these completed surveys they found that everyone described the pain as severe. The headache causes a stabbing or jabbing pain that starts suddenly usually on one side of the head. It mainly affects the area of the forehead above the eye.

Within minutes of the plane touching the ground, the headache usually goes away.

As for why airplane headaches occur, scientists think "it's due to an imbalance between the air pressure in the cabin and those in the frontal sinuses," says lead author Dr. Federico Mainardi.

In some people, their sinuses may have difficulty equalizing the increase in barometric pressure that occurs when a plane is landing and this may cause pain, suggests Mainardi, a neurologist at SS Giovanni e Paolo Hospital in Venice, Italy.

The exact cause of airplane headaches remain unclear, but it's likely due to several factors such as the shape of the sinuses, as well as the speed of the aircraft, cabin pressure, and even the maximum altitude reached.

While most of the sufferers in this study had their first airplane headache while they were in their 30s, the attacks don't appear to happen every time people fly.

Airplane headache was first described in the medical literature in 2004, and it was viewed as a rare occurrence. But now experts aren't so sure. "We suppose it's a common condition," says Mainardi, but they've yet to collect the data to back that up.

There can be other reasons for flight-related headaches: Air travelers may get a migraine or tension-type headache from a lack of sleep, stress, or holding their neck in an awkward position during a long flight.

And more than half the participants in this study also appeared to suffer from another type of headache. This raises the possibility that being prone to other kinds of headaches helps activate the pain pathways linked with airplane headache.

Mainardi hopes that airplane headache will become recognized as a new form of headache and included in the International Headache Society Classification , which currently includes more than 200 different types of headaches.

In the meantime, he says that in some cases, taking a non-steroid anti-inflammatory drug, such as ibuprofen or naproxen, along with using a nasal decongestant spray about 30 to 60 minutes before landing, may help relieve or prevent pain.

This article originally appeared on MSNBC.com .

Headache Attributed to Airplane Travel: A Review of Literature

Affiliations.

• 1 Inova Medical Group, Department of Neurology, McLean, VA, USA. [email protected].
• 2 Health Quest Medical Practice, Kingston, 12401, NY, USA. [email protected].
• 3 Inova Medical Group, Department of Neurology, McLean, VA, USA.
• PMID: 29904804
• DOI: 10.1007/s11916-018-0701-9

Purpose of review: Headaches due to airplane travel are rare but documented in the literature. We aim to provide a review of diagnostic criteria and treatment for this condition.

Recent findings: Several cases of this syndrome have been reported since it was first described in 2004. Airplane headache is classified as unilateral, stabbing, orbito-frontal pain, lasting under 30 min, and occurs during ascent or descent of a plane. Patients with this condition can develop anxiety and fear of flying given the intensity and severity of the pain. The pathophysiology of this syndrome is unknown, but theories include suspected barotrauma given changes in barometric pressure during ascent and descent. There are no randomized controlled trials regarding treatment, but case reports suggest headache prevention with pre-treatment with naproxen, decongestants, and triptans prior to air travel. Some non-pharmacological therapies reported include Valsalva maneuvers, chewing, relaxation techniques, and pressure at the pain area. As more cases of headache attributed to airplane travel are reported, epidemiological data can be obtained to further understand the incidence and prevalence of this condition, which can lead to improved treatment options for patients.

Keywords: Airplane headache; Airplane travel; Descent headache; Sinus barotrauma.

Publication types

• Air Travel*
• Barotrauma / complications
• Headache / epidemiology
• Headache / etiology*

10 Useful Tips to Manage Migraines and Headaches While Flying

Written by Greg Bullock on 15th Jan 2018 ✓ Scientific promise

There is nothing worse than being stuck on a plane when a migraine attack hits. You know full well that there is nowhere to go until the plane lands. Worse, when you reach your destination, you need to be functional—not wandering around in a haze of pain with a brain fog that you are unable to shake. In this post, we offer several strategies you can use to help reduce your migraine symptoms and headaches before, during and after your flight.

Pack your medication

This is hugely important. Make sure you have all the appropriate medication packed not just for your migraine but for any other health-related needs. And you should include the medicine you may require during the flight in your carry-on luggage. This may include anti-nausea medication if in-flight turbulence is problematic for you as well as acute migraine drugs that can help stall an attack should one develop.

Try a neck pillow

They may not be the most comfortable, but neck pillows sure beat the stiff seat backs and head rests of most economy flights. They will offer support that can allow you to lean back, relax, and get some rest—and most importantly, keep you from developing neck pain or joint stiffness, which might bring on an attack. Investing in a good travel pillow (between $10 to $30 on Amazon or in many airport gift shops) before your trip is a wise choice.

Wear precision-tinted glasses

Just imagine the brightness coming through the airplane window during a sunset flight and hitting you right in the eye—it does not sound like too much fun, does it? Thankfully, you can use precision-tinted TheraSpecs to help reduce the odds that the bright lights on the plane will trigger a migraine attack. (And they are also great for lighting everywhere else too—offices, grocery stores, etc.)

Turn off the overhead lights or have a sleep mask

You might not be able to control what your seatmates do, but you can turn off your own overhead lights to help reduce that potential trigger. Sympathetic passengers may also be willing to turn off their lights if you approach them nicely. As a last resort, you can find affordable sleep masks for $5 to $20 that can keep all the light out.

Manage scent triggers and bring your own snacks

If certain smells bring about migraines, you may want to consider adding nose plugs or a face mask to your carry-on bag, especially if you are around really strong odors. Tammy Rome at migraine.com found that dabbing a little Vicks under her nose would dull known scent triggers because, in her particular case, she was able to handle the smell of menthol. In addition, you should also plan to bring your own snacks as well. This will not only keep you from going hungry on a long flight, but it will also allow you to manage any specific food sensitivities.

Have your headphones

From the noise of the engines to shrieking children who are not happy about being on the airplane, there are plenty of noises that can bring on the head pain. Wearing headphones (preferably noise cancelling) or earplugs will help block out the sound and hopefully enable you to enjoy a more peaceful flight.

Drink lots of water

An oldie but a goodie. Staying well hydrated can help decrease the odds that you might end up with a migraine, given the penchant for dehydration to be a prominent trigger. This is especially important when you're flying, since cabin air is often very dry.

Relieve your ear pressure

Ear pressure can feel like a vice squeezing the rest of your head—which may quickly turn into a full-blown headache or migraine attack. If you start to notice this pressure building, you can try some of these strategies :

• Take an antihistamine if needed before your flight. This will reduce mucus and help prevent pressure from building.
• Yawn or swallow during takeoff.
• Try chewing a piece of gum or candy during takeoff, if yawning and swallowing don't work for you.
• Pinch your nose and keep your lips closed, then blow gently. This may pop your ears and relieve pressure.

Choose your seat carefully

When you book your flight, try to anticipate your needs. For instance, sitting by the window means that you are in a position to close the shade and block outdoor light from disrupting your travel experience. There may also be an advantage to having an aisle seat or being located in a particular section of the plane (e.g. a section nearer to the restrooms). Ultimately, know your comfort zone, and don’t be afraid to ask the flight attendants and/or your seatmates if they would be willing to accommodate.

Decrease travel stress

Do you know that stress can be a primary trigger for migraines? Do what you can to reduce stress ahead of time. This might include:

• Bringing most of your baggage with you, rather than checking it.
• Leaving plenty of time at the airport to catch connections instead of needing to run—even if flights are delayed.
• Wearing loose, comfortable clothing as well as minimizing jewelry and other accessories that may need to be removed at security.
• Making your travel plans well in advance and checking the details before you head out.
• Writing down any important details so that you won't lose them.
• Arranging your transportation in advance, either too or from the airport.

While you may not be able to completely eliminate the chances of a migraine attack while flying, you can reduce the odds considerably—not to mention manage your symptoms if they do manifest. These actionable steps will allow you to experience smoother travel in spite of your migraines.

Get tips for staying migraine free on mobile ➜

Tell us what has worked for you in the comments below. We would love to include your suggestions on future versions of this article!

TheraSpecs Glasses for Your Health

Try our therapeutic glasses and get relief for issues triggered by light, such as migraines, headaches, photophobia, concussion symptoms, seizures, eye health, and sleep.

Secure Shopping

60-day return guarantee

Free shipping on US orders

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Case Rep Neurol
• v.13(2); May-Aug 2021

Successful Treatment of Airplane Headache with Rizatriptan: Case Report

Optimal management of airplane headache (AH) is still unresolved. A female, 53 years, complained of severe short-lasting jabbing pain attacks over the forehead and in the eyebrows, mainly on the left side, that occur during take-off and landing. Neurological, opthalmological, and otolaryngological examinations and brain MRI were normal. It was diagnosed as AH. The patient was recommended to take 10 mg rizatriptan 30 min before the flight. It resulted in a complete absence of headache during the take-off and significant decrease of pain intensity during the plane descending. Based on the flight duration (about 2.5 h) and rizatriptan pharmacokinetics, the patient was recommended to take a second dose of rizatriptan 10 mg 1 h before flight ending. The patient reported a complete absence of pain attacks during the next flights. The effectiveness of AH pain attack prevention is based on the pharmacokinetic properties of the drug, time of pain onset during flight, and the flight duration.

Introduction

Today, in Ukraine and likely in most of the post-Soviet countries, proper management of headaches, especially rare headaches, remains a major problem [ 1 ]. Airplane headache (AH) is a rare form of headache disorder that develops exclusively during plane travels. AH was first reported in 2004 [ 2 ], and since then, there has been a steady increase in the frequency of reported cases. AH severe pain intensity can cause fear of flying and other anxious symptoms. Up to now, no specific treatment plan has been developed for AH, although several medications have shown beneficial effects (nonsteroidal anti-inflammatory drugs and triptans) [ 3 , 4 ]. Here, we report the case of successful treatment of AH pain attacks during the take-off and during the plane descending by rizatriptan if the drug was taken in certain time points based on the flight duration.

A patient (53 years old, female, school teacher) presented to a primary headache center at the Department of Neurological Diseases with Neurosurgery and Medical Genetics of Ukrainian Medical Stomatological Academy (Poltava city).

The patient complained of headache attacks that occur during each flight. Such headaches never occurred outside of plane flights. For family reasons, the patient regularly flies the same flight to Germany and back 2–3 times a year. The patient had the same headache episodes that occur during take-off and during plane descending. As a rule, a few minutes after the flight take-off, the patient suddenly experiences severe jabbing pain over the forehead and in the eyebrows, mainly on the left side (like thousands of needles are piercing through the head). Pain intensity was assessed retrospectively on visit at 10 points on the visual analog scale (VAS) of 0–10 with 0 representing no pain and 10 representing worst possible pain. There were no associated auras, photophobia, phonophobia, nausea, vomiting, or trigeminal autonomic symptoms (nasal congestion, tearing, and conjunctival injection). Pain attacks lasted no longer than 15–20 min. Also, the same pain attacks started during plane descending 10–15 min before the landing and always self-resolved when the patient was still on the plane. Rubbing forehead, swinging on the seat, and deeply breathing caused slight pain relief. As a rule, for the whole next day after flight, the patient experienced heavy head feeling.

The first headache attack occurred 3 years before for no apparent reason during plane descending. The patient was very frightened and after arrival was examined by an airport doctor in her passenger seat. Subsequently, the same pain occurred during every next flight.

More than once, the patient sought medical care for flight headache. The patient was examined by 2 outpatient neurologists, and no pathology was found. The patient without prescriptions tried to take before and during the flight ibuprofen 400 mg − without effect, as well as a combined analgesic drug “Citramon” (acetylsalicylic acid 240 mg, paracetamol 180 mg, and caffeine 30 mg) − also without the slightest effect.

The patient denied the history of migraine. The patient had frequent episodic tension-type headache (2–3 points on VAS) 1–2 times per month that were provoked by mental stresses. She has not taken any medication for tension-type headache relief. She does not have chronic diseases, including arterial hypertension and other cardiovascular disorders.

On patient examination, arterial pressure 125/80 mm Hg and pulse rhythmic 72 beats per minute were obtained. The neurological examination was without any abnormalities. The Hospital Anxiety and Depression Scale was 4 for anxiety and 5 for depression. Otolaryngologist, ophthalmologist, and therapist consultations did not reveal any abnormalities.

The blood tests, including the complete blood count, erythrocyte sedimentation rate, electrolytes, C-reactive protein, biochemical liver, kidney tests, and fasting glucose levels, were normal. A 12-lead electrocardiogram was normal. Brain MRI was also normal. According to the International Classification Headache Disorders-3 criteria [ 5 ], we diagnosed AH.

Due to ineffectiveness of nonsteroidal analgesic drugs, the patient was recommended to take 10 mg rizatriptan 30 min before the flight. After the next flight, by phone, the patient reported a complete absence of headache during the take-off and significant decrease of pain intensity (to 3–4 points on VAS) during plane descending. Based on the flight duration (about 2.5 h) and rizatriptan pharmacokinetics (the time of maximum plasma concentration is 1 h and the time of half-life is 2–3 h [ 6 ]) in order to prevent pain attack also during the descending phase, the patient was recommended to take a second dose of rizatriptan 10 mg 1 h before flight ending (thus, 2 h after the first rizatriptan dose).

At the next visit, the patient reported a complete absence of pain attacks during the take-off as well as during the landing. It has been recommended to use rizatriptan 10 mg according to the special intake regimen (in 30 min before the take-off and repeatedly 1 h before the flight ending) on the same flights or on flights with longer duration.

Up to now, there is still uncertainty about the treatment of AH. The current literature indicates that AH can be treated with simple analgesics and nonsteroidal anti-inflammatory drugs (such as naproxen or ibuprofen) administered before airplane travel [ 3 ]. But, in our patient, the use of ibuprofen and combined analgesic drug had no effects.

Also, the current literature indicates that triptans might be effective for AH [ 3 , 4 ]. To this day, effects of triptans on AH pain are hypothetical. One assumption is that AH might be caused by a rapidly changing cabin pressure, as it is seen during take-off and landing phases [ 3 , 7 , 8 ]. Due to possible variations in the anatomical and structural construction in the individual ethmoid sinuses (ethmoid sinuses have random pneumatization patterns that vary among individuals), these patients cannot equalize the pressure during the take-off or landing [ 8 ]. Ethmoid cells and ethmoidal arteries are innervated by the ethmoidal nerve (ophthalmic branch of the trigeminal nerve), where ethmoidal nerve endings may trigger a stimulus as a consequence of sinus barotrauma and thereby local inflammation in the tissue due to the lack of pressure equalization thus activating the trigeminal vascular system as well as trigeminal cervical complex [ 3 , 4 , 7 , 8 , 9 , 10 , 11 ]. Prostaglandin E2 has been shown to be significantly high in AH patients during a simulated flight in a pressure chamber when compared with healthy subjects [ 9 ]. It is speculated that prostaglandin E2 is elevated due to local inflammation, which may cause vasodilation in the cerebral arteries and induce AH [ 9 ]. So, it has been suggested that triptans prevent AH attacks through multiple mechanisms of action − vasoconstriction effect, peripheral neuronal inhibition, inhibition of transmission through second-order neurons of the trigeminocervical complex, and inhibitory influences on trigeminovascular sensory input [ 8 , 9 ].

Up to now, it remains unclear which of the triptans should be chosen to prevent AH. Ipekdal et al. [ 8 ] reported clinical cases of complete prevention of AH by different triptans (sumatriptan, zolmitriptan, eletriptan, and naratriptan). As for rizatriptan, there is only 1 report on prescription of rizatriptan (10 mg) for AH with effective prevention of AH attacks [ 12 ]. Among the 4 triptans (sumatriptan, zolmitriptan, rizatriptan, and eletriptan) that were available in our country at the time of patient visit, we selected rizatriptan. All mentioned triptans (except sumatriptan) have almost similar availability (40–50%); however, rizatriptan has the shortest time of maximum plasma concentration (just over 1 h) [ 13 ]. The latter advantage of rizatriptan makes it possible to take the drug comparatively shortly before the flight and thus taking into account the possible flight delay. From theoretical point of view, in our case (flight duration about 2.5 h) for prevention of landing AH, it is appropriate to use triptan with longer half-life time than rizatriptan (e.g., eletriptan 3.5–6 h [ 13 ]). But, we decided not to change the drug because of good effectiveness of rizatriptan for prevention of pain attack during the ascending phase.

Earlier it was assumed that prophylactic drug management of AH should be appropriately timed depending on the time of AH occurrence (during take-off, landing, or both), depending on the duration of air travel, and depending on the peak action of prophylactic medication [ 8 , 12 ]. According to a systemic review, onset of AH was found mostly during the descending phase in 210 patients ( n = 210/275), followed by the ascending phase in 33 patients ( n = 33/275), and only 18 patients ( n = 18/275) were found to report it both during descending and ascending phases [ 4 ].

The simplest regimen of triptan use is in the cases of AH pain occurrence only during the take-off − triptans are reported to be the most effective when taken 30 min before a flight [ 8 , 12 ]. In cases of AH pain occurrence during landing or even during both take-off and landing, it needs to be taken into account also the flight duration and drug pharmacokinetics. It had been shown that patients with AH during landing took 1 regular tablet of rizatriptan 30 min before the flight and subsequently became completely AH free in short-lasting flights (1–2 h), but experienced a mild headache in long-lasting flights (2–3 h) [ 12 ]. The latter phenomenon was explained by the pharmacokinetics of rizatriptan [ 6 ].

When prescribing rizatriptan 30 min before the flight, we used the experience of successful use of triptans about 30 min before the flight for prevention of pain attacks during ascending [ 8 , 12 ]. Most likely, based on the flight duration (time period between rizatriptan intake before the take-off and time of AH pain onset during the plane descending was a little over 2.5 h), rizatriptan blood concentration in our patients at the time of descending had already decreased to a critical level, insufficient to prevent AH pain attack during the descending phase. Based on the chronology (interval between taking the first dose of rizatriptan and pain onset during the ascending phase is about 40–45 min), for AH attack prevention at the end of flight, we were guided by the same logic − the time interval between taking the second dose of rizatriptan and pain onset during the descending phase should also be about 45 min. So, it was recommended to take rizatriptan just 1 h before flight ending (which is approximately 45 min before the expected onset of pain). So, in cases of AH pain attacks during both take-off and descending, if a flight duration is 2 h or more, it is likely expedient to take the first dose of rizatriptan 10 mg in 30 min before take-off and the second dose of the drug 10 mg in 1 h before flight ending. However, most likely, this issue is very individual and requires further clarification. The main limitation of the study is its single-case study content of AH treated with rizatriptan, so we cannot confidently exclude a placebo effect.

In cases of AH attack occurrence during both take-off and landing, for effective use of rizatriptan, flight duration should be taken into account, as well as the pharmacokinetic properties of the drug.

Statement of Ethics

Written informed consent was obtained from the patient for publication of this case report and any accompanying images. The study has been approved by the Ethics Committee at Ukrainian Medical Stomatological Academy and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Conflict of Interest Statement

The authors do not have any conflicts of interest to declare.

Funding Sources

The authors have not received any funding for conduct, authorship, or publication of this study.

Author Contributions

Iryna Delva involved in data acquisition, case management, and manuscript preparation. Mykhaylo Delva involved in concept, study design, definition of intellectual content, data analysis, manuscript preparation, manuscript editing, and manuscript review.

• Share full article

Advertisement

Supported by

Are Planes Safe Right Now? Here’s What the Experts Say.

You should expect the unexpected while flying, but few disruptions should provoke serious concern, aviation experts say.

By Niraj Chokshi and Christine Chung

Smoke in the cabin. A tire blowout. A cracked windshield. No shortage of problems can affect a flight, fueling traveler anxiety and contributing to thousands of daily delays and cancellations around the world.

But for all of the frustration and alarm such events cause, it can be difficult to interpret and understand their severity. Here’s how aviation safety experts say travelers should think about disruptions when they occur.

Problems happen.

Several alarming air travel incidents have made headlines in recent weeks — a sharp plunge toward an ocean, an unnerving wobble that damaged the tail of a plane and an aborted departure after an apparent engine fire .

But the most common mishaps and malfunctions, even if hair-raising, are not typically severe, experts said.

A hydraulic leak, for example, is a familiar occurrence that pilots take seriously, but it is not as disruptive as it may sound. That’s because planes have backup hydraulic systems, which are used to power equipment like the landing gear, brakes, wing flaps and flight controls, allowing planes to take off, fly and land. A plane veering off a runway, in what is known as a runway excursion, makes for captivating video and a possibly terrifying experience for those on board. But it doesn’t necessarily cause significant damage to an airplane or threaten the safety of those on board.

The same is true of the wide range of mechanical or maintenance issues that can come up before takeoff, which might force a pilot to hold a plane at its gate or return to the gate from taxiing. Those incidents are important to understand and address, but they are often minor, experts said.

“The pilots are saying, ‘I’ve been highly trained, I’m highly educated in this airplane, and we have to return to the gate and get the experts involved out of an abundance of caution,’” said Shawn Pruchnicki, a former airline pilot and an assistant professor at the Center for Aviation Studies at Ohio State University. “That is the system working perfectly. That’s a good thing.”

Sometimes, such problems can derail a flight or take an airplane out of commission. But in other cases, they can be fixed quickly. And because airplanes are packed with fail-safes, there are times when a flight with a malfunctioning system can safely proceed simply by relying on one or more backups instead.

Flying is a complex, gravity-defying feat that’s repeated thousands of times each day in a wide range of conditions. So travelers should not be surprised when things go wrong, said Amy Pritchett, a pilot and professor of aerospace engineering at Pennsylvania State University.

“Little small components will always start to burn out or break,” she said. “There will always be potholes in the pavement in the taxiway that jostles something. There’s always questions of whether the weather is good enough to fly, whether you might hit turbulence or not. All these things are sources of variability that need to be actively managed.”

Flying is safe.

Another thing for travelers to keep in mind is that serious flight problems are extremely rare, experts said.

Flying is safer than driving or traveling by train in part because safety is built into the design of everything from air traffic control to the airplane itself. Important systems and procedures have backups, there are rarely single points of failure, pilots receive intensive and repeated training, and airlines prepare for a wide range of possible outcomes.

“It’s the safest form of transportation ever designed by humankind,” said John Cox, a former airline pilot who runs a safety consulting firm. “Be careful driving to the airport.”

Over the past several decades, commercial aviation safety in the United States has improved more than fortyfold, according to a 2022 analysis of commercial aviation safety conducted by the National Academies.

According to the National Transportation Safety Board, typical causes of accidents include turbulence, hard landings, collisions on the ground with other planes or vehicles, and component failures, such as a malfunctioning wing flap or engine.

Flying is so safe in part because the industry generally responds to every problem, even those that pose little threat. In the United States, airlines, manufacturers and agencies like the Federal Aviation Administration and the N.T.S.B. are constantly monitoring and reviewing risks and hazards in air travel.

“The level of systems that are in place monitoring current-day commercial air transport are profound,” Ms. Pritchett said. But this doesn’t mean that anyone involved can lose vigilance in assessing the possibility of danger, she added.

And while trips are occasionally cut short, experts said, diverting a flight from its destination generally reflects due caution by pilots, airlines and air traffic controllers, not a life-threatening emergency. “Could we continue to our destination?” said Kenneth Byrnes, a pilot and an associate professor who leads the flight training department at Embry-Riddle Aeronautical University. “Yes, but is it the safest thing to do?”

Placing blame is complicated.

Because aviation is complex and defined by redundancy, problems rarely have a singular cause. Instead, most serious problems — even catastrophic ones — are a result of multiple factors.

“There’s never a smoking gun, so to speak,” Mr. Pruchnicki said. “There’s never this ‘aha’ moment, when we’re going through wreckage or we’re going through records and we say, ‘Ah, I found the single reason this plane crashed.’”

Take the episode early last year in which two planes nearly hit each other on a runway at Kennedy International Airport. The National Transportation Safety Board found that several factors had contributed to what could have otherwise been a disaster.

The pilots of one plane were distracted as they proceeded down the wrong taxiway, the agency found. At the same time, the air traffic controller who gave them instructions didn’t notice because his focus was elsewhere. And a runway status light activated too late to warn the pilots of the mistake, the agency concluded.

In investigating such incidents, placing blame is not only difficult, but also generally discouraged, experts said. Kyra Dempsey, who writes about aviation accidents in a blog, Admiral Cloudberg , said that “the blameless post-mortem is a cornerstone of modern aviation safety,” facilitating an open safety culture in which people are willing to report concerns .

Mr. Cox, the pilot turned consultant, said that “aviation accident investigators are really more interested in understanding cause than assigning blame because our job is to see that it doesn’t happen again.” Instead, “the lawyers get into blame,” he said.

Perspective is important.

When a mishap occurs, it’s important to keep some context in mind, experts said.

A casual observer might notice, for example, that many problems seem to affect two types of planes: Boeing 737s and Airbus A320s. But those plane families make up more than half of the commercial jets in service, so they are naturally reflected most in news coverage.

Experts also warned against confirmation bias. When an airline or a manufacturer figures in a headline-generating episode, the media and the public tend to be on alert for other problems involving the company, even those that have little to do with the company or that might not even be significant enough to attract much attention from safety agencies.

“When something happens, you need time to discover and learn about exactly what happened, and why did it happen,” said Jeff Guzzetti, a former accident investigator for the F.A.A. and the N.T.S.B. “That’s something that you can’t do in a news cycle or even two news cycles.”

It can take the N.T.S.B. months, and sometimes more than a year, to conduct investigations, which culminate with safety recommendations to prevent future accidents.

After a fuselage panel blew off a 737 Max during a flight in January, Boeing was intensely scrutinized, and rightly so, experts said. But several also said they received many calls from reporters in the months afterward seeking comment on problems involving Boeing planes in cases that had little to do with the company.

“Just because it’s a Boeing airplane that has a mechanical problem doesn’t necessarily mean that has anything to do with Boeing,” Mr. Pruchnicki said.

In the episode involving the fuselage panel, the plane was virtually new, focusing attention on the manufacturer. But a manufacturer is probably not at fault when a problem occurs with a plane that was delivered years earlier and has been flying safely since, experts said.

Niraj Chokshi writes about aviation, rail and other transportation industries. More about Niraj Chokshi

Christine Chung is a Times reporter covering airlines and consumer travel. More about Christine Chung

Explore Our Business and Tech Coverage

Dive deeper into the people, issues and trends shaping the worlds of business and technology..

Inflation’s Wild Ride: ​​As the U.S. presidential election approaches, politicians are focused on who is to blame for price increases. How did we get here ?

A Manufacturing Shift: ​​In a global marketplace reshaped by volatility, multinational brands that have relied on Chinese factories for decades are moving production to India .

Cutting Their Losses: ​​Some Wall Street banks, worried that landlords of struggling office buildings won’t be able to pay off their mortgages, have begun offloading their portfolios of commercial real estate loans .

Overpaying for Medicine: ​​Middlemen known as pharmacy benefit managers are driving up drug costs  for millions of people, employers and the U.S. government.

The Future of Streaming: Which streaming services will survive? Which will die? We asked top media executives to predict what lies ahead for the industry .

How Delta made itself America’s luxury airline — and what United wants to do about it

Delta Air Lines  is the country’s most profitable airline. CEO Ed Bastian’s challenge is to make sure his carrier stays on top.

The airline’s unit revenue, the amount it brings in for every seat it flies one mile,  outpaced  its competitors’ last year. Delta’s share price has soared almost 23% in 2024, more than any rival in the rocky airline   sector, in a rally that’s outdone the  S&P 500 ′s. It expects free cash flow to rise as much as 50% this year to between $3 billion and 4 billion, and is eyeing a return to an investment-grade credit rating. And a stat any traveler would appreciate: Delta came in first in punctuality last year, with more than 83% arriving on-time, according to the Transportation Department.

Rival  United Airlines  — second to Delta in net profit margins — is circling. It says it could  grow   profits  even more this year.

“Knowing that there’s someone that thinks that they can take that mantle from us, that keeps us on our toes and keeps us continuing to drive hard,” Bastian told CNBC.

Delta has fashioned itself America’s premium airline. It has won over hordes of splurging travelers, many of them carrying  American Express  cards, Delta’s cash cow of a partner that generated almost $7 billion for the airline last year. Sales growth of Delta’s roomier and more expensive seats continues to outpace revenue from standard coach.

As they vie for luxury flyers, both Delta and United have  added more high-end seating  to their planes to cater to travelers who deem worthwhile a $300 surcharge for a few inches of extra legroom on a cross-country round trip, or 10 times as much for a seat in business class.

Bastian, a former auditor who said he took his first flight at age 25 for a business trip (New York to Chicago), is in charge of ensuring Delta lives up to its brand luster.

More from CNBC

• Fed Governor Bowman says she’s still open to raising rates if inflation doesn’t improve
• EU charges Microsoft with ‘abusive’ bundling of Teams and Office, breaching antitrust rules
• Airbus shares fall 12% as company cuts 2024 guidance on targets, deliveries

On Wednesday,  Delta will take its next shot  in the battle for high-spending flyers when it opens its newest,  highest tier of airport lounge  at John F. Kennedy International Airport for passengers in its Delta One cabin, its top product that features lie-flat beds for longer flights.

At more than 39,000 square feet it will be Delta’s largest lounge, accented with pillows that have iconic zig-zag motif of Italian fashion house Missoni, its new amenity kit partner. It features complementary spa treatments, like ice globes and serum for jet-lagged eyes, along with showers, a full restaurant, and a deck overlooking the airfield, in a bet that travelers’ desire to treat themselves is here to stay.

Delta is taking a page from the playbooks of United and  American , which  already dedicate their swankiest lounges  to customers flying in long-haul business class. Delta plans to open Delta One lounges in Boston and Los Angeles later this year, and is studying airports where it could open others.

“The thing with this industry is no good idea goes uncopied,” said Raymond James airline analyst Savanthi Syth.

Meanwhile, United is placing huge orders for new  Boeing  and Airbus planes and remodeling hundreds of narrow-body cabins that feature seatback screens and bluetooth technology, a strategy that aims to cater to travelers in international business class or on the cheapest basic economy tickets.

“We haven’t exactly achieved the No. 1 profitability status in the industry, but I know we’re on our way,” United’s Chief Commercial Officer Andrew Nocella said in an interview last month. “If we continue to invest in our customers through great service and great products and great network, we know that will feed upon itself and it’ll help us achieve the financial results that we’re looking for.”

The airlines and American are approaching their 100th birthdays, and are trying to stay ahead — if not drive — shifting travel demand and still turn a profit.

United is adding to the more than 300 airports it serves. Figuring out the next hot destination is “part art” and “part science,” said Patrick Quayle, its head of network planning. The airline’s sprawling global network makes United the biggest U.S. airline by capacity and it recently launched service to places like Dubrovnik, Croatia and Amman, Jordan.

Quayle pointed to United’s addition of Cape Town, South Africa, which it first announced before the pandemic, as a success.

“Another airline has subsequently copied us. ... I might want to add based in Atlanta,” he said, alluding to Delta’s home city.

The latest changes come at a difficult time for a lot U.S. airlines. Labor and other costs swelled after the pandemic, eating into margins despite  record numbers of travelers . Added capacity in the U.S. market has forced carriers to  discount fares  in off-peak travel periods.

It’s tricky, and expensive, to change course. Even  Southwest Airlines  is facing  investor pressure  to add things like premium seating or  seat assignments  as its simple business model shows signs of age.

Meanwhile, U.S. consumers are  growing more selective : Some corporate leaders have lamented a spending pullback while others, like Delta’s CEO, are saying the opposite. Americans are still digging into the so-called experiences economy, and paying for more comfort along the way, according to Bastian.

“They may not be buying that new EV or that that new house, but they’re saying we’re going to go out and experience the world and invest in that experience,” he said. “And that’s why you see it happening in high-end concerts, high-end hospitality.”

‘Brick by brick’

When the U.S. was careening toward recession almost two decades ago, Delta’s leaders made a correct bet that travelers would eventually pay more to fly on its jets.

Delta was emerging from Chapter 11 bankruptcy in 2007, which other U.S. carriers found themselves in the years after the Sept. 11, 2001 terrorist attacks.

Former CEO Richard Anderson said the airline had to start with basics: Stop losing bags. Make sure flights didn’t get canceled and arrived on time. Clean up the cabins.

“It was about building the operation brick by brick,” said Anderson, who handed the reins to Delta’s former president, Bastian, in 2016. “It didn’t matter what you did with AmEx. If the flight canceled, you ruined your brand.”

Delta took better care to avoid maintenance problems. It also started ferrying planes to airports to avoid cancellations if a replacement aircraft was needed.

And the carrier tried to clean up its image, hiring a marketing firm that advised former President Barack Obama’s 2008 presidential campaign.

Anderson said the airline needed to be consistent and not fly its mix of paint jobs and cabin interiors. It faced fresh competition from low-cost airlines like a then-spritely upstart out of Queens, N.Y. called  JetBlue Airways . Delta and United had both launched their own low-cost subsidiaries, but they discontinued them.

Delta executives knew they needed a brand to match if they were going to command a premium over competitors.

“One of the things about being a premium product is consistency, consistency in policy, consistency in appearance,” said Anderson. “If you got on a flight in Tokyo we wanted you to feel like you were home.”

After the string of changes, Delta’s performance improved. Corporate business travel contracts helped boost profits and still do, as business travel returns post-pandemic.

Delta had a key advantage over competitors. After it came out of bankruptcy, it merged with Northwest Airlines in 2008, allowing it to stabilize and expand around the world while other carriers floundered. The rest of the industry spent much of the next decade recovering from bankruptcies and a subsequent musical chairs of mergers that  left four big carriers in control of about three-quarters of the U.S. domestic market . Delta’s rivals were years behind the carrier on integrating their merged staff, operations, networks and fleets.

Bastian said the carrier’s focus on reliability has made life easier for not just its customers, but also its employees.

“They’re not having to explain for a cancellation or mishandled luggage,” he said. “They have time to serve rather than to apologize.”

Delta is also unique as the least unionized of the major U.S. airlines, at about 20%. In April, as campaigns were underway to organize its flight attendants and other workers, it again  raised worker pay . Flight attendants for Delta’s regional carrier Endeavor, which are unionized, have recently demanded compensation on par with the carrier’s mainline flight attendants.

Time to remodel

After Delta got the basics down, Bastian, 67, who joined Delta in 1998, said it was time for the airline to focus on more ambitious projects.

“You had the liberty to start investing in premium,” he said. “You started to figure out how to to make first class more available to customers.”

It has expanded in big-spending New York and Los Angeles, the country’s two largest air travel markets by revenue, according to aviation data firm OAG.

Delta also built up its host of global alliances, joint ventures and minority ownership stakes, giving it more reach. That includes its 49% stake in Virgin Atlantic, which already had a strong foothold in premium air travel and popular lounges.

“I think some of that heritage has made its way into the core of Delta,” said Virgin Atlantic’s CEO Shai Weiss. “I’m not suggesting we are the messiah for Delta, but there is no surprise that Delta and Virgin Atlantic see eye-to-eye on many things.”

The vast majority of the more than 940 million people that flew on U.S. airlines last year fly in coach, and Delta has tried to make its flights more desirable travelers on all sections of the plane.

It remodeled old and dated terminals, and built out its network of luxury airport lounges, which are tied to its lucrative credit card deal with American Express. It added seat-back televisions and better in-flight entertainment options, and in February 2023, it  announced  its long-awaited  free Wi-Fi  to customers enrolled in its SkyMiles frequent flyer program.

Delta has invested more than $12 billion to rebuild and update its U.S. hubs with soaring ceilings, new technology and in some lounges, a signature scent. (“It’s proprietary,” said Claude Roussel, who oversees Delta’s lounges, when asked what was in it.)

One of its latest efforts is its terminal and new Sky Club at New York’s LaGuardia Airport, alongside other airlines’ new terminals. A decade ago, then-Vice President Joe Biden famously said someone who was blindfolded and taken to that airport would think, “I must be in some third-world country.”

The airline faced big problems along the way like a dayslong system outage in 2016. And the worst of all: Covid-19. Like other airlines, Delta accepted billions in federal aid to weather the pandemic. The carrier successfully urged some  17,000 workers to take buyouts , hiring newer, lower-paid staff that lacked the experience of departed employees. Early in the process, Bastian said the newer workers gave the company a “juniority benefit.” The airline employed about 100,000 people in the U.S. as of the end of last year.

Delta and its competitors also pulled out of many small cities as the pandemic eased, isolating some smaller cities amid a shortage of regional jet pilots.

But international travel has proved resilient so far, as consumers show they are willing to shell out on experiences.

Luxury air travel? In the U.S.?

Luxury air travel and the United States didn’t go together for many years — and   might not still, if you ask well-heeled globetrotters.

U.S. airlines don’t offer on-board showers or  roomy suites  like those on the superjumbos flown by the likes of Etihad Airways or Singapore Airlines. But the U.S. air travel market, the world’s largest, has gotten a number of upgrades in recent years, and travelers have grown to expect the same convenience they get from their online shopping sites and ride-hailing and food-ordering apps.

“Delta’s not bougie by any stretch, but when your competitors don’t try very hard, it doesn’t take much,” said Henry Harteveldt, a former airline executive and founder of Atmosphere Research Group.

But as a rewards-credit card boom, strong consumer spending, social media envy and a wanderlust that predated the pandemic combined to boost demand, airlines executives were taking notice.

Delta’s sales from premium products are growing faster than revenue from its main coach cabin, a trend the airline forecasts will continue. Sales from Delta’s loyalty business, premium cabins and other streams comprise more than half of the carrier’s revenue.

Airlines have made big changes as they struggle to accommodate the big-spending travelers armed with elite status. Major carriers have all overhauled their frequent flyer programs to reward the biggest spenders instead of those that fly the most miles,   and made it harder to earn coveted elite status.

And at Delta and other airlines, many of the perks for luxury flyers come through lounges.

One of Delta’s Sky Clubs in Los Angeles International Airport offers a separate, dedicated security lane for customers flying Delta One, away from the masses at the airport. That feature will make it to the new JFK lounge later this year, a Delta spokesman said.

United and American Airlines have also worked to glam up and expand their airport lounges, access to which is a common perk with credit cards.

Delta  softened some restrictions  on Sky Club lounge access last year — which it made to end annoying and  unsightly long lines  to enter its exclusive airport real estate — after an uproar from customers.

'We’re constantly pushing each other'

Both Delta and United have issued sunny financial forecasts for this year, while many carriers are losing money or not pulling in similar profit margins.

“Watching [Delta] succeed, I became convinced that the product mattered and service mattered, and we have done that at United now,” United CEO Scott Kirby said at a JPMorgan industry conference in March.

And at an investor conference last month, he pointed to how the two are pulling away from the rest of the pack in profitability, particularly at big hubs.

United has made some big bets that paid off. It held onto its wide-body planes, when travel demand collapsed in the pandemic, and has benefitted from the surge in international travel.

With United on Delta’s tail, Bastian is trying to expand the airline’s reach. Bastian has attended the massive Consumer Electronics Show in Las Vegas and has announced new partnerships with  Lyft  and  Starbucks  for its loyalty program.

He says he can’t mystery shop on other carriers because he’s too recognizable, but said his team flies on competitors regularly to see what they can improve.

“We don’t own the market rights to innovation in our industry,” he said.

When asked what Delta can improve, Bastian threw kudos back to United for its detailed messages to travelers when there’s a disruption.

“They’ve done some nice things with their app,” he said. “I still think ours is better, but ... they’ve done a nice job in terms their communications with their customers and how they manage trip interruptions.”

Bastian added: “We’re constantly pushing each other.”

Boeing sanctioned over media briefing that 'provided investigative information,' NTSB says

• The National Transportation Safety Board announced sanctions against Boeing on Thursday.
• The sanctions are related to the investigation of Alaska Airlines flight 1282.
• Boeing will be subpoenaed to appear at an investigative hearing on Aug. 6 and 7.

SEATTLE — The National Transportation Safety Board announced sanctions against Boeing on Thursday, saying the media briefing about safety improvements in its plants violated regulations related to the investigation of Alaska Airlines flight 1282 .

“During a media briefing Tuesday about quality improvements at Boeing Commercial Airplanes, a Boeing executive provided investigative information and gave an analysis of factual information previously released,” the NTSB said in a statement announcing the sanctions. “Both of these actions are prohibited by the party agreement that Boeing signed when it was offered party status by the NTSB at the start of the investigation. As a party to many NTSB investigations over the past decades, few entities know the rules better than Boeing.”

Elizabeth Lund, Boeing's senior vice president of quality, told members of the media Tuesday that the NTSB’s investigation was at least partly looking to identify who was responsible for the door plug incident.

Boeing wants you to feel safe on its planes. It's working to fix safety in its factories.

“The fact that one employee could not fill out one piece of paperwork in this condition, and it could result in an accident, was shocking to all of us,” she said. 

“The who is absolutely in the responsibility of the NTSB. That investigation is still going on and I’m going to not comment on that right now,” Lund added later in response to a reporter’s question.

The NTSB said that’s not what it’s working toward.

“In the briefing, Boeing portrayed the NTSB investigation as a search to locate the individual responsible for the door plug work. The NTSB is instead focused on the probable cause of the accident, not placing blame on any individual or assessing liability,” the agency’s statement said.

As a result of Lund’s disclosures Tuesday, the NTSB is restricting Boeing’s access to materials produced by the ongoing investigation. Boeing will also be subpoenaed to appear at an investigative hearing on Aug. 6 and 7 related to the incident, but will be barred from asking questions of other participants.

The sanctions could also add to Boeing’s ongoing legal headaches.

“Given that Boeing is under investigation by the U.S. Department of Justice in relation to its Deferred Prosecution Agreement stemming from Boeing’s interactions with the FAA prior to the Boeing MAX fatalities, the NTSB will be coordinating with the DOJ Fraud Division to provide details about Boeing’s recent unauthorized investigative information releases in the 737 MAX 9 door plug investigation,” The NTSB statement said.

Boeing acknowledged the NTSB's actions in a statement.

“ As we continue to take responsibility and work transparently, we conducted an in-depth briefing on our Safety & Quality Plan and shared context on the lessons we have learned from the January 5 accident," a spokesperson said. "We deeply regret that some of our comments, intended to make clear our responsibility in the accident and explain the actions we are taking, overstepped the NTSB’s role as the source of investigative information. We apologize to the NTSB and stand ready to answer any questions as the agency continues its investigation.”

Zach Wichter is a travel reporter for USA TODAY based in New York. You can reach him at [email protected].

The Key Points at the top of this article were created with the assistance of Artificial Intelligence (AI) and reviewed by a journalist before publication. No other parts of the article were generated using AI. Learn more .

Starliner still hasn't returned to Earth. The repeated delays may be the next big headache for Boeing.

• Two NASA astronauts are still in space after Boeing's Starliner spacecraft faced delays.
• The spacecraft's plight adds to the pressure on Boeing.
• The company faces questions over safety after a door plug on one of its planes blew out in midair.

When Boeing announced in 2015 that its $4.2 billion spacecraft would be named Starliner, NASA officials hailed the manufacturer's innovation as a "great victory" that heralded the start of a new age of space exploration.

Nearly a decade later, that new era is off to a rocky start.

NASA astronauts Butch Wilmore and Suni William are still in space after the Starliner spacecraft, which was designed to ferry NASA personnel to and from the International Space Station , was hit by a series of issues on its maiden crewed voyage.

The aviation giant's first commercial spaceship experienced malfunctioning thrusters and several helium leaks as it docked with the ISS.

The two astronauts aboard Starliner were planned to be at the space station for a little over a week, but Boeing and NASA have delayed their return to Earth to sometime in July.

The FT reported on Wednesday that Boeing said Starliner was performing well and the astronauts were not stranded. "It is a test flight," the company said. "The mission is still going and it is going well."

It echoes similar previous comments by both Boeing and NASA that Starliner is safe and operating effectively .

Officials have stressed that the latest delay is simply to allow ground teams to assess the five helium leaks and thruster issues the craft has experienced.

Still, Starliner's teething issues add to the multitude of woes facing outgoing Boeing CEO David Calhoun .

Related stories

The airplane maker has been in a state of crisis since the door plug on a Boeing 737 Max 9 plane flown by Alaska Airlines blew out in midair earlier this year .

Since then, a series of whistleblowers have come forward with allegations about Boeing's approach to safety , with one describing a "schedule over safety" culture in which employees were pressured to "overlook" concerns.

The company previously told BI that those allegations were not representative of the work it has done to "ensure the quality and long-term safety of the aircraft."

Boeing is facing federal investigations into the door blowout incident and a Southwest Airlines flight, which experienced a potentially dangerous "Dutch roll" movement while in the air.

The company could also soon be hit by criminal charges after the Department of Justice accused it of violating a settlement agreement over two 737 Max 8 crashes that killed 346 people in 2018 and 2019.

It's no wonder that Boeing is reportedly struggling to recruit Calhoun's successor.

The company has faced furious criticism from lawmakers and airlines , with the CEO of Boeing's biggest customer, United, describing the Alaska Airlines incident as "the straw that broke the camel's back."

At a Senate hearing last week, the company was accused of "cutting corners" on safety . Sen. Richard Blumenthal described it as a "moment of reckoning" for the company.

Understandably, repeated Starliner delays are a setback that Boeing does not need. When it launched earlier this month, the spacecraft was already years late and $1.5 billion over budget . Boeing is also lagging behind rival SpaceX, which has been transporting astronauts to the ISS since 2020 .

SpaceX founder Elon Musk never misses an opportunity to trash-talk a rival, and Boeing's plight is no exception.

The billionaire has frequently criticized Boeing on X, posting that the company had too many "non-technical managers" and calling out Calhoun's lack of an engineering background .

NASA and Boeing did not immediately respond to a request for comment made outside normal working hours.

Watch: 5 dangerous flight moments passengers and crew won't forget soon

• Main content