Migraine headaches can last for days and bring debilitating symptoms, such as severe pain, loss of balance, vomiting, and vision disturbances. For people who suffer from this type of headache occasionally, the toll is difficult, yet manageable. But for chronic sufferers, these painful symptoms come with a very real economic downside that involves more than the cost of medical care and medications. A comprehensive analysis by the American Migraine Prevalence and Prevention (AMPP) study found that chronic migraine sufferers—those who get 15 or more headaches per month—report considerably less productive time in the workplace than those who suffer less frequent migraines. Lost productive time is due to lost work days and reduced productivity as a result of the migraines. Lost productive time directly impacts the bottom line for companies. AMPP found that, on average, a chronic migraine sufferer loses 215 more hours per year of work than an occasional sufferer, which translates to about $5,300 per year of lost production. When you factor in indirect costs, such as emergency department visits, doctor visits, medications, and treatments, that number balloons to $7,750. According to the Migraine Research Foundation, employers in the United States lose more than $13 billion each year due to the 113 million lost work days. These statistics do not take into account employees who had to leave their jobs or retire early due to their migraines. A statistical brief that contains data provided by the Healthcare Cost and Utilization Project, entitled "Headaches in U.S. Hospitals and Emergency Departments, 2008," found that headaches accounted for nearly 2.4% of all emergency department visits and of these visits, 34.6% were for migraines. Additionally, the most common type of headache associated with inpatient stays was migraine. While this economic news seems daunting for chronic migraine sufferers and those who employ them, it's important to note that according to the AMPP study, many migraine sufferers don't seek treatment. Encouraging migraine sufferers to seek help can directly (and favorably) impact a company's bottom line. The causes of migraines are often mysterious, but there are known triggers that lead to migraines. Some triggers include caffeine (especially high doses of 300 milligrams, about three cups of coffee or more); alcohol (especially dark-colored beverages such as whiskey and red wine); aspartame; tyramine (found in pickled or smoked foods); monosodium glutamate (MSG, an additive often found in soups, Chinese food, and snack foods), and chocolate. A review of migraine research at the New York Headache Center suggests that keeping a food and symptom journal to pinpoint any triggers is a positive and inexpensive way to control your migraines. What else can you do? Good old-fashioned exercise helps relieve stress, a common cause of headaches. The proper amount of sleep also curbs chronic migraines, as under- or over-sleeping has been linked to headaches. Medications can also help prevent migraines or reduce their frequency. Once a headache does begins, various prescription and over-the counter medications are available to stop, shorten or lessen the effects of the migraine. So while there is a very real negative economic issue surrounding chronic migraines, education in migraine prevention and treatment could go a long way toward reducing absenteeism that chronic severe headaches cause.