Migraines are not simply bad headaches. Migraines are a neurological disorder that’s quite painful yet common in individuals across the nation. Of course, there are several factors (or triggers) that contribute to a migraine, such as noise, bright lights, air pollution, and more. It might come as a shock to know that the most heavily populated cities in the United States are not the ones with high migraine rates.

Although life might be busy for New York City or Boston dwellers, it is quite rare to wake up with a headache each morning in these cities. Migraine patients might find that they require peace and comfort to combat a majority of migraine-related symptoms, so if you live in any of the following listed U.S. cities, it is best to take extra precautions. Here is a list of the worst cities to live in if you suffer from frequent migraines:

1. Cincinnati, OH
A migraine can be caused by a variety of reasons, including sound, smell, or sights. Researchers have recently compiled a list of the worst states to live in for migraine sufferers by categorizing the top states into different causes. For instance, Cincinnati ranks highly in lifestyle and food triggers. This means that living in Cincinnati, you may often experience high amounts of stress or have irregular sleeping habits. This city is also full of delicious, but triggering foods, such as chocolate and red wine. While Cincinnati is not the highest of the trigger categories, it presents the highest overall challenge.

2. Madison, WI
Madison is ranked highest for lifestyle triggers, and this may mean that living here is much more difficult than living in any other city. Lifestyle triggers in Madison may include long work hours, intense workout sessions, trouble sleeping, frequent sunburns, and more.

3. Little Rock-North Little Rock, AR
Little Rock is ranked highest for environmental triggers, a term that may include anything from pollution and noise to social image and relationships. In this city, you may experience frequent migraines due to unsteady weather and extreme temperatures. While you may not be impacted by many of the social factors yourself, they contribute overall to the number of migraines experienced in the population. These factors include high divorce and crime rates, long commute times, and high suicide rates.

4. Knoxville, TN
Knoxville may sound like heaven for food-lovers, but for patients with frequent migraines, this city may be otherwise. It is ranked highest in food triggers, and while this category may sound a bit silly, foods play a large role in the onset of migraines. Foods that may trigger migraines include dairy products, wheat, tomatoes, onions, citrus fruits, and more.

5. St. Louis, MO
Like Cincinnati, St. Louis is also ranked high in lifestyle and food triggers. While it may be in both categories, it is not necessarily at the top of either, making this a more bearable city to live in than any of the above.

Migraines and sinus headaches are typically mistaken for one another; however, they are completely different. While a sinus headache may be the result of the common cold or small triggers, chronic migraines can affect a person’s quality of life. The condition may interfere with the person’s ability to perform simple tasks or even go to work. A person experiencing chronic migraines may experience one or more of the following symptoms:

• Nausea
• Dizziness
• Head pain varying in intensity
• Sensitivity to light, sounds or smells

Along with the several categories that can cause a migraine, researchers have also identified links between pollution and migraines. Smoking triggers for migraines may include tobacco, smog, and air pollution. Chronic migraine cures can be as easy as lifestyle changes or using medications such as antidepressants. Medications that may be recommended include NSAIDs, anti-seizure meds, and beta blockers. Your physician will most likely advise that you consume the given medication on a monthly basis.