Background: Clinical observations of a relationship between unpleasant dreams and migraine headaches have been reported previously. Methods: Due to the anecdotal quality of these case reports, this study empirically investigated the significance of this relationship. Dream content categories were selected corresponding to emotional factors associated with stress that trigger migraine headaches. A total of 37 migraineurs recorded 10 dreams each, 5 that preceded migraines and 5 that did not. Results: Univariate F tests revealed that 4 of the 5 variables contributed significantly to the overall effect, specifically anger, misfortune, apprehension, and aggressive interactions. Conclusions: Recommendations include discussing the predictive value of dreams with regard to nocturnal migraine attacks, and therapeutic implications are suggested.