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The Migraine-Sleep Connection

The Migraine-Sleep Connection

For migraine sufferers, sleep can be both friend and foe. Our experts explain the crucial role it plays in prevention and treatment, and what migraine sufferers can do to improve their sleep hygiene

Image: Shutterstock/fizkes

Migraines & Sleep

If you have ever had a migraine, you know how incapacitating they can be. Spotty or loss of vision are just a few possible symptoms of migraines. Other symptoms include nausea, vomiting, dizziness, and extreme sensitivity to light, sound, smell and touch.

The Migraine Research Foundation reports that today, migraines affect approximately 39 million U.S. adults and children with a total of one billion sufferers worldwide, making it the third most common disease in the world. Classified as a neurological disease, it is considered one of the worst, as it is responsible for over 1.2 million emergency room visits each year for acute attacks.

With migraines so prevalent in the world, studies and research are severely underfunded and lacking. Patients are left largely on their own when it comes to understanding their migraine triggers and the best ways to ease their symptoms. 

Migraine sufferers know that sleep typically plays an integral role in migraines. Sleep deprivation or excess may be a trigger for an attack, and a large number of patients use sleep as a tool to cope with their pain. In fact, the proper sleep environment during an attack can be one of the best ways to soothe symptoms. We’ll explore the complex role sleep plays in migraines as a trigger, preventative measure, and treatment.

Sleep And Migraines

How Migraines Work

WebMD defines a migraine as a neurological disease that occurs when hyperactive nerve cells cause your blood vessels to constrict and expand. It sounds fairly harmless, but anyone who has ever had a migraine knows that it is not that simple. These impulses are powerful and cause your brain to release chemicals that are inflammatory enough to actually produce pain from these pulsations.

Fatigue and exhaustion are other symptoms of a migraine. When your brain begins pounding, and you feel that familiar pressure between your eyes, you find yourself unable to function in the face of such pain, and sleep is all that you want.

Sleep As A Migraine Trigger

For that reason, sleep is one of the most popular self-treatments for a migraine. By giving your eyes a break, your body has a chance to rest so you can recharge those batteries. In fact, the Migraine Trust reports that sleep is particularly effective in treating migraines in children. 

Although sleep can be a miracle for some migraine sufferers, not all experts agree that sleep is helpful for those blinding headaches. In fact, some researchers consider sleep to be a detriment, according to a new review of several case studies by Dr. Mark. Green, Director of Headache Medicine and Clinical Professor of Neurology, Anesthesiology and Dentistry for Columbia University. 

He argues that an untreated problem is still likely to be there when you wake up, writing, “Going to sleep with an untreated migraine is commonly a mistake, as it may worsen during the night and become difficult to treat in the morning. If a migraineur is sleep deprived, he or she can expect more migraines, while those who oversleep may wake with attacks that are very resistant to therapy.”

Sleep Deprivation And Its Effect On Sleep 

While studies continue to uncover more about this elusive disease, we are learning more about it every day and how intertwined migraines actually are with our sleep.

We do know definitively that sleep deprivation and poor sleeping habits directly impact migraines. Missouri State University conducted a 2010 study that showed rats who were deprived of REM sleep were more likely to experience substantial changes to special proteins that work like pain triggers. When the rats didn’t get the full rest that they needed, they secreted more of these proteins that overstimulate the nervous system and trigger pain. It is very similar to what happens in humans.

More sleep is not always a good thing, however. If you sleep too much, this has also been shown to trigger migraines. When we are in our deepest states of sleep, known as stages three and four, a neurotransmitter imbalance can occur if you are suddenly awakened in the middle of that sleep cycle, and it can be strong enough to trigger a migraine. Selective serotonin reuptake inhibitors (SSRIs) are a form of antidepressant that has been proven successful in treating issues surrounding these neurotransmitters and their role in sleep issues.

It is not only sleep deprivation that causes your migraines. How well you sleep can also affect the strength of your migraines and their frequency. 

Some experts consider migraines to be a warning system for the body, letting you know when you have pushed yourself too far and need to fully rest. Says the Migraine Trust, “If you are sleep deprived, suffering a migraine may actually force you to keep still and lie down in the dark, in the hope of trying to sleep as a way of ridding yourself of the migraine. Having too much sleep may also have the opposite effect and keep you awake with a migraine on subsequent nights. Both scenarios may be a way of trying to redress both sleep pressure and circadian alignment, and keep the system in equilibrium.”

Sleep Disorders and Migraines

In addition to too much sleep or lack thereof, there are other reasons to blame for interrupted sleep and migraines. Verywell Health includes insomnia, sleep apnea, bruxism and restless legs syndrome as leading causes. 

There are several other common sleep disorders that are more common in those who experience migraines:

  • Interrupted sleep
  • Insomnia
  • Fatigue
  • Snoring
  • Restless leg syndrome
  • Early morning wake-ups
  • Difficulty staying asleep

Insomnia

Insomnia is the most common problem that people face with their sleep, and it especially affects migraineurs. This refers to an inability to fall and stay asleep, with poor quality of sleep, interrupted sleep and inadequate sleep schedules also common symptoms. Those who experience migraines are more likely to have insomnia. Having both insomnia and migraines puts you at a greater risk of depression and anxiety.

Sleep Apnea

Sleep apnea is characterized by shallow breathing or gaps in breathing during sleep, which can cause the body to wake itself up to take a deeper breath. Not only is it dangerous, but the pain that comes from reduced oxygen intake is theorized to be worse while you sleep and thus may trigger a migraine.

Bruxism

Bruxism is more commonly known as grinding your teeth, and it is a popular coping mechanism for stress. The relationship between migraines and Bruxism is murky. Experts theorize that teeth grinding may activate the cranial trigeminal nerve that plays a role in migraines, or that those with migraines have a highly sensitive central nervous system that is more susceptible to Bruxism pain.  

Restless Legs Syndrome

Interestingly enough, doctors have found that restless legs syndrome can also be associated with migraines. Migraine patients tend to have a higher risk of RLS, and RLS symptoms may be more severe in those with migraines.

If you suffer from any of these conditions, talk to your doctors to see how they can be helped. Your doctor may refer you to a neurologist who can better look at your brain and sleep patterns to find the right solution for you.

Image: Shutterstock/Prostock-studio

Taking Control Of The Sleep-Migraine Cycle

With sleep so closely tied to our health, it is crucial to take steps to reduce the impact of migraines and lower your risk of continued and more serious attacks.  Since too much, too little, and low-quality (interrupted) sleep can all be migraine triggers, prioritizing your sleep health is one major preventative measure you can take to protect yourself.

Maintain Good Sleep Hygiene

Just like our mouths and bodies have hygiene routines to feel their best, our sleep health has its own hygiene best practices. Sleep hygiene includes all of our daily habits that impact our ability to sleep, including exercise, diet, caffeine intake, and even screen time. A sleep hygiene routine is all about consistency so that you set your body clock to fall asleep quickly at the right time, and wake up refreshed at the right time.

Sleep Hygiene Tips For Migraine Sufferers

When creating your new sleep hygiene, these are the five most important tips to follow to help ensure better sleep and fewer migraines.

  1. Don’t skip meals. Your body needs fuel to function and fight off those headaches.
  2. Get the right amount of sleep. Sleeping too little or too much can confuse your brain and cause a chemical imbalance that can lead to migraines. Unplanned or too frequent naps can also disrupt your sleep cycle. 
  3. Watch your caffeine and alcohol content. Both alcohol and caffeine are proven triggers for migraines and can significantly hamper your sleep hygiene.
  4. Limit your pain medications. Many migraineurs swear by Excedrin Migraine, and rightfully so, but taking these kinds of over-the-counter medications can actually prove ineffective or dangerous when taken more than a few days in a row. This includes other medications like acetaminophen, aspirin, ibuprofen or a combination of any of the above.
  5. Consider other treatments. Medicine isn’t the only way to treat a migraine. When you feel the familiar, dreaded stirrings, immediately try to find a cool, dark place where you can lay down, close your eyes and rest for a while.

Know Your Triggers

Everyone’s body is different, so it’s normal for people to react to migraines differently. What may be a severe trigger for one person may not be a trigger for others. If you are able to identify what is causing your migraines, you are already one step ahead of the game, because now you know exactly what to target. 

These common migraine triggers are good things to keep track of:

  • Stress
  • Exercise
  • Fatigue
  • Medications
  • Alcohol and caffeine
  • Poor diet

It’s important to take the time to record your migraines. Try to record as much information as possible, including the time and date, its length, your symptoms and where you feel pain. If you treat your migraine with medication or another treatment, indicate those, as well. This migraine journal can help your doctor understand your migraine triggers and how to manage them.

Accordingly, a sleep log can be exceptionally helpful in identifying your sleep patterns over an extended period of time. Be sure to review our tips on how to create a useful sleep log that you and your doctor can use to study your sleep-related issues and better understand how they are impacting your migraines. 

Sleep During a Migraine: How to Make it Work

When a migraine is severe enough, it can be painful just to close your eyes and lay in bed. These are some tips to help you get comfortable if you choose to sleep off a migraine:

  1. A damp washcloth is a popular go-to and should be placed over the eyes, temples or the back of your neck, depending on where you are feeling the most pain. The cool wetness will help alleviate some of the inflammation that is causing all of that pain. Some migraine sufferers find a cold leaf of lettuce or frozen washcloth particularly helpful.
  2. Gel eye masks can also help in times like these, and can be kept in the freezer so they’re ready at a moment’s notice. Inexpensive options can typically be found at the drug store, online on Amazon, or through discount retailers.
  3. You can also purchase a special cooling pillow to fight inflammation associated with migraines.
  4. A headache-targeted massage can be incredible for reducing some of the tension and helping your brain to relax. If you do not have someone to give you a head massage, consider an inexpensive scalp massager. The American Massage Therapy Association also provides guidelines for self-massage that sufferers can use during an attack to jumpstart the healing process.
  5. Invest in a mattress that is soft but supportive enough to support your body and make for comfortable sleep. A migraine attack is not the time when you want to feel a worn-out mattress, have a spring poking you in the back, or otherwise experience physical irritation.There are plenty of great mattresses available for under $500 that can transform the way you sleep.
  6. Install blackout curtains to keep out the light. When your eyes are throbbing, any sign of light can make the pain worse. Blackout curtains will not only help you establish great sleep hygiene in general, but it can also be a lifesaver when you can’t bear the stabbing pain of the light.

Tools For Migraine Sufferers

There are several apps that are also available to help those who live with migraines. These can be very helpful in tracking, analyzing and treating your migraines in the future and for many different reasons. 

Migraine Buddy A diary and tracker all-in-one, this app is actually designed by real neurologists who add tons of educational resources to help you understand why migraines are happening to you.

Manage My Pain Pro This paid app focuses on information gathering for your medical team. As you add details about your migraines and sleep, the app will generate charts, graphics and statistics to make understanding your neurological health that much easier.

Blue Light Filter & Night Mode With so many of us increasingly dependent on our smart devices, this blue light filter and night mode can help your eyes adjust to ambient conditions and protect you from migraine-causing blue light and eye strain.

Relax Melodies: Sleep Sounds

Find relaxation and establish more regular and deeper sleep with this free app that includes guided meditation and exercises to help prepare your brain and body for sleep.

Migräne App

Created by German migraine scientists, this app is not only a treasure trove of information, but it also includes everything you need to track and analyze your migraines for your doctor. You can also use the app to connect with a global community of scientists, researchers and migraineurs just like you.

The Bottom Line

Every day, science is learning more and more about our brains and the way chemicals interfere with healthy brain activity.  Developments in medicine, combined with healthy habits, can make a difference in both the frequency and severity of migraines. To live a more migraine-free life, evaluate your sleep patterns and lifestyle to see what changes you can make for a healthier and more pain-free tomorrow.