Migraineurs learn early on to identify their triggers and develop ways to avoid them. From food to noise or light levels, weather conditions and even temperature, many situations can bring on a migraine headache, including sleep or its lack.
Several studies undertaken since the 50s reveal a distinct link. In one study, 80% of 147 women who took part said they felt tired on waking, and none reported feeling refreshed. While migraine sufferers may recognize that they have both poor sleep habits and migraine, not all of them manage to make a direct connection.
Sleep and Migraine Connections
It can feel like a chicken and egg situation. Are your migraines causing your sleep disruptions, or is the way you sleep triggering your migraine?
We go through around six stages of sleep during the night, including the REM (rapid eye movement) phases. The neurotransmitters serotonin and dopamine are produced during stages 3 and 4, when we’re in the deepest sleep. Interrupted sleep patterns can lead to insufficient of these ‘feel good’ chemicals being produced.
REM sleep, which happens four to six times during a normal night’s sleep, is strongest just before waking. Research suggests that migraines and cluster headaches have a strong relationship with REM sleep, although it’s not clear exactly what causes the headaches. It could be hormonal changes, neurotransmitter changes or a combination of both. Some experts believe the chemicals that cause people to wake from REM sleep with a headache are also those that play a role in the migraine mechanism.
The Gene Connection
Migraines tend to run in families, although not always. Recently, research uncovered a potential link between genes and migraine, when a study revealed that a certain gene mutation predisposed family members with the same mutation to have sleep disorders. The gene responsible is the one that controls circadian rhythms, the natural body rhythms attuned to the 24-hour light/dark cycle. All the family members studied had an unusual sleep pattern, preferring to retire very early and get up equally early. Scientists give this sleep pattern the name ‘advanced sleep phase’, and people with the disorder typically retire between 6pm and 9pm, rising between 1am and 5am.
Further studies involving mice revealed chemical changes in the mice’s brains, similar to those in human migraine sufferers. They also displayed a sensitivity to heat and touch that is also reported by those with migraine.
Identifying Sleep Problems
Since it’s so common for migraineurs to report feelings of tiredness on waking, there’s a good chance it could also play a role in your own migraine pattern.
If you haven’t already done so, add sleeping patterns to your migraine diary. Note down how well you slept, for how long, and how you feel on waking. After about a month you may be able to identify patterns that indicate whether sleep quality affects your migraine.
Some people find too much sleep is as detrimental as too little, so finding your personal solution is vital rather than relying on the findings of others.
Forming Better Sleep Habits
Addressing your sleep habits could give long lasting relief from migraines, once you know the things to change. Here are some tips to bear in mind:
- Have a Regular Sleep Cycle — disruptions in sleep patterns can trigger migraine, so that weekend lie in might not be as relaxing as you think. Going to bed and rising at the same time every day helps build a steady, more restful sleep habit.
- Go to Bed in a Calm State of Mind — switch off the TV and mobile devices to give your mind time to unwind before sleep. Periods of quiet, without external stimulation, help the brain prepare for sleep.
- Avoid Food and Drink Before Bed — Getting up in the middle of the night for bathroom visits disrupts sleep rhythms.
- Conquer Fear — if you’re used to waking with a migraine you could fear going to sleep. This vicious cycle obviously makes the problem worse but professional help is available. Ask your doctor about counseling or cognitive behavioral therapy to help you develop a healthier outlook on sleeping and migraine management.
- Have a Medication Review — some migraine medications may make you sleepy or have the opposite effect, and the time of day you take it could affect the way you sleep at night. If you have problems sleeping, wake up feeling tired or with migraine, it may be worth investigating your regular medications to see if they’re working with or against you. Simply changing the times you take them (if this is possible or advisable) could help you sleep more soundly.
Managing migraine is deeply personal since everyone’s experience is different. The links between sleep quality and migraine are clear, so it’s worth investigating how sleep figures in your own migraine patterns.