Getting enough sleep is important for most people, but for migraine sufferers the quality of sleep can affect them as much as the quantity. Without restful sleep we’re not at our best, and we have lower resistance to health conditions.
Migraines and Sleep Problems
If you’ve ever lain awake in the early hours with an aching head, your sleep patterns could be the cause. Headache sufferers have a two to eight times higher risk of experiencing sleep problems than the general public, according to the American Migraine Foundation.
Statistics show that in specialty migraine clinics more than half the patients have chronic sleep disorders. Scientifically-accepted evidence shows that a relationship exists between migraines and sleep habits, but many people don’t understand the link—or how to manage the condition.
Drawing the Connection
A 2016 study showed definite connections between the quality of patients’ sleep and the frequency of migraines. The most frequently-noted connection was poor or disturbed sleep patterns, particularly REM (rapid eye movement) sleep, which occurs around 6 times in an 8-hour sleep period. This is the dream phase, when our bodies produce serotonin and dopamine. It’s also the time when migraines are more likely to develop, because if REM sleep is disturbed it can result in insufficient production of these two neurotransmitters that are important in regulating pain.
When REM sleep is interrupted, impulses from the nerve cells cause blood vessels to constrict and then expand, releasing chemicals and inflammatory substances that cause pain. This is a common cause of migraines that develop just after sleep is disturbed, which explains why migraines occur so frequently in the early morning.
Reasons for poor quality REM sleep include:
- Snoring, sleep apnea and bruxism (tooth grinding), which causes the sleeper to wake up multiple times a night
- Sleeping disorders, such as circadian rhythm, narcolepsy, restless leg syndrome (RLS), and sleepwalking
- Alcohol, drug or caffeine usage
- Irregular lifestyle habits
Lack of sleep causes the production of three kinds of migraine proteins, so ongoing sleepless nights could result in chronic pain manifesting as migraine because of insufficient rest.
Identify Sleep-Related Migraines
It’s better to avoid developing a migraine migraine than treating one after it begins, so preventing sleep-related migraines is the first step to resolving this issue.
Track Your Habits: Add a section for sleeping patterns to your migraine diary. Make daily notes on how well you slept, how long it lasted, and your overall well-being when you wake up. Record whether you experienced difficulty falling asleep, and whether you’re anxious or depressed. View this alongside your other diary records to see if there’s correlation between any factors.
Discover Your Sleep Challenges: Find out if you snore heavily or grind your teeth, either by asking a sleeping companion, recording your night’s rest on your smartphone, or downloading and using a sleeping app. These not only measure the length and quality of your sleep, but can also determine factors such as your body temperature. Wearables such as the Apple Watch and FitBit combine this with signs of snoring and sleep apnea to provide a detailed sleep report.
Check Your Genetics: Migraines often run in families, which means there is a potential link between members who are predisposed to this condition. The gene in question controls circadian rhythms, which keeps our bodies in tune with the daily 24-hour light and dark cycle. Recent research identified a family with unusual sleep patterns who all rose between 1 am and 5 am, and who all suffered from migraines.
Form Better Sleep Habits
Going to bed at the same time every night is important for developing a consistent sleep schedule. This trains your body clock to “power down” at a specific time in every 24-hour period. When you combine this with a regular wake-up time, you’ll find you feel tired and ready for bed at the same time each evening. Additional steps you can take to form better sleep habits include:
- Adopting a Good Sleeping Position: The positions you choose to sleep in can cause tension in your frame and trigger migraine pain. Even if you don’t actually develop a migraine during the night, your quality of sleep may be affected and you’ll wake up feeling tired and weak. Struggling to face the day feeling worn out makes you more susceptible to a migraine attack, so get the most comfortable bed you can afford and ensure you sleep with a pillow the right height to avoid straining your neck muscles.
- Implementing Sleep Hygiene: This is a common term used for following a routine before sleeping, which consists of regular activities designed to relax you. Begin with a warm bath that soothes your muscles. Eliminate all disruptions and embrace a quiet period as you prepare for bed. Read a book instead of watching TV or reading on a tablet. These all help to lower the quantity of cortisol your body produces, which keeps alertness and stress levels down.
- Avoiding Stimulation Before Rest: Cut out alcohol, caffeine and smoking for between 4 and 6 hours before sleeping, to ensure you aren’t over-stimulating your brain ahead of bedtime. You can avoid natural stimulation, too, by taking a long bath soak, skipping viewing exciting TV shows and films, or doing anything that pushes you into activity. Write out your to-do list for the morning before you try and sleep, so you’re not kept awake thinking of things you need to remember.
- Creating a Safe Haven: The right sleep environment is vital to encourage healthy, undisturbed rest. Turn your bedroom into a safe place that’s cool, dark and uncluttered. Keep the temperature steady between 60F and 67F, and ensure it’s well-ventilated. Get rid of any digital clocks and other brightly-lit objects that can intrude on your sleep, and avoid noise pollution by wearing earplugs if necessary. Eye masks can also help prevent distraction or the intrusion of light in the morning.
- Getting Moving Early: If you’re a fan of evening workouts, make sure you do them early enough to complete the routine at least 3 hours before you’re ready to sleep. While exercise is an excellent way of relaxing and releasing endorphins, it also releases cortisol that increases alertness. If you feel physical activity is essential close to your bedtime, focus on doing relaxation exercises correctly to help you wind down for the day.
- Watching Your Intake: As well as avoiding stimulants, it’s a good idea to eat lighter meals at night to avoid any foods that can cause indigestion. Heavy, protein-filled dishes are a common sleep-killer, and by reducing the quantity of liquid you take in you can also avoid having to make several trips to the bathroom during the night. Review your medications, too, in case you’re using anything with sleeplessness as a side effect.
Treating Your Sleep Related Migraines
Managing your sleep and mood is critical for treating sleep-related migraines. Migraineurs who get insomnia often also experience anxiety or depression. When combined with poor sleep patterns and mood problems, they struggle to function and this affects their quality of life and increases their migraine frequency. Common treatments for insomnia include behavioral sleep therapy, cognitive therapy, relaxation training and sleep behavior modification, performed by sleep specialists or psychologists, according to the National Sleep Foundation.
Antidepressants are sometimes used as migraine treatment, specifically the selective serotonin reuptake inhibitors (SSRIs), which can help stabilize the serotonin membranes and block migraines. For sleep apnea, many patients find their migraines improve or stop after receiving apnea treatment.
If your sleep quality doesn’t improve in a few weeks after introducing these measures, consult your migraine doctor to find out if other issues are present. Talk to them about pharmaceutical solutions, or alternative products such as valerian or melatonin.