Learning how to sleep with migraine can be difficult. Everyone who has migraine understands that symptoms are so much more than the head pain depicted in those annoying commercials where someone gets a little headache, takes an over the counter pill and moves on with their day. Migraine doesn’t work quite like that. It is a complicated neurological condition and brings complicated symptoms with it, even between attacks. While migraine begins in the brain its complexities involve many different systems in the body. Migraine can affect our ears, eyes, digestion, blood pressure and heart rate and even parts of the nervous system that control movement. We can feel symptoms from our head to our toes. Prioritizing sleep in spite of migraine and sleep disorders should be at the top of your list.
Migraine can also affect our sleep. One complexity that doesn’t get enough attention is migraine sleep disturbances. In fact, according the American Migraine Foundation, those with migraine are between 2-8 times more likely to experience sleep disorders than those without migraine. And migraine sleep disturbances can present themselves in many ways. Let’s talk about how to sleep with a migraine and the sleep disorders that can come along with it.
** While Migraine Strong writes about the latest in migraine treatments, this is not medical advice. We are patient educators and all information you read should be discussed with your doctor.
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The relationship between migraine & sleep
Migraine has an entangled connection with sleep. We can trigger migraine attacks by sleeping too little and also by sleeping too much. To twist things further, migraine disease can actually create sleep disturbances and having a sleep disorder can make migraine worse. They are related and can influence each other.
Let’s talk about some of the most common sleep disturbances in those with migraine.
- Insomnia- Difficulty falling asleep & staying asleep is the most common migraine sleep disorder.
- Sleep Apnea– Sleep related breathing disorders like snoring & sleep apnea is very common in those with migraine as well. Morning head pain is often related to this condition. If you have head pain upon waking that goes away with treatment, this is worth looking in to.
- Sleep related movement disorders- Restless Leg Syndrome & even sleep walking occurs significantly higher in those with migraine. 1-6% of the general population experience sleep walking, but that number rises to 30% in those with migraine. Fluctuating levels or serotonin are thought to be the connection between sleep related movement disorders and migraine. If you experience this, have your iron stores checked (serum ferritin) as low levels can contribute to restless leg syndrome.
- Daytime fatigue- Although this symptom is not as commonly reported to physicians, excessive daytime fatigue is a common symptom of those with migraine and sleep disturbances.
- Hypnic Headache- also known as the alarm clock headache most commonly occurs in people over 50 years old. It is the only headache that is strictly related to sleep and wakes you up which is where it gets its name.
- Teeth Grinding & jaw clenching also known as bruxism- Another entangled relationship, jaw clenching can trigger a migraine attack and migraine can trigger teeth grinding during sleep.
- Night Terrors- More than nightmares, night terrors involve physical movement and vocalizations. They occur more often in young people and in females. But, they are also common in those with restless leg syndrome, migraine and sleep apnea.
Why do migraine sleep disorders happen?
Migraine, anxiety, depression and sleep disorders are often comorbid conditions. So why do migraine sleep disorders happen? Sadly, clinicians really are not 100% certain. Like pretty much everything else related to migraine and its comorbid conditions, we need more research! Because getting to the bottom of the complex neurological processes underlying migraine, mood & sleep disorders and how they interact with each other, is crucial to paving the way for new treatment strategies and relief. Until then, the connection between migraine & sleep disorders is often explained through shared neurological structures in the brain where pathways of sleep and headache cross.
Migraine, sleep and mood are all connected
Sleep, headache and mood (particularly anxiety & depression) are all interconnected because they all involve similar neurotransmitters in the brain. They share underlying neurotransmitter dysregulation as a result. Migraine disease seems to flip a switch and over sensitize parts of the brain stem, it seems to particularly excite the pain system in the brain. Because your sleep (and mood) is controlled in the same area of the brain, they have greater difficulty functioning effectively as a well. The good news is, when migraine is controlled and frequency & severity of symptoms improve, sleep & mood also improve. They’re so related that if you treat any one of them the others often improve as well.
Researchers believe several other factors also contribute to migraine sleep disorders including…
- Age- adolescents and middle age individuals.
- Genes.
- Medications.
- Environmental factors such as stress.
- Psychological comorbidities including anxiety & depression.
- Physiological factors such as pain affecting the trigeminal nerve and central sensitization.
- Neurological mechanisms- Several neurotransmitters (chemical messengers) are theorized to play an important role in sleep disorders and in migraine including serotonin, dopamine, melatonin and more.
Learning how to sleep with migraine – know your options and resources
While it’s not imperative to determine which condition came first, sleep disorder or migraine, treatments can differ. For instance, pharmaceuticals such as tricyclic antidepressants & benzodiazepines may help insomnia, but they are not recommended for those with sleep apnea. This means it’s important for you to give your doctor as much information as possible about your sleep patterns and symptoms including the time of day you experience them to determine the best line of treatment tailored for you.
Treatment for migraine sleep disorders might include:
- Setting a regular sleep schedule- Migraine brains like consistency, keeping your sleep routine consistent can improve disturbances.
- Cannabinoids- CBD has an overall calming effect and can help induce sleep for some people.
- Supplements like vitamin D and B vitamins may help regulate the gut-brain connection improving sleep. Magnesium in the forms glycinate and citrate can have a calming effect. As mentioned above, checking for and correcting iron deficiency anemia may also be helpful.
- Melatonin– If you’d rather not take a supplement consider eating foods with melatonin in them before bed to encourage your natural melatonin. Try foods with melatonin in them like tart cherries, bananas, walnuts & almonds Try dimming lights before bed to encourage natural melatonin as well.
- Medication- Talk with your physician about how to sleep with a migraine & medication options for migraine sleep disturbances.
Stress management migraine and sleep
The most important strategy for learning how to sleep with migraine just might be stress management. It’s essential for everyone, but especially in those managing migraine. Practicing a healthy lifestyle including staying hydrated, getting good quality sleep, exercising and eating healthy all work together to calm neurotransmitters involved in migraine disease.
Managing stress might include…
- Yoga
- Cognitive Behavioral therapy to take a deep dive into practicing stress management skills.
- Biofeedback- There is a great app where you can see your heart rate on the screen and learn further relaxation training through diaphragmatic breathing by Juva Health.
- Forest bathing- Spending time in nature and in natural light.
- Spending time with animals.
- Meditation apps and so much more.
How about gadgets for encouraging how to sleep with migraine and sleep disorders?
It’s important to pay attention to your sleep environment and routine. Migraine is complicated. Our biology has created hyper-responsive migraine brains. Because of that, our brains are constantly responding to our emotional environment, our physical environment and our sensory environment in ways those without migraine don’t. Our hyper-responsive brains are easily affected by our mood. We notice lighting, sounds, odors & room temperature more than most. So set yourself up for success by paying attention to how your bedroom feels. Block out lights from electronic devices, pay attention to the cleanliness, organization and temperature of your bedroom, remove odors or add pleasing scents through an essential oil diffuser etc.
There are loads of gadgets on the market that can help you sleep with migraine. A few suggestions to consider are:
- Air Purifier at Amazon– This is the one I own and I’m so happy with it.
- Allay Lamp– Check out our review of the Allay Lamp for migraine and vestibular migraine.
- NodPod at Amazon– I use this almost every night. It’s awesome!
- Sound machine at Amazon– Particularly helpful to mask external noise.
- CPAP device- While these are available on Amazon, it’s best to talk with your doctor before purchasing one.
- Dodow Sleep Aid Device– Encourages mental relaxation to help you fall asleep.
- ChiliPAD Sleep System at Amazon– This is on my wish list!
- Bose Sleepbuds II at Amazon– Deliver relaxing sound to help you fall asleep and stay asleep.
Next steps for migraine sleep disorders
Whether you have a sleep disorder affecting your migraine or a migraine disorder affecting your sleep, a relationship is evident. Practicing healthy sleep hygiene habits, eliminating substances that impair sleep, implementing a multi-modal treatment plan and making necessary lifestyle changes can all help to improve your quality of sleep. Taking a deep dive into really understanding your migraine disease can make a positive and empowering difference as well. If sleep disorder symptoms continue to plague you, consult your doctor for more treatment strategy ideas. If you experience a lack of interest in your specialist helping you work through your migraine sleep disturbances or you do not have access to a headache specialist near you, consider Neura Health where you can speak with a headache specialist from the comfort of your own home.
References:
- https://pubmed.ncbi.nlm.nih.gov/34562960/
- https://pubmed.ncbi.nlm.nih.gov/8550359/
- https://www.frontiersin.org/articles/10.3389/fneur.2018.00095/full
- https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-016-0655-4#:~:text=Background,percentage%20of%20migraineurs%20experience%20EDS.
