Migraines And Sleep

Sleep away the migraine pain
Migraines And Sleep
Tom Greenspan
December 21, 2022

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Getting a good night’s sleep, especially with conditions like migraine, can be challenging for many.

But there’s more to migraine and sleep disruption than the headaches associated with this condition. That’s why we are here today to help you understand the complex relationship between sleep and migraine.

What Is a Migraine?

Many people confuse migraine with usual headaches, which isn’t the case. So, let us start by giving you a brief introduction to this condition.

Simply speaking, migraine is a neurological condition that causes frequent episodes of throbbing pains or sensations on one side of the head. The intensity of the pain can vary from moderate to severe, typically accompanied by sensitivity to light and sound, nausea, and even vomiting.

A migraine attack can last for anywhere between a few hours and days, interfering with your daily life and affecting sleep, among other things.

Does Migraine Cause Poor Sleep Quality?

Migraine and poor sleep (in the form of sleep disturbances and sleep disorders) are interrelated. But there isn’t enough research to help us understand what causes this comorbidity. 

That said, many believe that sleep disorders or disturbances share some common neurological mechanisms. That is to say, a few factors that generally contribute to poor sleep can also play a role in migraine development. We will talk about them in a later section. 

Overall, it’s a widely accepted fact that low-quality sleep or sleep disorders like insomnia can trigger migraine headaches in many patients. 

In fact, some patients may experience migraine attacks even when sleeping, primarily due to disruptions from sleep disorders or external factors. And sleep disturbances, in any form, can transform episodic migraine (less than 15 episodes per month) to chronic migraine (more than 15 episodes per month).

In other words, there’s a direct relationship between sleep problems and the frequency of migraine episodes. The more sleep disturbances you experience, the more may be your migraine frequency and vice versa.

As such, some of the common sleep disturbances experienced by migraine patients include (but aren’t limited to):

  • Low sleep time
  • Difficulty falling asleep and staying asleep for long
  • Snoring
  • Fragmented sleep causing you to wake up frequently 

These problems can, in turn, cause other issues in migraine patients, like:

  • Excessive daytime sleepiness
  • Daytime fatigue even after sleeping through the night
  • Reduced focus and concentration

Migraine And Sleep Disorders

Sleep disorders are often among the leading causes of more severe and frequent headaches. In this regard, there are some specific sleep disorders that are usually experienced by migraine patients, such as:

1. Insomnia

Perhaps, insomnia is among the most common sleep disorders, even in migraine sufferers. It’s typically referred to as a condition when people face difficulty falling asleep or staying asleep through the night. 

You may experience light sleeping and wake up frequently, even with the slightest or zero disturbance. This can affect your overall sleep quality, resulting in daytime fatigue.

Many migraine sufferers may often complain about experiencing the above symptoms between their migraine episodes. Not only that, but some people may also awaken suddenly from the deep sleep stage due to the onset of chronic headaches and find it difficult to fall asleep again. And this can translate to insomnia over time.

Overall, there’s a higher risk of insomnia in migraine sufferers, with the majority of chronic migraine sufferers being vulnerable to experiencing insomnia symptoms almost daily. Alternatively, migraine as a sleep disorder can be a high-risk factor for migraine. 

Besides, both these conditions can make you susceptible to anxiety and depression over time. 

2. Obstructive Sleep Apnea

Sleep apnea is a condition where your normal breathing automatically starts and stops while you’re asleep. And obstructive sleep apnea (OSA), the most common type, occurs when your throat muscles relax more than usual, blocking airflow to the lungs. Naturally, this will cause you to wake up frequently at night, resulting in poor-quality sleep.

Head pain and snoring, which are common symptoms of sleep apnea, can put you at risk of developing chronic migraine. Moreover, both child and adult sufferers of migraine may wake up with migraine pain if they suffer from snoring and breathing problems from sleep apnea.

That said, people with chronic migraines are more vulnerable to developing OSA (than episodic migraine sufferers). However, there’s no real evidence to suggest that OSA, in particular, is more frequent in migraine patients than others. But OSA symptoms can cause chronic migraine episodes, primarily resulting from sleep disruptions. 

Besides, the already sensitive to pain migraine sufferers find it challenging to deal with the head pain resulting from the reduced oxygen intake, intensifying their headaches. 

3. Bruxism

Bruxism or teeth grinding in sleep is a symptom of temporomandibular joint disorder (TMJ), which causes pain and discomfort in the jaw and other facial muscles. And in many cases, bruxism develops alongside episodic and chronic migraines, though the exact reason remains largely undiscovered.

However, one possible explanation is that bruxism and TMJ can affect a cranial nerve called the trigeminal nerve, which is said to be involved in migraine pains. Another theory suggests that migraine sufferers become more sensitive to the pain caused by TMJ and bruxism. 

This is generally due to a migraine-related condition that causes the central nervous system to become hypersensitive to stimuli like pain.

4. Restless Legs Syndrome

Restless legs syndrome has a dual relationship, as migraine sufferers are almost always at higher risk of developing this condition. Likewise, the intensity of the discomfort in the legs can be significantly more for people with migraine. 

This relationship may be caused by problems in dopamine release, a hormone or neurotransmitter that contributes to both movement and sleep regulation.

Shared Mechanisms Between Migraines And Sleep

As you may have already understood from the disorders listed above, the link between sleep and migraines can be linked to certain shared mechanisms, or rather, dysfunctions in them. And here are some more examples of them:

1. High Serotonin Secretion

Serotonin is a neurotransmitter that can regulate sleep, among other things. High levels of serotonin can cause wakefulness, disrupting the deep sleep stage commonly known as REM (rapid eye movement sleep).

And though serotonin levels are generally low between migraine attacks, they can increase significantly during an episode, which may cause migraine sufferers to stay awake at night. In tandem with the sleep disorders mentioned above, the result is low sleep quality and reduced sleeping hours. 

2. Brainstem Dysfunctions

Dysfunctions in the brainstem can also contribute to the relationship between sleep and migraines by means of unusual serotonin production mentioned above. Moreover, the changes in hypothalamus activities right before you sleep cause migraine pains.

Migraine patients who also suffer from insomnia may have a brain stem deformity that disrupts the process of moving between sleep stages, causing insufficient or poor-quality sleep.

3. Hindrance Of The Glymphatic System

The glymphatic system has been only recently discovered as a macroscopic waste removal system believed to remove wastes like metabolites and soluble proteins from the central nervous system. 

Although there hasn’t been enough research to establish the link between the glymphatic system and migraines, it may have some sort of ‘therapeutic’ effect on sleep. And since sleep treatment is often used as an effective method to treat migraine, it may be concluded that dysfunctions in this system can trigger migraines by failing to regulate sleep.

Apart from that, there may be a possibility that sleep disorders or disturbances in migraine sufferers may hinder the process of waste removal by the glymphatic system. And the leftover waste may contribute to migraines.

Sleep And Migraine Treatment 

Given the evidence that already establishes a relationship between sleep and migraine, treating sleep disturbances and disorders can reduce the intensity and episodes of migraine. As such, here are a few tips and tricks that can help.

1. Resist Sleeping In The Day

Although insufficient sleep at night can induce daytime sleepiness, it may be better to resist the urge to sleep during the day. This can disrupt your circadian rhythm (or sleep-wake cycle), making you stay awake during the night. 

Over time, you may become susceptible to insomnia, worsening the severe symptoms of chronic migraine.

2. Develop Good Sleep Habits

Meditating, deep breathing exercises, warm baths, and cutting screen time before bed can all contribute to healthy sleep. Not only that, but these activities may also help alleviate stress, which is a common trigger for insomnia and sleep disorders.

3. Seek Cognitive Behavioral Therapy

Getting professional behavioral therapy can make you familiar with behavioral interventions that can help relax the mind and body and teach better sleeping habits and sleep hygiene. Ultimately, you can get a good night’s sleep with reduced disruptions.

Final Words

If your sleeping habits are making your insomnia worse or vice-versa, we’d advise contacting a sleep specialist to get the right treatment. You may also be required to take a sleep test for a better diagnosis. 

Moreover, maintaining a sleep diary to record the frequency of migraine episodes, especially while sleeping, can aid in the diagnosis.