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Do Your Sleep Habits Trigger Migraines?

Research suggests a link between sleep problems and migraines.
WebMD Feature

If you suffer from migraines, you may want to pay more attention to your sleep habits. That's the message from several studies which show that sleep problems, like insomnia, may actually trigger migraines.

Migraines and Sleep Problems

Migraines begin when hyperactive nerve cells send out impulses to blood vessels, causing them to constrict, then expand. This is accompanied by the release of brain chemicals and inflammatory substances that cause the pulsations to be painful.

In a study published in the journal Headache, researchers conducted a detailed sleep interview with 147 women with transformed migraines (where occasional or episodic headaches become chronic at least half of the days of the month). When asked whether they were refreshed or tired on waking, not one reported feeling refreshed, and more than 80% said they were tired when they woke. Complaints about sleep problems were prevalent.

In a second study on sleep habits and migraines, also published in Headache, researchers provided stronger evidence that good sleep habits reduce both the number and intensity of migraine headaches. In these findings, 43 women with transformed migraines received behavioral sleep instructions or placebo instructions in addition to usual medical care. The women recorded their migraine headaches in diaries. At the end of the study, the women who received behavioral sleep instructions reported a significant reduction in migraine headache frequency and intensity.

How Do Sleep Problems Cause Migraines?

Rapid eye movement (REM) sleep provokes migraines, says Vincent Fortanasce, MD, a Los Angeles-based neurologist, psychiatrist, and author of the Anti-Alzheimer's Prescription. Fortanasce tells WebMD that REM sleep provokes most powerful migraines that occur five to six hours after sleep begins.

Most of us go through about six sleep cycles with about four stages of sleep, plus rapid eye movement (REM) sleep. The deepest stages of sleep (stages 3 and 4) are necessary for the production of sufficient serotonin and dopamine, both neurotransmitters.

These neurotransmitters are the "feel good" chemical messengers in the brain, and both depend on adequate sleep; a decrease in serotonin and dopamine is associated with poor sleep or sleep problems.

One reason for waking with migraines is that REM sleep is most powerful just before awakening. Sleepproblems can then trigger migraines by causing instability of serotonin and a lowering of dopamine levels.

Antidepressants, specifically the selective serotonin reuptake inhibitors (SSRIs), may help stabilize serotonin membranes and block migraines. These medications are sometimes used as migraine treatment.

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