Sleep and Migraines

How migraines and sleep affect each other.

From the WebMD Archives

Migraines and sleep have a complicated relationship. Getting too little slumber -- or in some cases too much -- brings on migraines in people.

Plus, if you've already got a migraine, getting a good night's sleep can be tricky.

Exactly how poor sleep triggers migraines is still a mystery.

But whichever comes first -- migraines or sleep problems -- there are ways to ease both problems. Here's how to get started.

Migraine-Sleep Connection

Pradeep Sahota, MD, a University of Missouri migraine expert who also studies sleep, knows what it's like. He's had migraines since he was a teen.

During medical school, he found that sleeping only four or five hours at night could trigger a headache. But so could sleeping 10 hours on the rare night when he wasn't working.

Julie Ruminer of Greenwood, Ind., can relate. She gets at least five migraines a month, and sleep seems to affect them.

"Lack of sleep can trigger my migraines, but often it's combined with another thing," she says. "I'm bad about staying up late reading when my favorite author comes out with a new book. If I do that two nights in a row, or I do it and something stressful is going on or a weather system is moving through, I may get a migraine," she says.

But there are solutions. Anne Calhoun, MD, is a headache specialist in Chapel Hill, N.C. She's particularly interested in sleep issues.

In one of her studies, 43 women with chronic migraines were taught how to improve their sleep habits. In the group of women who addressed their bad sleep habits successfully, all but one saw their headache frequency decline until most days were headache-free.

8 Steps to Better Sleep

1. Set a regular sleep schedule. Give yourself eight hours in bed each night, and keep your bedtime and wake-up time consistent all week, Calhoun says. Avoid going to bed extra early if you're just going to use the time to lie awake. These steps help ensure that the sleep you get is deep and steady, and more restful.

2. Calm your mind. Practice a mental exercise that relaxes your mind after you get in bed. Calhoun suggests picking a distant memory -- perhaps walking through your favorite grandmother's house -- and reviewing it as if it were a silent movie playing in your mind. This will help slow down your brain waves, which supports sleep. Avoid watching TV or even reading in bed.


3. Eat and drink earlier. Drink no more than a teacup of fluid before bedtime to cut down on sleep-interrupting trips to the bathroom. For the same reason, avoid eating meals within four hours before bedtime, Calhoun says. (Much of the liquid we take in comes from the food we eat, along with beverages.)

4. Change your thinking. Some people whose migraines strike at night become afraid to go to sleep, Sahota says. If worrying about your migraines is keeping you from resting, consider talking to a counselor who works with people with chronic pain. An approach called cognitive behavioral therapy can help you learn how to adopt healthier thoughts and behaviors related to your migraines.

5. Cool off. Ruminer has learned some tricks to lull herself to sleep during a migraine attack. Cooling her room with the air conditioner helps.

6. Comfort yourself. When you have a migraine, some people find that placing cold packs on their head helps them sleep, while others prefer a warm pack, Sahota says. Try each to see which kind helps you more.

7. Take a two-pronged approach. After taking medication to stop a migraine, lie down in a dark, cool, quiet room. As you're sleeping, the medicine can go to work so you wake up feeling better.

8. Review your medications. Ask your doctor if any medicines you're taking – including migraine drugs – can wake you up or make your sleep less restful. If so, taking them in the morning may help limit their effect on your sleep, Calhoun says.

Getting to sleep without relying on medicine is the best option, Calhoun and Sahota say. So work on your sleep habits first. If you still can't get better sleep, talk it over with your health care provider.

WebMD Feature Reviewed by Laura J. Martin, MD on August 14, 2012



Julie Ruminer, Greenwood, Ind.

Pradeep Sahota, MD, chairman of neurology, University of Missouri, Columbia.

Anne Calhoun, MD, Carolina Headache Institute, Chapel Hill, N.C. 

Calhoun, A. Headache, September 2007.

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