Sleep, Migraine, & Insomnia

Sleep, Migraine, and Insomnia

Problems with sleep are a major issue among those with chronic migraine. These sleep troubles can be problematic for a number of reasons. Individuals with chronic migraine, often have problems with both falling asleep and staying asleep. The symptoms of the migraine itself can cause issues with falling asleep; which in turn leads to worsening symptoms from the migraine. Additionally, insomnia and other sleep disturbances can cause enough issues that they can become the very trigger that causes a migraine. Most of us have heard that while not enough sleep can cause a migraine, too much sleep can also be problematic. Unfortunately this can easily become a catch 22 or a vicious cycle between migraines and sleep disorders.

Sleep and migraine triggers

Dr. Alex Nesbitt is a research fellow in Clinical Neurology in the Surrey Sleep Research Centre at the University of Surrey. He explains that while lack of sleep, too much sleep, shift-work, and jet lag are all known to be possible triggers for a migraine, excessive sleepiness can be an element of prodrome, and the actual sleep itself can help alleviate a migraine in some cases1. I personally know many individuals that are episodic who can take a migraine abortive, go to sleep, and wake with the migraine completely gone. Some individuals can feel refreshed by nap, while others find they wake up with a headache or migraine.

Insomnia and chronic migraine

Many individuals with chronic migraine also deal with persistent insomnia. Individuals with migraine have a higher incidence of suffering from a group of abnormal sleep behaviors such as sleep walking, night terrors, and restless leg syndromes1. All of these sleep behaviors prevent the individual from achieving good restful sleep.

Insomnia and migraine may co-exist, especially in chronic sufferers. Both insomnia and migraine are more likely in people who sustain often quite mild head injuries, as part of a post-concussion syndrome. Excessive sleepiness, particularly during the daytime, can be associated with headache.

Connecting sleep and migraine

As nature prefers to stay in a state of homeostasis, an individual’s body will attempt to return the homeostasis in event that either sleep or wakefulness “overloads this system in favor of one state (sleep or wakefulness) versus the other, such as staying up late, having fragmented sleep, sleeping in at the weekends, or sleeping at inappropriate times relative to your body clock (as happens in jet lag)”1. One of the best steps for an individual with chronic migraine is to attempt to maintain a scheduled sleep cycle, regardless of work days or days off in order to try to reduce the ability of sleep issues to trigger a migraine.

Dr. Alex Nesbitt believes that a migraine could be an individual’s body’s way of placing the body back in balance by forcing someone who is sleep deprived to sleep due to the migraine or someone who has had too much sleep to be unable to sleep due to a migraine1. This way of thinking could explain why some individuals can easily sleep off a migraine and others find it impossible to sleep during a migraine.

More research is needed

While there are numerous links between chronic migraine and sleep issues, the bigger issue is that we need more research into the relationship between the two ailments. My own experience with neurologist and headache specialists alike has been their lack of interest in helping a patient deal with the insomnia aspect of their medical issues. Physicians all too frequently dismiss their patients concerns of insomnia. If more doctors would take their patients’ insomnia seriously and work to help them resolve that issue, their overall migraine days and pain levels may be lowered by sleep alone.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.
View References
  1. Nesbitt, A. (2012, February). Sleep and Migraine: Reluctant bedfellows? We look at the inseparable relationship between sleep and headache. Migraine News Journal, 106. Retrieved from https://www.migrainetrust.org/living-with-migraine/coping-managing/sleep/

Comments

View Comments (16)
  • 8 months ago

    Thank you for this article, I’m going to my neurologist in our next appointment about options. I basically no longer sleep (I’ve always had insomnia, it’s just gotten worse) without drugging myself but I’ve gone far off what my psychiatrist and I agreed on years back because it doesn’t work anymore. I’ll more or less white knuckle it for a few days, get knocked down with a terrible migraine and then take extra doses of drugs to get sleep. It’s not a solution. But I have been so focused on migraine I have been ignoring the insomnia issue.

  • ninafranco
    8 months ago

    I have found that with migraines you have to be extremely regular with your sleep patterns. Even though I am now retired I still make sure I go to bed no later than 11 and get up no later than 6:30. My cat is trained to wake me the instant the coffee maker goes off. He comes running into the bed and bops me on the face!. I always get up, have a cup of coffee, an English muffin and one or two excedrine migraine pills. If I have nothing to do I can actually go back to bed if I wish for another few minutes, or not, but I have to get that caffeine and food in my stomach early or I will sure as hell wake up a little later with a migraine!!!

  • curemigraine
    9 months ago

    Sleep is a huge problem for me and definitely a big trigger for my chronic migraines. However I have severe anxiety and insomnia that makes it very difficult for me to fall asleep at night – I often end up lying in bed for hours worrying, no matter how tired or exhausted I am. I take Benadryl or sleeping pills often to help me fall asleep. There really needs to be better research of the relation between sleep and migraine and more integrated treatment of the two. I’m a public health grad student in epidemiology, and my current project is looking at the relationship of migraine and sleep patterns – hope I can add some small contribution to the effort to understand this link and come up with better treatments for both.

  • Bskuhl
    9 months ago

    Sleep or the lack thereof has always been a migraine trigger for me. I also suffer from sleep apnea. During a sleep study, the doctor noted that I was experiencing a phenomenon called Alpha Wave Incursion. This means that pain was causing my brain to come out of the deepest stages of sleep back into a very low level of sleep. This phenomenon is often scene in patients who experience pain like fibromyalgia. I thought it was especially interesting because for the first time, I saw physical evidence that my brain was experencing pain. And as for those doctors with disbelieving eyes, it was very satisfying to say see I told you I was feeling very fatigued tired and in pain; just look at the sleep study and you can see why.

  • BchBm
    9 months ago

    I’m definitely on the can go to sleep in the drop of a hat side of the aisle. I’ve had chronic migraine for about 5 years and I guess episodic before that but I didn’t recognize it. When a strong migraine comes on, I will start to just fall out. It doesn’t last long but I have definitely come around with my head on my desk after feeling that irresistible pull to just go to sleep. Going to sleep is quite possibly the greatest thing in the world, even if the migraine isn’t gone it definitely helps to reset my body to more of a baseline and get things back to a lower level.

  • Amanda Workman moderator author
    9 months ago

    Well sometimes if you are able to go to sleep once you take your migraine medications, they do seem to help fight the migraine better. My husband has to remind me about that a lot. My migraine do not make me sleepy though. Do you try to work through your migraines is that what you meant about your head on your desk?
    Sending you lots of strength
    Amanda Workman

  • Maddy
    9 months ago

    My child has chronic daily migraine, had many bouts with insomnia. Was on 100mg Topamax, and still had breakthroughs, now has weaned down to 37mg and is having near zero episodes. This is what helped, and why I believe each item helped, from 4 years of copious research. Migraine is known to have low glutathione in he brain. She takes two things here. Acetyl-glutathione, which can cross the BBB, 200 mg p.m. 600mg of NAC 1x p.m.; it is the rate limiting step in glutathione synthesis, and it can also be used by body to synthesize taurine. NAC also scavenges and reduces the binding of glutamate to NMDA receptors – glutamate is excitatory and is a problem in migraine and epilepsy. P5P form of B6, at least 20mg, R5P form of riboflavin at least 15mg. Both are essential for neurtransmitters. Thorne basic nutrients vitamin has both. Find out your MTFHR status and see if you need methylated vitamins…if you have C677 NAC may not be for you and you may need TMG instead. Do 23andme!!! They know that chronic migraine has low ANA, anandamide – which is a natural pain killer our bodies make. The FAAH enzyme breaks down ANA. If enzyme runs too fast you have too little ANA. FAAH also breaks down PEA, if you add PEA orally it “keeps that enzyme busy” and theoretically you have higher ANA. Look into PEACure, or Normast. Taurine at night, dose up slowly starting at 100mg. Taurine is neuroprotective, and it modulates Calcium channels, and also works to normalize glutamate. Topamax is a calcium channel blocker BTW. She takes magnesium and low dose 250mg of MCHA calcium which has bone matrix. Vitamin D and life extension super K, which has K2 and K1. K is need to put calcium into bones and too much calcium in serum vs where it belongs is a problem.

  • Sophiasmom
    9 months ago

    Obstructive Sleep Apnea causes increased glutamate neuroexcitotoxicity. Insomnia in a child should be a big red flag for OSA. Children normally sleep very well. Topamax is a well known medication used to treat intracranial hypertension. OSA increases intracranial pressure and causes “migraine”. My son has OSA and IIH and if he does not use his BiPAP machine then he feels awful and gets headaches.

  • Maddy
    9 months ago

    …also CBD (THC free from Hemp) gummies (she won’t do the oil I tried), works as a rescue for her, and she never had any help from Triptans as rescue. I think she takes like 3 pieces of 30mg.

  • Sophiasmom
    9 months ago

    Dizzy Lady, the home sleep study is useless. you have grounds to insist on a new study in the facility. unfortunately with mild OSA as can cause this type of headache syndrome, even the facility study can miss it. I had to go to Stanford, and they found it. and after jaw surgery for this very mild OSA, my headaches virtually disappeared. I thought I had migraine all my life but it turns out it was intracranial hypertension. my intracranial pressure dropped from 23 to 14 after jaw surgery, and I went into remission. I cannot use a CPAP or even a BiPAP (better with intracranial pressure) because the valsalva involved would give me headaches. I was able to get some relief with a tongue retaining device, the aveoTSD. you can now find something similar on ebay for cheap, so it’s worth a try.

  • Sophiasmom
    9 months ago

    I was disappointed to see that this article does not mention obstructive sleep apnea. I am glad to see several people commented about it. Probably all humans have OSA, and it is a definite cause of migraine. Something most docs don’t connect, and even more of a disconnect is the knowledge that apnea increases intracranial pressure. intracranial hypertension headaches can present IDENTICAL to migraine. After my research, it seems to me that if you have not been given a spinal tap to rule out intracranial hypertension, that your migraine diagnosis is possibly flawed. it is a diagnosis of exclusion and IIH must be ruled out. If you have significant sleep problems as this article describes, then you have to consider that you have OSA and that it is increasing intracranial pressure to cause your headaches. unfortunately, very mild OSA is capable of creating this situation if you are prone to IIH.

  • Pkaplan
    9 months ago

    Several years ago I went from episodic, once a month migraines to chronic daily migraine. After seeing 3 different nuerologists with very little mention of my sleep difficulties, finally a physical therapist suggested I have a sleep study. I am not overweight and I do not snore but I have sleep apnea. It was not enough apnea for the insurance company to cover a cpap machine but the sleep doctor suggested I try it and he believed it to be a cause of the chronic migraine. It made a huge difference so I purchased a machine out of pocket. After 4 months of using a CPAP machine I am back to being episodic. It has changed my life.

  • DizzyLady
    9 months ago

    I suffer from this, too! I can usually go to sleep to begin with, but I can’t sleep soundly and have been waking up over and over in the night, tossing and turning and hurting all over. Melatonin and sleep aids no longer help. I’m having trouble holding things together and getting any work done, I feel so exhausted. I use a CPAP, but it doesn’t seem to be working for me so well anymore and the mask bothers me a lot now since I’m moving restlessly in bed so much. I had a home sleep test not long ago (although I doubt it was good – the little light on the device blinked all night and I slept very little) so it’s too soon for insurance to pay for another check. The sleep center said my apnea score was barely bad enough to need the machine. This feels so wrong and I think I’ll cry!

  • BrianJay
    9 months ago

    I have this. Like I think I’ll be fine and I feel fine then when I try to sleep it starts up. It’s horrible cause I’m so tired nowadays that it becomes harder to concentrate or even care about things around me.

  • Amanda Workman moderator author
    9 months ago

    Unfortunately it’s sleep and pain is very much a viscous cycle. None of my neurologist would admit it but my rhuem was very clear about it. I’m definitely sorry you are dealing with this issue. Have you brought it up with your doctors?
    https://migraine.com/living-migraine/the-terrible-two-fatigue-insomnia/
    Amanda Workman

  • BrianJay
    9 months ago

    I haven’t but I will when I see him. Problem is I think the migraines might be connected to something else too. I was given a CT scan and they found nothing, but I’m not really sure. I still feel intense, debilitating pain and the medicine they gave me is not working really.

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