People living with migraine commonly have difficulty sleeping. Disrupted sleep habits, decreased sleep quality, and sleep disorders can leave a person feeling exhausted. In fact, a study of 226 people with migraine found that almost 60 percent experience fatigue from the condition. Luckily, there are steps you can take to ensure better, more restful sleep.
MyMigraineTeam members are open about the ways their migraine symptoms affect their sleep patterns. Some say their migraine attacks are often so painful they wake abruptly from sound sleep. In many cases, this poor sleep leaves them feeling drained of energy: “I feel like I’m half drunk/hungover,” wrote one member, “especially in the mornings. My eyes feel like lead, and I find it hard to concentrate and focus.” Another member admitted that losing sleep had “a draining effect on my so-called life.”
Some members with difficulty sleeping have shared that they alternate between feeling “wired” and completely sapped. “Either I’m wide awake all night and day,” shared one member, “or I can’t keep my eyes open.” Others find that they feel exhausted all the time: “Fatigue, brain fog, no energy whatsoever, no drive or ambition,” said one member.
A lack of quality sleep can leave a person with little physical or mental energy to stay productive. Some members write that these effects leave them feeling guilty about lower productivity, distanced from their peers, and unable to participate fully in social or family activities.
Oftentimes, lack of sleep is a trigger for migraine attacks, rather than a symptom of migraine. Sleep disorders, sleep deprivation, and sleep overload are all widely accepted as factors that contribute to migraine attacks. Previous studies have suggested a negative correlation between hours of sleep and the severity of migraine. In other words, the less sleep a person gets, the more severe their migraine attacks are likely to be.
However, as many of those living with migraine know, sleep problems can also occur as the result of migraine attacks.
Some people with migraine cite the pain of headaches as the culprit for the loss of sleep. One MyMigraineTeam member said, “I’m having a sucky day, suffering majorly from pain and exhaustion and I can’t sleep.” This exhaustion following a migraine is known as the postdrome phase or, more colloquially, a migraine hangover. Another member replied to this post saying they also experience pain-related insomnia (“painsomnia”), writing that they are “sleeping four hours a night, on average.” Others blame their headaches for waking them up several times each night and making falling back asleep even more difficult.
Individuals with consistently low-quality sleep and those who experience migraine exhibit low levels of melatonin — a hormone that helps control the sleep-wake cycle concentrations. However, more research is needed to explore the potential link between melatonin, migraine, and sleep.
Sleep disorders are common among people living with migraine. Some sleep disorders commonly associated with chronic migraine include insomnia, sleep apnea (particularly obstructive sleep apnea), and teeth grinding. The most common of these sleep disorders, insomnia, affects between 50 percent and 75 percent of individuals who experience migraine symptoms.
Although there is little research on how migraine headaches cause sleep problems, scientists and health care professionals are investigating the potential links between the two.
Homeostasis is the combination of processes by which the body stabilizes itself, including the balance between being asleep and awake (sleep-wakefulness). One theory is that a migraine may occur as the body’s way of regulating and adhering to the body’s natural circadian rhythms. For people who do not get enough sleep, a migraine may arise as the brain’s unforgiving way of telling the body to lie down and rest. On the other hand, a powerful migraine may jolt one out of rapid eye movement (REM) sleep that the brain feels has lasted for long enough.
Medical experts have recently pointed to the central nervous system as involved in both the regulation of sleep schedules and the neurology behind migraine attacks. There appears to be a possibility that sleep problems and migraine are not two separate disorders but rather two symptoms or effects of the same biological malfunction.
Doctors often prescribe preventive medication for individuals who experience migraine, including blood pressure-lowering medications, antidepressants, and antiseizure drugs. Some of these medications — particularly antidepressants — may have side effects that include difficulty sleeping and fatigue.
The most common belief of why sleep disturbances are found so often in people with migraine is the nature of the condition. Almost half of all migraine attacks occur early in the morning between 4 a.m. and 9 a.m. They are also known to be severe and debilitating — enough to wake an individual from deep REM sleep. The pain of the migraine may interrupt natural sleep patterns, leading to poor sleep quality.
Although sleep problems can be disruptive and exhausting, there are ways you can work toward getting a better night’s sleep. Talk to your health care provider or a neurology expert for ways to prevent migraine from interfering with your sleep.
One of the best ways to get better sleep with migraine is to make sure it is being treated properly. You can work with your neurologist to determine what treatment or combination of treatments works best for preventing migraine and managing your symptoms when attacks occur.
Another step toward avoiding migraine attacks is to observe what triggers contribute to your migraine symptoms. Many medical professionals recommend keeping a headache diary to help in this process. The information you compile in your migraine diary may help you identify what triggers your migraine attacks, such as certain foods, feelings (like stress), or situations. Once you determine what is triggering your migraine attacks, you can take steps to avoid or mitigate them.
Feeling overtired can trigger migraine attacks. This can lead to an unfortunate and painful cycle of migraine leading to fatigue, which then triggers another migraine, attack and so on.
In the Guide to Healthy Sleep, the American Migraine Foundation suggests several practices to help increase the quality of one’s sleep. These suggestions — often referred to as “sleep hygiene” — include going to bed and waking up at the same time every day, avoiding things that disrupt your bedtime (like eating or using devices with screens), and following the same bedtime routine before sleep.
MyMigraineTeam members have shared ways they cope with sleep difficulties. These suggestions include taking time out of the day to relax or meditate and exercising regularly — both of which can decrease stress, a common migraine trigger. Exercise, particularly moderate aerobic exercise, has the added benefit of decreasing insomnia.
Some MyMigraineTeam members have reported taking medications to help them sleep, such as Desyrel (trazodone) and Zanaflex (tizanidine). Others have had positive experiences with gabapentin (sold under the brand names Neurontin and Gralise). Your doctor can advise you on whether medications would help regulate your sleep schedule — and, if so, which ones may be right for you.
You are not alone in battling migraine and sleep problems. MyMigraineTeam, the social network and online support group for those with migraine, is an outlet for discussing common experiences and finding support.
Do you struggle with migraine fatigue or sleep disturbances? How do you manage it? Share your experiences in the comments below or by posting on MyMigraineTeam.