Migraines and Sleep

Migraines and Sleep
By Jana Beeman, CHHP, CHP, AADP

It’s one of those nasty truths that migraine sufferers know all too well: when you don’t sleep well, you get migraines, and when you have migraines, it’s often really hard to sleep. So the question becomes: What can I do?

I personally have always had the kind of migraines that chain for at least 2 – 3 days, often for weeks on end. Sometimes you get rid of it in the afternoon or evening and think maybe you’ve gotten clear, only to wake up in the middle of the night with one. Or even when you don’t wake all the way up, your sleep is disturbed by the pain.

Years of experimenting and research has given me a few tools to use for better sleep, with or without a migraine. Here is a list of ‘better sleep basics’ which are useful to anyone who wants a better night sleep, whether they get migraines or not:

Go to sleep and get up at close to the same time every night, whether it’s the weekend or not
Sleep in a darkened room – if the room isn’t able to be darker, use eye shades
Don’t eat heavy foods or sweets after 6 pm – if you’re hungry, eat something light
Drink fluids throughout the day and stop about 3 hours before bedtime – just sip if thirsty
If you have to drink caffeine during the day, stop at least 4 – 5 hours before bedtime
Schedule your day to allow at least 7 – 8 hours sleep
Try not to sleep more than 7 – 8 hours, as that can trigger headaches
Sleep in a cool environment – we all sleep better when the room’s a bit cold

As for the temperature in the room, migraineurs will usually find that they feel better when the room is cooler, and they can control body temp through how much covers they have on. I struggled with this for years, because my hubby likes to sleep under a LOT of covers, and I don’t like the weight, so I finally got a really soft, fuzzy blanket which goes on top of the comforter, and he sleeps under all the layers, and I sleep under the one blanket. I also like a fan on the floor so that if I get too warm in the middle of the night I can pull my blanket back and get cooled off fast. The other bonus is when I feel a migraine coming on, I can move the fan so it blows in my face, which helps stave off the headache. If I’m awake enough, I’ll get up and use one of my other fast-acting tips, such as grabbing a cold pack and putting it on the back of the neck.

For those of us who suffer from insomnia, with or without migraines, there are some more advanced steps that can be used to help with sleep. One of the most effective things I’ve found is taking 5mg of melatonin half an hour before bedtime – I especially like the extended release formula. You can start with 2mg and move up to 5mg if you don’t feel it’s working, but don’t take more than 5mg, as that can actually disturb your sleep. If you start waking up in the middle of the night and can’t go back to sleep, try reducing the amount you’re taking. Taking it every night helps establish a healthy sleep pattern, so eventually if you miss a night it won’t matter, and some people can slowly step down off the melatonin and continue to sleep well.

Another thing that can work miracles in achieving better sleep is meditation. Whether you try meditating in silence, to music, or using a meditation CD, daily (and nightly) meditation helps calm the mind and sleep becomes much more automatic. I personally do quiet meditation during the day and often use meditation CDs at night. I wear headphones and listen to it through a portable cd player as I’m falling asleep, then some time during the night I wake enough to slip off the headphones. Insomnia had been my constant companion for decades, paired with the migraines, and meditation made a huge difference in quality of life for me – both in sleep quality and migraine control, and I’ve seen it do the same for many of my clients. It may not be for everyone, but if it’s something you can experiment with, you might notice a change in how you sleep as well as how you feel on a daily basis.

When it comes to sleeping and migraines at the same time, it can get complicated. Some migraines ‘like’ pressure on the head, and if you can get into the right position, you may be able to fall asleep and beat the migraine. Other migraines ‘dislike’ any pressure, so lying down is out of the question. Sometimes you can fall asleep and the migraine will ‘blossom’ and wake you, and by then it’s too well established to use any of the early onset practices, so heavy prescription meds are the only answer.

If you try sleeping but you can feel your headache doesn’t like the pressure, it’s better to get up. Have a cup of caffeinated tea and take an OTC or prescription pain reliever, put a cold pack on the back of the neck and maybe on your eyes, snuggle up in a warm blanket so the body doesn’t get chilled, and wait it out. Once you start to feel the headache responding, then you can try going back to bed, but you might want to take a fresh cold pack with you, or a cold eye mask.

When you are finally able to sleep, be careful not to oversleep, or that can trigger another onset. It’s better to get up as soon as you wake and try to nap later or just go to bed earlier the next night than to sleep too long. For many people, getting ‘too much’ sleep is a trigger, and too much can be anything over 4 – 6 hours. So if you’ve managed to get a chunk of sleep in – at least a few hours – and have naturally awakened, it’s best to get up.

Napping can be a wonder cure for people with migraines, and it can also have its downside. If you take a nap, and the room is warm, and you sleep for more than an hour, you may wake up with a migraine even if you didn’t have one when you went to lie down. On the other hand, when you have a migraine, take your drugs or a cup of tea, grab a cold pack and go lie down, napping can help you through the onset stage, and the headache is gone by the time you wake up.

The best way to figure it out is to keep a journal of sleep and napping patterns, and how you felt before/after, and if you’d taken anything before sleeping. You’ll start to see your patterns emerge and will be better able to judge what the right action will be for you.

We all need enough good, pain free and restful sleep. Finding the right combination of what our bodies need to achieve that takes a bit of experimentation and paying attention to what helps and what doesn’t.

For more tips and information on better sleep, migraine pain control and meditation, visit my website at www.balancedlifetoday.com or my blog at www.balancedlifetoday.com/blog/. Please post any questions you may have on my blog.