There are strong associations between sleep deprivation and headaches, including migraines. At The Insomnia and Sleep Institute of Arizona, Dr. Vimala Sravanthi Vajjala offers headache medicine to help manage your head pain so you can get the sleep you need. It’s difficult to sleep when you’re in pain—and, likewise, that lack of sleep might increase your pain symptoms and headache episodes. There are many studies that show the correlation between headaches and sleep, including a recent analysis that used transcranial magnetic stimulation (TMS) as a method for pain management. They found that less sleep “alters central nervous inhibition from GABAergic and dopaminergic mechanisms differently in individuals with migraines versus those without.”
There are different types of headaches. Migraines are especially painful primary headaches. About 15 percent of adults 15 – 64 years old struggle with migraines globally. It is also the leading cause of disability in those under the age of 50. Most patients diagnosed with migraines also report having a headache upon waking and trouble falling and staying asleep. However, they also try to use sleep as a method for avoiding headaches, which can lead to unnecessary napping and hence more trouble falling asleep when they should be sleeping. It is a vicious cycle, but it can be managed with the right help.
Sleep Restriction Study
Sleep restriction, or having a sleep expert intentionally “withhold” sleep for two nights is a common human experimental model for analyzing insufficient sleep. This method was used for the migraine/sleep study and participants only got about 50 percent of the sleep they needed. A control group, those who don’t have migraines, were also included. In healthy participants, it was shown that deprivation can change the cortical inhibitory and facilitatory systems—which seemed to increase sensitivity to pain. This increased pain sensitivity has previously been found in those with a migraine diagnosis. It is also suspected to be connected to more homeostatic sleep pressure, which calls for a greater need for sleep.
Even with these findings, the researchers report that the relationship between migraines and sleep—as well as underlying pathophysiology—requires more investigation. The sleep restriction study revealed an opposite effect during the cortical silent time (which is an interruption of voluntary muscle contraction via stimulation of the contralateral motor cortex). During sleep restriction, the period was reduced to 139.6 minutes from 147.9 minutes, on average.
A Multi-Step Approach to Treatment
If you have both migraines and trouble sleeping, you may benefit from treating symptoms of both—at least initially. Our clinic offers headache medicine that is prescribed and recommended with sleep disorders in mind. After all, some headache medicine includes caffeine and other stimulants, which should not be used for those who are having problems falling asleep. Causes of insomnia, besides migraines, should also be addressed. You can combine headache medicine with options like cognitive behavior therapy for insomnia (CBT-I) for the most effective solution.
CBT-I includes identifying insomnia triggers and changing your sleep environment and sleep hygiene. For instance, removing all electronics from the bedroom and ensuring the temperature is right and lights are dim is a good first step. Avoiding caffeine and screens before bedtime is essential. Figuring out when to exercise in order to be healthy and ready for bed may take some trial and error under the guidance of a sleep expert. There are also calming activities like meditation, reading a book, drinking sleepy-time tea, and taking a warm bath which can help get your body and brain ready for bed.
Don’t think that headaches and insomnia are just part of a normal life. Get the help you need by contacting The Insomnia and Sleep Institute today. Give us a call during business hours or, for the quickest response, complete the online contact form.