Beyond Medication: Sleep and the Migraine Brain

Written by Jessica Puterbaugh | March 19, 2024

Sleep and Migraine

If ever there was a tale of a complicated relationship, it is the story of sleep and the migraine brain. Get too much sleep, and you will likely trigger an attack. Get too little, and you are also likely to trigger an attack. Feel tired and take a nap, and yet again that can trigger an attack. Fatigue is a highly common and debilitating symptom among those with migraine, and yet many report migraine wakes them up and is the cause of not getting enough sleep. To complicate matters even more, for many, sleep is often the only thing that relieves the pain of a bad attack, and getting quality sleep at night has been shown to reduce head pain. So how do we navigate this ever so complicated relationship? Prioritizing sleep and maintaining good sleep hygiene is an important place to start. Here are some tips for getting your brain the rest it needs.

8 Tips for Good Sleep Hygiene:

1. Create a consistent sleep schedule.

It’s important to go to sleep, and wake up, at the same time every day. Even on weekends. According to the National Sleep Foundation, most adults need between 7 and 9 hours of sleep a night. If you’re getting less than that, try going to bed about 15 minutes earlier each week and working your way up to more sleep time. If you’re sleeping more than that, try gradually waking up a bit earlier, as too much sleep time can also trigger attacks. When setting a sleep schedule, make very gradual changes so that you don’t surprise your brain with too much too quickly, as this will likely trigger an attack – remember, the migraine brain doesn’t like change, so take it slow and easy.

2. Develop—and stick to—a bedtime routine.

Again, the migraine brain loves consistency. Developing calming bedtime rituals can help your body and mind unwind from the day, and send signals to your brain that it’s time to sleep. Some bedtime rituals may include:

  • Taking a warm bath or shower
  • Doing some light stretching
  • Listening to soft, soothing music
  • Drinking some tea (make sure it’s caffeine-free!)
  • Reading something light and familiar

3. Avoid naps.

This is a tricky one for those with migraine, as we so often feel exhausted. Taking long naps during the day can sabotage our nighttime sleep, creating a vicious cycle of never feeling well-rested. If you must nap during the day, try to take a quick power nap, sleeping only 10—20 minutes, and do it earlier in the day so it does not interfere with your bedtime routine.

4. Create an environment conducive to sleep.

Your bedroom should be calm and free of distractions. Ideally, it should be a room used only for sleeping. Consider the light, noise and temperature of the room:

  • Use dark curtains or black out shades to block unnecessary lights
  • Try a white noise machine to neutralize noises during the night
  • Keep the room cool and choose lightweight sheets and bedding that won’t get too hot during sleeping

5. Avoid overstimulating activities before bedtime.

Limit screen time, including TV and social media scrolling, in the evenings and try to not to use any screens 1-2 hours before bedtime. Likewise, avoid listening to or reading anything too stimulating close to bed, and try not to get into any heated discussions or arguments close to bedtime. Give your brain time to decompress before it’s time to sleep.

6. Hydrate during the day and limit fluids a few hours prior to going to bed.

Try to make sure you are getting enough fluids during the waking hours of the day. This can prevent the need to make those pesky nighttime trips to the bathroom, which can often lead to wakefulness and loss of precious sleep time, especially as we get older.

7. Avoid too much caffeine.

While caffeine can help abort attacks for some, drinking too much or too late in the day can make it difficult to fall asleep and can disturb your nighttime sleep patterns. If you must have caffeine, limit it to small amounts and drink it early in the day.

8. Stay active during the day.

Exercise can relieve stress and help you sleep better at night. Just be sure not to exercise too close to bedtime. Read more about the benefits of exercise for migraine management and how to create an individualized exercise plan.

Prioritizing sleep and organizing your sleep schedule can help you improve the quality and length of your sleeping time, and help you better manage life with migraine.

If you have tried these tips and still have trouble getting adequate sleep, talk with your doctor. Underlying conditions such as sleep apnea, restless leg syndrome, asthma, GERD and thyroid issues among others can greatly impact the quality of your sleep, so it’s important to cover all bases.

Tell us! How does sleep impact you? Do you have any healthy sleep habits to share?

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