Do your sleep habits trigger migraines?

If you suffer from migraines, you may want to pay more attention to your sleep habits. That's the message from several studies, which show that sleep problems, like insomnia, may actually trigger migraines.

Migraines and sleep problems

Migraines begin when hyperactive nerve cells send out impulses to blood vessels, causing them to constrict, then expand. This is accompanied by the release of brain chemicals and inflammatory substances that cause the pulsations to be painful.

In a study published in the journal Headache, researchers conducted a detailed sleep interview with 147 women with transformed migraines (where occasional or episodic headaches become chronic at least half of the days of the month). When asked whether they were refreshed or tired on waking, not one reported feeling refreshed, and more than 80% said they were tired when they woke. Complaints about sleep problems were prevalent.

In a second study on sleep habits and migraines, also published in Headache, researchers provided stronger evidence that good sleep habits reduce both the number and intensity of migraine headaches. In these findings, 43 women with transformed migraines received behavioural sleep instructions or placebo instructions in addition to usual medical care. The women recorded their migraine headaches in diaries. At the end of the study, the women who received behavioural sleep instructions reported a significant reduction in migraine headache frequency and intensity.

How do sleep problems cause migraines?

Rapid eye movement (REM) sleep provokes migraines, says Dr Vincent Fortanasce, a Los Angeles-based neurologist and psychiatrist . Fortanasce says that REM sleep provokes most powerful migraines that occur five to six hours after sleep begins.

Most of us go through about six sleep cycles with about four stages of sleep, plus REM sleep. The deepest stages of sleep (stages three and four) are necessary for the production of sufficient serotonin and dopamine, both neurotransmitters.

These neurotransmitters are the "feel good" chemical messengers in the brain, and both depend on adequate sleep; a decrease in serotonin and dopamine is associated with poor sleep or sleep problems.

One reason for waking with migraines is that REM sleep is most powerful just before awakening. Sleep problems can then trigger migraines by causing instability of serotonin and a lowering of dopamine levels.

Antidepressants, specifically the selective serotonin reuptake inhibitors (SSRIs), may help stabilise serotonin membranes and block migraines. These medications are sometimes used as migraine treatment.

Do your sleep habits trigger migraines?

How are your sleep habits? Do you have difficulty falling asleep? Do you toss and turn most of the night? Do you feel irritable, fatigued and even depressed the next day after a rough night trying to sleep? Whether you suffer with migraines or not, non-restorative sleep and impairment of daytime function is a problem for millions of people.