As patients have found relief from sphenopalatine ganglion (SPG) blocks, researchers have been looking for ways to make the procedure easier for the patient.
Today the research is continuing. Although the SPG block is considered a temporary solution, there is some evidence that there may be a longer term benefit, with some patients reporting that their attacks lessen even after the initial benefit of the block wears off.
But there have been problems with the procedure. Some doctors have used long Q-tips inserted in the nose, but the procedure is uncomfortable and it’s unclear how much medication actually reaches the SPG.
Sometimes needs are also used, and anesthetics.
But new devices are being developed to make the procedure a lot easier and more effective. A device is placed in the nose, and a small spaghetti sized catheter is gently released, getting the medication directly to the SPG with a minimum of discomfort.
Here are a couple of videos to check out.. The first is an actual patient with the Tx360, and the third the Tx360 again (a longer video explaining the procedure to doctors).
Just how common is sleepwalking? Estimates range quite a bit, although a study in 2012 suggested that almost 30% of us walk in our sleep sometime in our lives.
Those who sleepwalk on a regular basis do tend to complain that they’re sleepy during the day. But there may be a lot more to the condition than we realize. Sleepwalking is closely related to other disorders, including depression, headache, and migraine.Photo courtesy Herzi Pinki
The relationship between sleepwalking and migraine is a complex one. For example, depression and migraine are also linked. Magnesium levels are linked to both migraine and sleepwalking. Changing sleep schedules are linked to both. Certain medications may affect both, such as antihistamines, mild tranquilizers and a few antipsychotics. Obstructive sleep apnea is also strongly related to both.
This spring a report on a fascinating sleepwalk study was released. The authors of the study confirmed that migraine and headache were highly associated with sleepwalking. (This doesn’t mean that most migraine patients walk in their sleep. It does mean that if you sleepwalk you are much more likely to have migraine.)
But a fascinating twist is that patients were very unlikely to experience pain while sleepwalking. In other words, banging your knee on the table while you’re sleepwalking is unlikely to even wake you up. In fact, one patient fell off his roof and broke his leg, but didn’t wake up until the morning!
There are obviously many mysteries about pain still to be solved. However, there are some key things you can do about sleepwalking, especially if you have migraine as well:
Get into a regular sleep schedule, and dedicate more time to sleeping/getting to sleep. Take some low-stress, low-light, low-technology time in the evening.
Focusing on your sleep may actually help relieve migraine and stop sleepwalking. It’s funny in fiction, but it needs to be taken seriously in real life.
You’ve noticed it’s starting to happen on a regular basis. All of a sudden, you wake up with a headache.
You didn’t have the headache when you went to sleep. Where did it come from? It may just be mild, but it could be severe – you might even feel sick.
Now that you’re awake, the headache lasts for a few minutes – but could even last up to four hours.
And it’s happening several times a week now – twice a week, maybe four times, or even every night.
It’s possible that you have a rare kind of primary headache known as hypnic headache.
But don’t jump to conclusions too quickly. This headache, sometimes known as the “alarm clock headache”, really is quite rare. It tends to happen in people over the age of 50, and it can easily be misdiagnosed.
The reason is that there are many other reasons why you may wake up with a headache. Sleep apnea is a common trigger of certain headaches, for example.
If you wake up feeling restless, it probably isn’t hypnic headache. A hypnic headache generally won’t last for more than 4 hours. And it will wake you up quite often – more than twice a week, often every day.
If you suspect you have hypnic headache, your doctor will want to ask some questions to try to find an underlying cause. Chances are she will give you a different diagnosis. Like I said, it’s rare.
However, if you are diagnosed with hypnic headache, there are some excellent treatments.
A recent study suggested that lithium is the best treatment for these types of headaches. Oddly enough, caffeine consumption upon waking is the second-best treatment. Melatonin or indomethacin may also be tried if these are not effective.
For more information about hypnic headache, check the links below:
With all the new treatments becoming available for migraine, it’s easy to forget about some of the older treatments that have helped some people avoid attacks.
Back in the 1960s, researchers began to realize the important connection between migraine and a certain neurotransmitter – serotonin. As the decades went by, there was an increasing interest in the relationship between serotonin and migraine, and finding ways use this knowledge to treat attacks.
Today we know more about the complexity of migraine and migraine attacks. But serotonin remains an important, and at times controversial, component. Low levels of serotonin not only relate to migraine, but other comorbid diseases and disorders, including depression, sleep problems, and other types of chronic pain. One complimentary treatment has been especially studied as a migraine preventative – 5-hydroxytryptophan, or 5-HTP.
The body uses 5-HTP naturally in the creation of serotonin. As a supplement, 5-HTP is made from the seeds of griffonia simplicifolia, a climbing shrub native to central and west Africa. 5-HTP supplements have been used to treat a variety of conditions, including depression, fibromyalgia, insomnia, obesity, and sleep disorders.
The use of 5-HTP for migraine and other types of headache remains controversial, because not all clinical trials showed a significant benefit. Also, it seems that very little serotonin increase can be seen in the brain itself.
However, several trials did show that 5-HTP benefited patients, with a lessened need for other medication, lower pain levels, shorter attacks, and fewer attacks. It may be that the increase in serotonin the the body as a whole does benefit patients with migraine in particular.
Taking 5-HTP for Migraine or Headache
Like many supplements, it is best to use 5-HTP as a complimentary preventative treatment. And as with any preventative, it is helpful to try it for at least three months, using a headache diary to measure its effectiveness.
Clinical trials have generally used 400-600mg of 5-HTP daily for adults (20mg per 10lbs/4.5kg of body weight for children).
You should take extra caution with 5-HTP if you have diabetes or high blood pressure. Do NOT take 5-HTP with antidepressants. If you are taking triptans, or other supplements, talk to your doctor.
Back in March I posted some information about “Icekap”, a “hat” with ice packs that can be used for conditions like migraine and insomnia. That may not sound like an astounding product at first, but it actually generated a huge amount of interest from our readers.
Andrea Jones, the founder of Icekap, was kind enough to send me an actual Icekap to try – so here’s a review.
Initial Observations
Taking my first look at the Icekap, I was impressed with the quality. This is not something that’s been thrown together. The material is soft. There are three ice packs, an extra “fleece sleeve” for one of the ice packs, and a bottle with 5ml of essential oil.
Actually using the Icekap
Sliding in the ice pack for the posterior pocket.Just reading the information on the Icekap website, this is the part I was a little confused about.
So what I did was put the three ice packs in the freezer. When I was ready to use the Icekap, I took them out. There are three “slots” on the inside of the cap. You can just turn it inside out and slide the ice packs in. It won’t fall out because of the way the pocket is designed.
The first large one goes in the back, where it will cool the back of your neck. The second large one slides into a pocket on the top, to keep the top of your head cool. Finally, the long skinny one goes across the front, to cool your forehead. With the skinny one you have the option of putting it in an extra “case” so it won’t be quite as cold.
The Icekap then slides easily onto your head.
On either side is a strap, which you can either leave loose or attach (velcro-type fastener), depending on how tight you want the cap to be.
The regular size Icecap (more on sizes in a moment) weighs about 640g once it’s all assembled together (if you use every piece). But it’s balanced and comfortable and didn’t feel heavy to me.
That’s it! You can press and knead the ice packs a bit to make sure they’re comfortable and where you want them to be.
The essential oil is basically a little bonus. It’s a mix of lavender peppermint in a coconut oil base. If you want, you can apply two or three drops onto your neck or wrists or even use it in a diffuser.
Pros and Cons of the Icekap
Oddly enough, my biggest complaint is that the Icekap is VERY cold. Now that is obviously what some people want, but let me explain a bit more.
The ice pack on your forehead is particularly pressed against your skin. Now there is more than one layer of material there, so it’s not like you’re going to get frostbite. But if you have a larger head (mine is about average, I think!) and the regular size Icekap, you may find it pressing quite a bit and so very cold.
I think the second time that I tried the Icekap the packs weren’t quite as frozen, so it was a little better.
Obviously this will vary with the temperature of your freezer. And the solutions are simple – in fact, it’s probably better to have the packs a little too cold than not cold enough.
First, you can add the extra sleeve for the pack in front. You can adjust the pressure somewhat. You can put the Icekap on for less time, and then repeat (that’s what I did, and it worked fine). Actually, you won’t want to have it on for more than 15 minutes to half an hour at a time.
Long ice pack with fleece sleeveActually, the packs are very adjustable. You don’t even need to use all of them – you can easily wear the cap with only one or two packs where you want them. With the extra cover, you can use the long pack separately – I tried it, for example, on the back of my neck all by itself. It also works over the eyes if yours are feeling hot and swollen.
Now this problem would probably be solved with a large size Icekap. I would encourage the average and large men out there to go with the large for sure. It’s very adjustable, so it’s easier to make it more snug than to loosen it.
If anything, it was smaller around for me than it was up and down. But you can actually pull it down partway over your eyes to help block some light.
In fact, it’s reversible! You can wear it with the larger ice pack at the front (just turn the Icekap around) and have the cool and dark right over your eyes. Nice!
The packs themselves are excellent quality (I’ve tried quite a few different kinds – even reviewed one here). They didn’t get hard, and are easy to “knead” a little to the softness and shape you want them.
I also tried heating one – ten seconds at a time. Just knead it a little and let it sit for a couple of minutes so the heat is distributed throughout.
The material of the Icekap itself is soft and stretchy, and easy to adjust.
The ice packs are not hard to put into the Icekap. However, you might want to consider putting them in ahead of time, putting the whole cap in a freezer bag, and putting them all in the freezer together. That way you don’t have to mess around with assembly in the middle of a migraine attack. Again – they’re not hard to put in, but during a severe attack the easier and faster the better.
This is not a fashion cap you’ll want to wear out on the town, but it has the feel of a topper for a Yukon winter when you’re just getting the dog sled ready. 🙂
The essential oil is also an excellent bonus (and I’ve tested a lot of those too). Lavender and peppermint are two of the most popular oils for aromatherapy for migraine, and the go well together. Of course, not everyone will want to use the oils during an attack, but if not putting them into a diffuser at bedtime would be lovely.
Final thoughts…
Overall, I’m happy with the Icekap, I will continue using it, and I do recommend it. It does seem to be better than just using ice packs, because you can adjust the “cold therapy” against your head and keep it there even as you roll around in bed or move around the house.
I didn’t try it later on at night, but I suspect it would be a huge help for someone with insomnia. Grab it from the freezer and put it on, just for five minutes, and chances are you will sleep a lot better. You could even pull out the ice packs afterwards and put them in your pillow, although I think using the Icekap itself is far more effective. I hope to give it a try one day soon.
Now that you’re awake, the headache lasts for a few minutes – but could even last up to four hours.
or 
The first large one goes in the back, where it will cool the back of your neck. The second large one slides into a pocket on the top, to keep the top of your head cool. Finally, the long skinny one goes across the front, to cool your forehead. With the skinny one you have the option of putting it in an extra “case” so it won’t be quite as cold.
On either side is a strap, which you can either leave loose or attach (velcro-type fastener), depending on how tight you want the cap to be.
