behavioural sleep modification

Headache, migraine and sleep – we’ve known for a long time that these things are connected.  Changes in sleep patterns can trigger migraine attacks (this may be one of the reasons you get “weekend headache“).

But there is a key indicator which could put you on the road to better treatment.

The question is:  When you woke up this morning, did you feel refreshed?

In fact, do you generally feel refreshed when you wake up in the morning?

Well, you should.  But if you have chronic migraine, you probably don’t.

A study at the University of North Carolina set out to see how women with chronic migraine felt in the mornings.  87.7% said they felt “tired”.  And – get this – 0% – not one – reported feeling “refreshed”.

Of course there are a lot of disorders related to “un-refreshed” sleep, such as ADHD, fibromyalgia, restless leg syndrome, snoring – some of these things may cause it, some may be made worse by it.  One study found that feeling refreshed by sleep was an important predictor of psychological well-being (mental health) in men.  No doubt it’s the same for women.

For more on sleep and migraine, check out Migraine – Wakeful Nights and Sleepy Days?

So if you’re not feeling refreshed, what does that mean?

First, it could mean you have another disorder that is keeping you from getting good sleep, and therefore making your migraine and/or headache symptoms worse.  For example, sleep apnea, restless leg syndrome, or grinding your teeth.  Taking too many “painkillers” could also interrupt your normal patterns of work and rest.

It could also be that you simply have bad sleep habits.  You watch spend time on your tablet watching movies in bed.  You drink too much coffee late in the day.  You’re not letting go of the stresses and concerns of the day, but working through them at all hours.  You consistently go to bed late.

If you’re feeling tired in the morning – I don’t just mean groggy, but you wake up un-refreshed and tired – you should talk to your doctor.

And no, taking sleeping pills for the rest of your life is not the answer.  Your doctor will try to find out if there are other symptoms or conditions that are keeping you from sleep.  There are excellent questionnaires and simple tests that will point her in the right direction, and if need be she can call for a sleep test (polysomnography).

She can also help you with behavioural sleep modification (BSM), which will help you learn how to get more quality sleep.

In fact, in a follow-up to the first study we talked about, patients who received BSM did tend to improve.  In fact, almost half of those who had chronic migraine only had episodic migraine after 6 weeks.

That’s a major step in the right direction.

A lack of sleep isn’t just making your headaches worse.  It can impact every area of life.  If you’re not feeling refreshed in the morning, it could be a major clue that gets you on track to some important treatments.