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Progressive Muscle Relaxation to Conquer Sleep Issues

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Migraine is often associated with trouble sleeping. This means that a sleep disorder could be making your migraine worse, or your migraine may be contributing to your lack of sleep.

sleep trouble

One of the comorbid conditions, a condition that tends to go along with migraine, is restless legs syndrome (RLS) (also called Willis-Ekbom Disease). In RLS, you have trouble sleeping because of sensations in your legs. Your legs feel restless, or throbbing, or aching.

In searching for the latest research for RLS, I was reminded of one that is being used currently that has also been used for a long time for insomnia itself – and that is, progressive muscle relaxation. It was first described in medical literature almost a hundred years ago, but it’s still being studied today.

The beauty of progressive muscle relaxation is that you can learn to do it at home in bed, with no devices or drugs, and no spending of money. 🙂 It’s a technique that has been used with migraine patients, restless legs syndrome patients, and insomnia patients alike. That means that it also may help improve symptoms in a number of related conditions.

Progressive muscle relaxation is a specific way to tense and then relax muscles throughout the body. Detailed descriptions can be found in the linked articles below, but it’s not complicated. And trials have had quite positive results.

If you have trouble sleeping, do yourself a favour and check out an article or two below. This is a simple technique that may make a significant difference.

Migraine Fighting Devices: Getting Smarter?

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Devices designed to fight migraine continue to develop and build on one another. One example is the Relivion device.

Relivion for migraine

Relivion uses the familiar neuromodulation that we’ve seen in other devices such as Nerivio. It looks similar to devices such as Cefaly. But let’s let the makers of the device explain what they’ve done to make it unique:

Relivion® is the first non-invasive multi-channel brain neuromodulation system for treating neurological and neuropsychiatric disorders. It offers precise, personalized care by delivering unparalleled stimulation to six branches of the occipital and trigeminal nerves via three adaptive output channels. This creates a cumulative effect by releasing neurotransmitters in the brainstem and modulate brain networks associated with control of pain and mood.

A new ecosystem for brain neuromodulation

So basically, this device can provide stimulation to various nerves in the head through various “channels”. This means that the neurostimulation can be much more customized for the patient. And for the disease.

You may have noticed that there’s no mention of migraine here. Instead – “disorders”, plural. That’s because it’s been designed from the start to even be customized for different issues, including migraine.

The study for migraine was presented in 2019 at the American Headache Society Annual Meeting, in a report entitled “First Non-invasive Combined Occipital & Trigeminal Nerve Stimulation Digital Therapeutics System for Treatment of Migraine”. The study compared a sham device with a working device, and measured patient response at 1 hour, 2 hours, and 24 hours. At each time interval, patients using Revilion for migraine were in better shape than the control group. For example, 43% of patients using the device were pain free after two hours (compared to 11% in the control group).

The other reason that this device is adaptive is that it can be controlled using a smart phone.

And what else could this be used for, besides migraine? Depression is the main other condition at the moment, which will also be good news for migraine sufferers with comorbid depression. But it’s also being investigated for use for insomnia and ADHD.

As investigation continues with this and other devices, patients will have more options for pill-free treatment, and maybe even treatment that will take care of more than one condition.

For more information, visit the official site of the makers of Revilion, Neurolief. The study mentioned above can be found in pdf format here.

CGRP Medication Side Effects – “I hadn’t thought of that…”

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One of the things patients like about CGRP related migraine medications is that the side effects are often less than with other drugs. But there can be side effects.

Calendar clock
Side effects – mostly temporary…?

A recent study used a checklist to see if patients would notice other side effects that weren’t so obvious, or that they might not think of right away. The researchers were concerned that some of these were missed in some of the original trials.

This particular study was presented at the 62nd Annual Scientific Meeting of the American Headache Society, and came from the Chicago Medical School and Robbins Headache Clinic. 119 chronic migraine patients were first asked about side effects generally, and then they were handed a checklist.

The study itself is arguing for the use of checklists to identify side effects, but for us it is interesting to see which adverse effects were noticed using the checklist.

These patients had been on therapy for two months. What about you? If you’ve taken a CGRP related drug, have you noticed any of these? Here are the most commonly reported ones:

  • Constipation
  • Anxiety
  • Injection site reaction/irritation
  • Insomnia
  • Hair Loss
  • Muscle Pain/Cramps
  • Joint Pain
  • Irritability
  • Increased Headache
  • Depression
  • Nausea

Again, remember that generally speaking side effects from these medications have been mild. Some also go away with time. For example, many patients experience increased headache for a few days or a couple of weeks, but then start to feel better. Weight gain lasted from 1-4 months. Of course injection site reactions were usually very brief.

However, some symptoms could be ongoing, so do check with your doctor. Hair loss, constipation, and sexual dysfunction, for example, seem to last longer (but again, many people have no problems whatsoever).

What’s been your experience?

(Study abstract here (scroll down): CGRP Monoclonal Adverse Effects: Evaluation Via Use of a Checklist

What’s Up? – I’m Just Not Sleeping Well!

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Most of us know that poor sleep can trigger migraine attacks, or make migraine symptoms worse or more frequent.

What we may not realize, however, is that there are many, many reasons why we may not be sleeping well.

A teddy bear with insomnia. :(

So today we’re going to look briefly at a few of those reasons – and think about some basic information that we can give to a doctor or specialist to start looking for causes and treatments.

A few [surprisingly common] reasons why people don’t sleep well:

  • Depression: A case where one can make the other worse, and vice versa.
  • Sleep apnea (sleep apnoea): …of various types.
  • Hot flashes
  • Your pet: It’s moving around, getting up onto your bed… ? It’s a common problem!
  • Migraine: Of course, had to mention that one. Another case where one can make the other worse.
  • Caffeine
  • Some antidepressants: And other common medications too!
  • Worrying about not sleeping: Yup
  • Sleeping pills: Yes, not using sleeping pills properly can lead to major problems.
  • Overactive thyroid
  • Acid reflux
  • Restless Legs Syndrome
  • An uncomfortable bed: Just how old is that pillow?
  • Poor bedtime routine: For example, too much screen time in the last two hours of the day.
  • Temperature: In the room/bed
  • Alcohol: (in spite of common myths)
  • Heart failure
  • Obstructive Lung Disease
  • Someone else in the room who can’t sleep

…and those are only a few examples. As you can see, some are serious in themselves, some not. Some are obvious, some are not. Some are easy to fix, some are not. But it helps to open up your mind and think about all the possibilities, instead of just assuming it’s one or two of the more commonly mentioned things.

It’s critical that we think about sleep when we’re trying to get good treatment for migraine, and other headache conditions as well. So where do we start?

Easy Sleep Evaluation

It helps to evaluate your own sleep, and then bring the information to your doctor. This doesn’t mean using an app with complicated charts, although that might be useful. And actually, you want to avoid obsessing too much about your sleep on a daily basis, which can easily make things worse.

Harvard Medical School has published a very useful “sleep diary” to fill out. There are simple questions for before bed, and after you wake up. They recommend using this diary every day for a week before talking to your doctor or specialist.

Before bed:

  • Medications during the day
  • Caffeinated beverages during the day
  • Alcohol during the day; list amount and time
  • Exercise during the day
  • Sleepiness during the day
  • Naps during the day
  • Food consumed within three hours of bedtime
  • Activities within two hours of bedtime

In the morning:

  • Bedtime last night
  • Approximate time it took to fall asleep
  • Approximate number of awakenings during the night
  • Reasons for awakening, if known
  • Time of awakening for the day
  • Level of energy and alertness after waking up in the morning (feeling refreshed?)

If you sleep with someone else in the room, also ask them what they’ve noticed about your sleep.

For more useful information, check out the full article here: Insomnia: Restoring restful sleep

Yes, Fibromyalgia and Migraine are Strongly Linked

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Another study has confirmed the link between fibromyalgia and migraine, with some interesting side notes.

The study was actually comparing chronic migraine (CM) and chronic tension-type headache (CTTH) with fibromyalgia, to see which were more connected. There was a connection with both – over a quarter of the patients with CTTH also had fibromyalgia. But for CM, over 2/3 had fibromyalgia!

Fibromyalgia and Chronic MigraineSome patients are so focused on one condition that they don’t take the time to consider the other. It’s very important to realize that you may be struggling with more than one condition, requiring more than one treatment. (For more, see Is Migraine a “Symptom” of Fibromyalgia?)

CM patients with fibromyalgia also experienced “increased frequency of photophobia, phonophobia, anxiety, depression, and insomnia”. Another reason why both conditions need to be taken seriously. This connection was not seen in the patients with CTTH.

Strictly on the fibromyalgia side, the fibro tended to have a higher impact on life if the patient also had chronic migraine.

It is very helpful to talk to your doctor if you think you may be dealing with more than one condition. There may be excellent treatments that can help with both. The more you know, the more you can choose the right treatment for you.

For more on this study, read: Fibromyalgia Among Patients With Chronic Migraine and Chronic Tension-Type Headache

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The articles on Headache and Migraine News are © 2004-2024 J. Cottrill.
Every effort is made to ensure the accuracy of each article, and to point you to further sources of information. However, this site is for informational purposes only and should never replace a visit to your doctor.