Sleep
The healing powers of sleep for headache pain have been recognized in medical literature for over a century. In the late 1800s, researchers noted how sleep relieved headache, and physicians frequently prescribed hypnotic sedative drugs to induce sleep and treat pain.
Migraine research in the 1970s and 1980s began to explore the relationship of sleep to headache recovery. Several studies of migraineurs during this time found that those who slept during a migraine attack were able to recover more quickly than those who didn't sleep or merely dozed. The restorative power of sleep for headache resolution has also been noted by migraineurs in several largescale surveys.
Children with migraine are more likely to suffer from sleep disturbances and associated behavioral problems than their peers without migraine. This may include insomnia and resistance to bedtime. Educating children and parents about proper sleep hygiene and reinforcing positive sleep behaviors is important to reducing migraine frequency.
More recently, large-scale studies have demonstrated that migraineurs are more likely to experience sleep disorders (e.g., insomnia, sleep apnea). Those that are sleep deprived (i.e., sleep six hours or less per night) tend to experience more severe and more frequent attacks. Researchers at the Headache Center of Atlanta conducted a study of over 1,200 migraineurs, and found that 85 percent of patients choose to sleep or rest to recover from headache, and 75 percent of patients reported that they had no choice but to sleep or rest to resolve their head pain.
The exact mechanisms by which sleep helps to relieve migraine are unknown. But researchers have uncovered some clues. Migraineurs who experience attacks that wake them from sleep may have increased REM-stage sleep cycles. During REM sleep, the neurotransmitter changes in the brain, including decreases in serotonin production, could be the trigger for the appearance of a migraine attack.
Studies have shown that people who suffer from migraine are three times as likely to experience excessive daytime sleepiness. This may be due to the higher incidence of sleep disorders in migraineurs or from the sleep-robbing impact of migraine attacks and subsequent migraine-related disability.
Another biological clue to the sleep-migraine connection may be melatonin, a hormone secreted by the pineal gland. Melatonin helps to regulate sleep cycles and also has anti-inflammatory properties. Migraineurs may have lower levels of this hormone than the general population. Further large-scale studies are needed to determine whether or not melatonin supplementation is an effective treatment option for migraine patients.
Sleep hygiene, or the practice of getting regular, healthy amounts of sleep, can be a great preventative strategy in migraine treatment as well. A University of North Carolina study found that good sleep hygiene reduced the frequency of migraine 29 percent and the intensity of migraine pain 40 percent, compared to migraineurs who didn't practice good sleep hygiene.
Chapter 14 offers some helpful strategies for achieving healthy sleep patterns with proper sleep hygiene.
