Many headache sufferers struggle with sleep.
Headaches and sleep are closely linked, and the connection goes both ways: Headaches can make it more difficult to get a good night’s sleep, while poor sleep can trigger or worsen headaches.
That’s why it’s important to understand how sleep affects your headache, so you can get advice and treatment to better manage both your sleep and your headache.
In this blog, we’ll explore why sleep is important for preventing headaches.
Finally, we’ll describe some concrete measures that can help you get a better sleep routine.
The goal of good sleep as a preventive measure is the same as with other preventive measures we write about on headache-info.no: The measures help you tolerate more in everyday life and thus increase the threshold for getting a headache.
Hence the name LimiCeph. (Limina=threshold, and Cephalgia=headache).
Key messages about sleep and headaches:
- Good sleep prevents headaches: Sleep problems can both trigger and aggravate headaches.
Maintaining good sleep routines can increase the threshold for developing headaches and thus withstand more everyday stress. - Sleep problems are a risk factor for chronic headaches: Insomnia, sleep apnea, snoring and bruxism are common sleep problems that can lead to headaches.
People with chronic pain and head conditions, especially migraines, are at higher risk of developing sleep problems, and sleep problems also increase the risk of chronic headaches if you don’t try to improve your sleep. - Identifying the underlying causes of poor sleep is crucial: To effectively prevent headaches, it’s important to identify and treat the underlying causes of poor sleep.
This can include medical conditions such as sleep apnea, depression or medication side effects.
A thorough assessment can provide targeted advice and treatments that improve both sleep quality and reduce the risk of headaches. - Tips to improve sleep and prevent headaches: Establish good sleep routines, exercise regularly, and practice relaxation techniques to improve sleep and prevent headaches.
Feel free to read the blog for more and more unknown tips to prevent sleep and headaches.
If you want to see references to different parts of the blog, you can click on the relevant point, or contact us at post@limiceph.no.
What types of sleep problems are related to headaches?
The most common sleep problems that can lead to headaches are:
- Insomnia; difficulty falling asleep, difficulty sleeping through the night, or waking up too early and being unable to go back to sleep.
This happens at least three nights a week for more than three months.
Insomnia is often referred to as sleep problems. - Snoring
- Sleep apnea, which means that you stop breathing when you sleep. Breathing pauses of more than 10 seconds, more than 5 times per hour, are defined as illness.
- Bruxism/cutting teeth: Biting or grinding teeth at night can contribute to increased tension in the jaw, which in turn can cause headaches. Many people refer to this as tension headaches, but jaw headaches are probably more correct as the headache starts from the jaw.
Common to sleep problems is that you wake up with a headache, although insomnia can also cause headaches later in the day.
Often the headache is on both sides, or the whole head (global headache).
Some of the sleep problems have overlapping causes, and you may have several of the challenges at the same time.
Each individual with sleep problems must be thoroughly assessed to find the right advice and treatment, which in turn can provide good results in preventing headaches.
How many people with headaches have sleep problems or insomnia?
Sleep problems or insomnia affect 50 to 75% of people with chronic pain and head disorders, especially migraine. People with migraines are 2 to 8 times more likely to develop sleep problems compared to the rest of the population.
Children who struggle with sleep over a 10-year period are more likely to develop episodic and chronic migraines.
How can poor sleep trigger headaches?
Poor sleep can trigger headaches through several mechanisms:
- Disturbed pain control: Sleep deprivation can affect the brain’s ability to regulate pain.
When the brain doesn’t get enough rest, its ability to dampen the experience of pain can be reduced, which can lead to minor stimuli triggering headaches. - Inflammation: Poor sleep can increase levels of inflammatory markers in the body, which in turn can increase the risk of headaches.
- Hormonal imbalance: Sleep deprivation affects the production of several hormones, including melatonin and serotoninboth of which play a role in the regulation of sleep and headaches. Low levels of melatonin have been linked to migraines, while an imbalance in serotonin can trigger both migraines and tension headaches. Estrogen and progesterone also play an important role in relation to headaches. In women with a menstrual cycle, the last phase of the cycle can trigger headaches, especially if the body does not get enough rest. Due to the significant hormonal load in the last 10 days of the cycle, women need more rest during this phase. This underlines why migraine is often referred to as a threshold condition – more rest can increase the threshold for triggering migraines, even in conjunction with menstruation.
- Muscle tension: Poor sleep can increase tension in the muscles and make the nervous system more sensitive to pain. This can contribute to several types of headaches, including migraines, tension headaches, neck headaches/cervicogenic headaches, jaw headaches and cluster headaches.
- Increased sensitivity to triggers: Being sleep deprived can make you more sensitive to other headache triggers such as light, sound, stress, and changes in diet or physical activity. With little sleep, these triggers can trigger headaches, while with sufficient rest, you can experience the same triggers without getting a headache.
- Too little and too much sleep: Several types of headaches, including migraines, are best prevented by regular routines and good sleep hygiene, including going to bed and getting up at regular times.
That’s why it’s not just too little sleep, but also too much sleep that can trigger migraines.
For example, some people may experience more migraines on weekends or at the start of holidays when they sleep more.
Why do headaches cause poorer sleep?
Headaches can negatively affect sleep in several ways:
- Pre-phase of a migraine attack: The hours or days prior to a migraine attack, known as the pre-phase, can lead to sleep disturbances such as difficulty falling asleep or frequent awakenings, due to neurological changes in the brain. These sleep disturbances can both be a consequence of migraine and help trigger the attack itself.
- Pain: Pain is the most obvious factor that can disrupt sleep.
Acute headaches can make it difficult to fall asleep, while chronic pain can lead to frequent awakenings throughout the night. - Fatigue: Chronic headaches can lead to a constant feeling of fatigue, which in turn can disrupt sleep patterns.
Even if you feel tired, the constant pain can make it difficult to achieve deep, restorative sleep. - Hormonal processes: Hormonal changes resulting from headaches can affect sleep.
Here are some examples:- Cortisol, the body’s stress hormone, can cause you to go into “fight-flight” mode when you have a headache, making it harder to relax and fall asleep.
- Melatonin : In migraine, the production of melatonin can be reduced, making it harder to fall asleep.
- Serotonin: Both migraines and tension headaches can be linked to low serotonin levels. Chronic migraines in particular can reduce serotonin levels over time, which can affect melatonin production and lead to poor sleep.
- Lifestyle: With frequent or chronic pain, it can be difficult to exercise, focus on good food routines and it can be challenging to relax.
Many people are already stressed, or stressed due to the life situation that frequent or chronic headaches can lead to.
All these factors can affect sleep, among other things.
It is possible to get help with lifestyle challenges, and over time you can get better control of both your sleep and your headaches.
Medical conditions that can affect sleep
Several medical conditions can negatively affect sleep, including both underlying illnesses and the use of certain medications. For example, people with sleep apnea, depression or anxiety can often experience poor sleep quality, which in turn can lead to an increased risk of headaches. A wide range of medications, including cortisone, strong painkillers (opioids), beta-blockers and antidepressants, can reduce sleep quality .
Also, remember that overuse of painkillers and headache attack medications can cause headaches(medication overuse headache). Those struggling with MOH often wake up with a generalized, global headache due to the half-life of the medication.
Typical headache types associated with poor sleep
Migraines and tension headaches are the two most common types of headaches associated with poor sleep. Other headaches related to sleep are cluster headaches and hypnic headaches.
Also keep in mind jaw headaches and neck headaches/cervicogenic headaches as possible diagnoses. Both types of headaches can occur due to tension at night due to biting or unfortunate lying position, as well as stress and poor sleep.
How do you describe a typical headache in the morning after poor sleep?
Headaches that occur in the morning after a night of poor sleep are often described as a deep, pressing pain that can be present on both sides of the head.
Some people may also experience a “global” headache, i.e. the whole head, and the pain may come from within.
This type of headache can be accompanied by tiredness, difficulty concentrating, and a feeling of being “foggy”.
If you also suffer from migraines, cluster headaches, cervicogenic headaches or other types of headaches that often occur on one side, the poor sleep will primarily contribute to triggering a known headache, and the character is as it usually is.
The role of the hypothalamus in sleep and headaches
The hypothalamus, a small structure in the brain, plays a key role in both sleep regulation and pain processing.
It is responsible for regulating the body’s circadian rhythm, which controls sleep cycles, and also has connections to the brain’s pain pathways.
Dysfunction in the hypothalamus can lead to both sleep disturbances and increased pain sensitivity, which may explain the link between poor sleep and headaches, particularly migraines and cluster headaches.
Particularly striking are the various symptoms migraine patients may experience before an attack, such as changes in appetite (appetite or nausea) and sleep-wake rhythms (yawning, fatigue, sleep disturbances), hypersensitivity to certain stimuli (light, smell, sound sensitivity), mood swings and changes in fluid tolerance and others.
The hypothalamus is wholly or partly responsible for initiating all these responses.
Understanding the role of the hypothalamus in hormone balance, normal day-to-day symptoms and vital body needs can help us gain control of both sleep and headaches.
The role of the glymphatic system in sleep and headaches
The glymphatic system is a relatively new discovery of how the brain gets rid of waste products. The system is only active at night. One theory is that poor and interrupted sleep will contribute to impaired function of the glymphatic system, accumulation of waste products and more easily lead to migraines. There is currently too little research to conclude whether there is a relevant connection between migraine and the glymphatic system.
What part of sleep affects the headache?
Rapid Eye Movement (REM) sleep is particularly important in the connection between sleep and headaches. REM sleep is the phase of sleep in which the brain is most active, and it is during this phase that many of the biological processes necessary to process information and regulate emotions take place. Interruptions in REM sleep have been shown to be associated with an increased risk of headaches, especially migraines.
Deep sleep is essential for recharging your batteries and having enough energy. If you don’t get enough deep sleep, the threshold for headaches is lowered. You become more irritable, more tired and more sensitive to stimuli.
Great tips for sleeping better:
To prevent headaches, it’s important to first rule out direct causes of poor sleep, then establish and maintain good sleep routines that promote deep sleep.
Here are some concrete measures:
Medical conditions:
- Check with your doctor if there are any medical conditions that may interfere with sleep, such as sleep apnea, depression or side effects from medication.
Discuss what measures can help.
Jaw, neck and back:
- Get help from a chiropractor or physiotherapist if you have pain in your jaw, neck or back at night that disturbs your sleep.
Also ask about measures such as exercises, sleeping comfort, pillow, mattress, what you should do in the evening and in the morning, and everything you need to prevent.
Control over triggers:
- Identify and limit triggers that can trigger both poor sleep and headaches, such as evening stress, irregular meals or dehydration.
Remember that triggers don’t always trigger headaches if you increase your headache threshold by maintaining a healthy lifestyle, including enough rest, sleep and physical activity.
Sleep hygiene:
- Sleep schedule: Go to bed and get up at the same time every day, even on weekends.
This helps stabilize your body’s circadian rhythm. - Recommended number of sleeping hours: 7-9 hours for adults, and much more for children and adolescents. Try to go to bed earlier if you haven’t covered the recommended number of hours – don’t sleep longer in the morning.
- Screen use: Avoid screens at least one hour (preferably 4 hours) before bedtime, as the light from screens can suppress the production of melatonin, the hormone that helps you fall asleep.
Melatonin is stimulated by dark or dim lighting. - Environment: Make sure your bedroom is dark, quiet and cool.
An optimal sleeping environment contributes to deeper and more recharging sleep.
Diet:
- Avoid caffeine and alcohol: Caffeine and alcohol can disrupt sleep, so it’s best to avoid these substances in the hours before bedtime if good, deep sleep is the goal.
- Healthy food: Eat foods that promote sleep, such as walnuts, if you’re hungry before bed.
Avoid foods that give you unstable blood sugar, including slices of bread, and foods that are hard to digest, like meat.
Also limit salty foods. - Fasting: Many people will benefit from intermittent fasting to sleep better. Avoid eating 2-3 hours before bedtime. This can help the body prepare for sleep by reducing digestive processes that can disrupt sleep. Ifthe goal of fasting is to prevent headaches, fasting must be considered in relation to the type of headache you have as fasting without guidance can trigger headaches.
Physical activity:
- Regular physical activity can improve the quality of your sleep, but avoid intense exercise just before bedtime as this can make it harder to fall asleep.
Stress and relaxation techniques:
- Practice techniques such as meditation, deep breathing, or yoga to reduce stress and prepare the body for sleep.
- A warm shower before bed can help the body relax, making it easier to fall asleep.
- Establish a calm evening routine that signals to your body that it’s time to rest.
HRV measurement:
- Many people are fond of measuring sleep quality and stress levels using smartwatches.
- Low HRV can indicate high stress levels, which can affect both sleep and the risk of headaches (not well documented). Using HRV measurement can help you understand how your stress levels affect sleep and headaches.
- Be aware that HRV measurement is not 100% reliable, and many people experience a large margin of error between measured HRV at night and how you actually feel.
If HRV measurement causes you more stress than it helps you understand your own stress patterns, it is better not to use it.
Melatonin:
- It is recommended to try non-medical normal self-measures before melatonin supplementation.
Melatonin promotes sleep and makes it easier to fall asleep.
It is a hormone that is produced by the epiphysis when it gets dark.
That’s why it’s very important to limit screens and light in the evening, a few hours before going to bed.
Some people also believe that light in the morning can be helpful in stimulating the body’s natural circadian rhythm. - Taking melatonin as a supplement has become popular, but is controversial.
Some studies show that it can be useful for preventing sleep and migraines in some groups, but works best for falling asleep more easily, not for overall sleep quality.
Also, not everyone should take melatonin, due to interactions with other medications.
Therefore, you need to consult your doctor before starting.
Conclusion:
Good sleep is essential for preventing headaches and maintaining overall health.
By understanding the link between sleep and headaches, and adopting good sleep routines, you can effectively reduce the risk of episodic, frequent and chronic headaches.
If you often wake up with headaches, or if your headaches develop and become more frequent, you should see if you can take some simple measures to improve your sleep.
Follow the list above and see if it can help you get better control of your headaches.
Feel free to contact us for help in assessing whether sleep or other factors are affecting your headaches. Limiceph has clinicians with a master’s degree in headache, both neurologist and chiropractor.
Read more about sleep on the pages of the National Center for Sleep Medicine. If you need help with your sleep, visit this page to see what treatment options are available in Norway.
Good luck to you!
Remember:
Better sleep is one of many preventative measures that can help you reduce headaches and live a more balanced and pain-free life. Together with other lifestyle changes, you can achieve even better results.
If you are unable to control your headaches, an assessment by a qualified healthcare professional for non-medical and medical treatment is recommended.
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Bio:
This article was written by Martin Herneblad-Due, chiropractor with a master’s degree in headaches. If you have any tips on other topics or other input, we would greatly appreciate if you send an e-mail to post@limiceph.no.
If you would like a consultation to assess your headache or get advice on preventive measures, please click here.
Acute?
If you have a new type of headache, increased headache frequency, new symptoms or severe headache attacks, it is important to see a doctor for a thorough examination. Read more here about when to take your headaches seriously..
New assessment?
Remember that the advice above is general.
If you need help tailoring an exercise program, want a reassessment of your headache, or need a holistic approach to your headache, including diagnostics, treatment and preventive measures, please contact us.
We have both a chiropractor and a neurologist with a master’s degree in headache that can help you.
