How to sleep with a migraine:
Millions of people happily hit the snooze button and enjoy an extra hour of sleep when daylight savings time ends. People with migraine, however, may dread turning the clock back. That’s because migraine brains do best on a consistent schedule, and sudden changes can trigger an attack.
If you have migraine and have trouble sleeping, you’re not alone. A new study found that people with migraine spend much less time in REM sleep, which is the most restful part. People with chronic migraines are almost twice as likely to have insomnia. People suffering from consistent migraines often wonder how to sleep with a migraine.
Even if you’re living with migraine, you don’t have to live with sleep problems and fatigue. The end of daylight savings is a good time to make a resolution: Try some new ways to get a better night’s rest. Here are some things you can try to help your sleep patterns when you can’t sleep with a migraine.
1) Develop a Better Sleep Schedule for Migraine
- Are sleep problems a migraine trigger for me?
- Why do migraine attacks wake me up?
- How can I get better sleep?
If you have migraine and you have trouble sleeping through the night, you’re not alone. People who have migraine are also 2 to 8 times more likely to experience sleep disorders, most commonly insomnia (difficulty falling or staying asleep).
However, researchers still haven’t pinned down the connection between migraine and sleep. It seems that migraine may cause disruptions in sleep, but sleep disruption may also trigger migraine. Or, one study notes, “migraine and sleep disruption may be symptoms of an unrelated medical condition, or they might be two intrinsically related phenomena with shared pathophysiological mechanisms.” Clear as mud, right?
Here’s the good news: Getting better sleep can potentially improve your symptoms. Here, we’ll answer some of the most common questions about sleep and migraine.
How do I know if sleep problems are a migraine trigger for me?
Even if scientists can’t agree on the underlying reasons sleep is linked to migraine, it can be really helpful to figure out how your own sleep patterns affect migraine. How? Start by gathering data.
- You might want to get a sleep tracker, such as the Fitbit, the Oura ring, or a pad that slips under your mattress. These trackers generally monitor several different aspects of sleep, including:
- How long you sleep each night
- The quality of your sleep — do you wake frequently? Toss and turn?
- The phases of your sleep, from light to deep to REM
- Environmental factors affecting sleep, such as the ambient temperature
- Lifestyle factors affecting sleep, such as exercise and caffeine
Once you have better information about how much and how well you’re actually sleeping, pair that with data about your migraine attacks. Download the free CeCe migraine management app, which makes it easy to log attacks and identify trends and triggers.
Armed with data about your sleep and your migraine attacks, you’ll see patterns emerge. Maybe you’re more susceptible to attacks when you stay up late for a few nights in a row. Maybe oversleeping on the weekend is to blame.
You also can consider doing a sleep study. This is when you actually spend the night in a sleep center while medical staff monitor your brain waves and analyze your sleep cycles. They may identify a serious underlying problem, such as sleep apnea (when you stop breathing at intervals throughout the night).
2) Start — and stick to! — a relaxing nighttime routine.
Maybe you crash into bed every night when you’re exhausted. Maybe you stay up too late scrolling on your phone or playing games. Maybe you rush around the house trying to get a few last tasks done before the chaos of the morning. Whatever your typical routine (or lack thereof), it’s time to rethink it.
If you’re wondering how to fall asleep with a migraine, try implementing a new routine. Experts recommend activities like:
- Playing calming music
- Reading or working on a word or number puzzle
- Dimming the lights
- Practicing a meditation or mindfulness exercise
Any of these relaxing activities will allow your brain to wind down from the day and prepare your body for sleep.
With CEFALY’s migraine devices, you can treat the root cause of your migraine before bed or at any time. When you attach the device to your forehead, it stimulates your trigeminal nerve and can lower the frequency of migraine attacks. You can use CEFALY either at the onset of a migraine or as a daily preventative treatment.
Examine your sleep environment.
Flat pillows. A too-warm comforter. An old, sagging mattress. Sound familiar? Upgrading your bedroom can help upgrade your sleep as well. Even if you’re on a budget, you can make small improvements, such as a mattress topper, a new pillow or crisp sheets. Some migraineurs say a weighted blanket helps them sleep.[iii]
Also, consider temperature and light. Set the thermostat to between 65 and 69 degrees Fahrenheit (adjust based on your own preferences). Invest in light-blocking shades and low-watt bulbs, or a dimmer.[iv] These changes may also help you feel better during a migraine attack, when all you want is cool darkness.
Be vigilant about cutting off caffeine.
People with migraine often have a love-hate relationship with caffeine. For some, caffeine can help relieve migraine pain; for others, it can trigger an attack. If you do consume caffeine, a good rule of thumb is to do so no later than 6 hours before bedtime. If you drink caffeine closer to your bedtime, it could interfere with your sleep and possibly trigger a migraine.
Another good practice with caffeine is to track your consumption levels and compare that to your migraines. Try tracking how much caffeine you drink and when you usually drink it. Then, compare those amounts to your migraine and sleep patterns.
See if you spot any correlations. If you notice you get bad sleep or more frequent migraines after caffeine, consider lowering your consumption.
3) Practice methods that can help you fall asleep — or fall back asleep.
Sometimes you feel more than ready for a good night’s sleep, only to lay down and find yourself awake for hours. Or, after finally falling asleep, you wake up a couple of hours later and find it impossible to drift off again. These sleep disturbances are even more common after daylight savings when an hour’s difference might throw off your sleep patterns.
Unfortunately, abrupt changes in sleeping patterns can trigger migraines. So, practicing ways to help you drift off to sleep becomes very important for people with migraines. If you’re concerned about migraine preventing sleep, consider new relaxation methods.
Recently we shared some migraine relaxation techniques that can also be used for sleep, such as progressive muscle relaxation and breathing exercises. Here are a few more to try:
- Pay close attention to light levels. As the CDC explains, being exposed to bright light two hours before bedtime will shift your sleep cycle later, “so you will tend to get sleepy and fall asleep later in the evening and will wake up later in the morning.” Being exposed to bright morning light does the opposite: it adjusts your sleep cycle earlier, so you fall asleep sooner.
- If you have a hard time falling asleep at night, dim the lights in your house in the evening, or wear dark sunglasses inside. It’s especially important to avoid blue light — the light emitted from phones and screens.
- Adhere to a set sleep routine. Try practicing good headache hygiene. This means sticking to healthy, predictable routines for eating, drinking, exercise, and sleep, including going to bed at the same time every night.
- Try non-pharmacological migraine treatments. Medication can affect your sleep cycle, whether by making you drowsy or waking you up when it wears off. Consider a clinically proven alternative to medication: the CEFALY device. It produces a mild sedative effect in many users, helping them fall asleep. When the 20-minute PREVENT mode is used daily, it gradually desensitizes the trigeminal nerve to reduce the frequency and severity of migraine attacks.
- Cut out caffeine and alcohol. Not only are both substances known migraine triggers, but they can disrupt sleep as well. One recent study found that the odds of having a migraine increased for those drinking three or more caffeinated beverages per day, but not for those consuming two or fewer per day.
- Upgrade your sleeping environment. If your mattress is sagging or just not supportive, you might want to invest in a new one. New pillows, fresh linens and cozy blankets all can help, as well as a fan for air circulation and white noise. Light-blocking shades are a must.
- Visualize a calm, peaceful place: Sometimes we lay awake because of excessive worries about our current situations. Instead of ruminating on these, paint a mental image of your favorite place. Whether it’s a calm beach with crystal blue water or your quaint back patio, envision yourself in this safe place. Try picturing the nearby sounds, smells and feelings that would occur while you’re there. Let this visualization relax you and it might take your mind off migraine pain or insomnia.
- Listen to soothing stories or guided meditations: If you want to distract yourself from your thoughts, try listening to comforting stories or meditations. If you have a favorite book that relaxes you or know of an effective meditation, keep that readily accessible. Find an audiobook, plug in your headphones and get lost in the words.
- Write down the things that worry you: If worries keep you awake, sometimes getting them out of your head and onto paper is the best way to drift off. Keep a notepad and pen by your bed just in case, so if you feel the urge to write, you can start quickly. A lot of times, when you transfer your fears onto the page, they don’t feel as scary. Treat it as though you’re emptying your head of these thoughts, and you might fall asleep more easily.
- Distract yourself with a mental challenge: Distracting yourself with a puzzle is another way to fall asleep. Try something like counting backward by sevens or pondering a tough crossword clue. Too often, we get so caught up in not being able to fall asleep that we let this stress keep us awake. If you focus on a mental puzzle instead, you distract yourself from these thoughts and induce sleep.
But, why do migraine attacks wake me up in the early morning?
Do you often wake up with migraine pain? The reasons why can be complex. If you take medication at night, it may wear off overnight, causing migraine pain in the morning. Caffeine withdrawal, too, may be the culprit. Other possible causes can be dropping endorphin levels, dehydration and — you guessed it — sleep disturbances.
To identify the reasons for your morning migraine attacks, keep logs of your daily routines: food, drink, medication intake, sleep times. See if there’s a strong association between any of these factors and the incidence of morning attacks.
Can you sleep off a migraine?
For many, sleep can be beneficial to provide relief from migraine pain. Although it’s important for those with migraine to stick to a regular sleep schedule, a brief nap can offer some relief.
Talk to your healthcare provider about chronic sleep problems.
Poor sleep may be caused by a physical condition you’re unaware of, such as sleep apnea or bruxism (grinding your teeth). Ask your healthcare provider to screen you for these conditions if you think they might be disrupting your sleep.
Insomnia also may be caused by migraine attacks. The early morning is a peak time for migraines because pain medications tend to wear off between four to eight hours. If you wake up with a migraine, ask your healthcare provider about options, including drug-free migraine acute and preventative treatments, to reduce your pain and get a restorative night’s sleep. Healthcare providers can help inform you on how to sleep with migraine.
Did you know CEFALY DUAL is now available without a prescription? Learn more about how CEFALY works and try it with our risk-free 60-day guarantee.
(Last updated on September 6, 2022)
[i] Kelman L, Rains JC. Headache and sleep: examination of sleep patterns and complaints in a large clinical sample of migraineurs. Headache. 2005 Jul-Aug;45(7):904-10. doi: 10.1111/j.1526-4610.2005.05159.x. PMID: 15985108.
[ii] Piquet M, Balestra C, Sava SL, Schoenen JE. Supraorbital transcutaneous neurostimulation has sedative effects in healthy subjects. BMC Neurol. 2011 Oct 28;11:135. doi: 10.1186/1471-2377-11-135.
[iii] https://americanmigrainefoundation.org/resource-library/establishing-healthy-sleep-habits/
[iv] https://www.hopkinsmedicine.org/health/wellness-and-prevention/preparing-your-bedroom-for-a-great-nights-sleep
[v] https://www.healthline.com/health/nighttime-routine#winding-down