What’s the Connection Between Insomnia and Migraine?

Insomnia can lead to an increase in migraine symptoms, but not the other way around. Cognitive behavioral therapy is a first-line treatment.

Living with migraine often goes hand in hand with insomnia. You might have trouble falling asleep or wake up in the middle of the night, or maybe you wake up too early and can’t fall back asleep.

These are all symptoms of insomnia, which is diagnosed when you have trouble falling or staying asleep for at least 3 nights a week.

You may also find that insomnia triggers migraine attacks.

Many researchers have tried to determine if insomnia causes migraine episodes or if it’s the other way around. They are finally beginning to come to some conclusions.

If you’re having trouble sleeping, read on for tips on how to manage. It may also lead to fewer migraine attacks.

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What’s the link between migraine and insomnia?

Researchers have been studying the link between migraine and insomnia for years.

A 2022 review found that disturbed sleep was common in people who had migraine and affected both adults and children.

According to a 2022 study, the risk of having migraine with poor sleep quality was almost four times higher than having migraine with good sleep quality. Poor sleep quality was linked to more pain, worse headaches, a bigger impact on daily life, lower quality of life, and more feelings of anxiety and depression in people with migraine.

How can you tell if poor sleep is triggering migraine attacks?

If you’re experiencing insomnia, tracking your sleep with a diary can help you determine how much rest you’re getting.

To track effectively, take note of the following:

• when you go to bed
• when you wake up
• how long it takes you to fall asleep
• how many times you wake up during the night
• how long you stay awake
• your overall sleep quality

You can also use sleep-tracking apps that sync with your phone or smartwatch. Then compare your results to a migraine diary to see if the two are related.

If you’re having trouble sleeping to the point it’s affecting your daytime activities, you may want to speak with your doctor. They can order a sleep study to look for other problems that may be causing you to sleep less soundly.

Common causes can include:

• circadian rhythm disorders
• sleep apnea
• narcolepsy
• stress and anxiety

Doctors can also use a noninvasive, wristwatch-like device called an actigraph to measure how well you sleep and your periods of rest and activity. You may wear it for up to 2 weeks.

Your health professional may also take blood tests to check for thyroid issues.

When to seek treatment for insomnia and migraine

Doctors can also suggest lifestyle changes and medical treatments to improve sleep. These changes may indirectly impact the frequency and severity of migraine episodes.

In an older 2016 randomized controlled trial, participants who received cognitive behavioral therapy for insomnia (CBT-i) had a 60% lower chance of experiencing a headache than those receiving a control treatment.

CBT-i is often the first treatment a doctor prescribes for insomnia. It’s typically a 6- to 8-week treatment plan that helps you learn how to fall asleep faster and stay asleep longer. It can help you feel less nervous about falling asleep, learn to relax and fall asleep faster, and practice healthy sleep habits.

It can involve sleep restriction therapy, which alots you a certain amount of time to spend in bed. CBT-i also uses stimulus control, which involves techniques such as using the bed only for sleep and not being in bed when you aren’t sleeping.

If these methods don’t work, doctors may prescribe short-term or long-term medications.

How to manage symptoms of insomnia and migraine

CBT-i helps reset your thoughts, feelings, and behaviors about sleep, which can help set the stage for a better night’s sleep.

Some tips, such as determining when to go to bed and when to get up, are individualized. Others are well-known for improving sleep cycles.

For example, once you determine your specific wake and sleep time, it’s recommended that you stick to it, even on weekends. This may be especially important for people with migraine.

Older foundational research from 2007 showed that sleeping too much, or oversleeping, was proven to trigger an attack for 32% of participants.

Caffeine and nicotine

Other adjustments may include changing what you eat and drink in the hours before bed. For instance, the stimulating effects of caffeine can take 8 hours to fully wear off. Nicotine is also a stimulant.

Alcohol

Alcohol can keep you in the lighter stages of sleep and cause you to wake up in the middle of the night after the sedating effects wear off. It’s also a common migraine trigger.

Large meals and excess liquids

Large meals before bed can cause indigestion, which can keep you from sleeping. Drinking too many liquids may interrupt sleep by waking you up for a trip to the bathroom. At the same time, it’s important to strike a balance so that you stay hydrated.

Complementary treatment options for insomnia and migraine

CBT-i can include other techniques to calm your mind and body.

Relaxation

Relaxation techniques can help you calm your mind and body. These can help you avoid worrying about not sleeping and may also be helpful in coping with migraine pain.

Exercise

Incorporating exercise early in the day, and no later than 2 to 3 hours before bedtime, can also be a stress reliever.

Stretching and gentle yoga may also be a way to unwind at the end of the day and can become a part of a routine that signals it’s time for the body and mind to shift into sleep.

Breathing and meditation

You may also learn other techniques like:

• breathing
• meditation
• guided imagery
• progressive muscle relaxation

Frequently asked questions

Here are some answers to frequently asked questions about migraine and insomnia.

Is insomnia a side effect of a migraine?

Recent research found that the chances of having a migraine attack are much higher for people with migraine after a poor night’s sleep. The two often go together, but insomnia isn’t caused by migraine.

Why can’t I sleep when I have a migraine headache?

It may be difficult to sleep while experiencing a migraine episode due to pain, discomfort, and the stress of the attack.

How can I get to sleep with a bad migraine attack?

If pain and other symptoms of migraine are making it hard to fall asleep, pain relievers or abortive medication are some of the best options for providing relief.

You can also try applying ice packs to help reduce pain and practicing relaxation techniques to calm the body and take your mind off of your symptoms.

What are the 5 Cs of migraine?

The 5Cs are thought of as some of the common migraine triggers for people. They include:

• chocolate
• coffee (and other sources of caffeine)
• cheese
• claret (and other red wines)
• citrus fruits

While these may trigger a migraine attack for some people, they don’t include all types of triggers, like a poor night’s sleep.

Takeaway

If you’re having issues with insomnia, like trouble falling asleep or waking up in the middle of the night, your doctor can help you determine why.

They may use CBT-i to help you reset your thoughts, feelings, and behaviors around sleep. You may also learn some new techniques to reframe your sleep issues that you can use when you have a migraine attack.

In the end, you may end up sleeping better and have fewer migraine days.