Sleep and migraine

By: Rachel Baxter, Communications Officer, The Migraine Trust

18th March 2022

In this blog, we answer common questions about sleep and migraine.

Does sleeping help migraine?

Many people find that sleep helps to ease their symptoms if they’re having a migraine attack. Even sleeping for just an hour or two can be beneficial. Sleep also appears to be particularly good at helping children recover from a migraine attack. If you’re having an attack and are able to lie down and get some rest, taking a nap may help you feel better.

I get a migraine when I sleep too much or too little, why is this?

Many people find that if they get more sleep than normal they wake up with migraine symptoms, while others find that sleep deprivation triggers their migraine.

A migraine attack caused by too much or too little sleep may actually be a way for the body to restore the delicate balance between sleep and wakefulness. For example, if you’ve slept too much, migraine pain might then keep you awake, or if you’ve not slept enough, feeling unwell with a migraine attack might force you to lie down and take it easy. Therefore, it’s thought that sleep-related migraine might be a way for your body to redress your sleep/wake balance by either keeping you awake when you’ve had too much sleep or forcing you to sleep when you’re sleep deprived (although a migraine attack is an extreme and over-compensating response).

We also know that the brains of people with migraine don’t like routine change. So, if you usually wake up at 7am Monday to Friday and then suddenly sleep in until 10am on a Saturday morning, this change in routine may trigger an attack. As can getting five hours of sleep after a late night when you’re used to getting eight hours most nights.

Sleep changes may also inadvertently change your eating routine – if your body is used to breakfast and a cup of tea at 8am every day, and you haven’t eaten or drunk anything by 10:30am because you’ve slept in, a drop in blood sugar or caffeine craving might trigger an attack.

If you do find that you tend to get migraine attacks following changes to your usual sleep pattern, trying to go to bed at the same time each night and setting an alarm at the same time everyday could help. Drinking plenty of water and eating breakfast once you’re up might also help you avoid a morning migraine attack. Keeping a migraine diary should help you and your doctor work out if sleep is a migraine trigger for you.

I can’t sleep when I have a migraine attack, what can I do?

It can be really difficult to fall asleep when you’re having a migraine attack, particularly if the pain is very severe, you feel like you might be sick, or you’re experience other intense symptoms. While there’s no magic one-size-fits-all solution for getting to sleep during a migraine attack, the following tips might help you.

  • Taking painkillers, anti-sickness drugs or migraine medication like triptans may help ease your symptoms, although triptans work best when taken right at the start of an attack. If you don’t have any medication, speak to your GP about treatment options. If nothing seems to help, ask your GP for a referral to a neurologist or headache specialist.
  • Avoid stimulants like sugar and caffeine as these can keep you awake.
  • Try eliminating lights and sounds from your room if you can, and avoid looking at screens.
  • Use hot or cold packs, like ice packs or hot water bottles, as these can help ease pain.
  • Try practising relaxation or deep breathing techniques (tools like the Calm app might be helpful).

Can certain sleep positions trigger migraine?

We know that neck and shoulder problems can make migraine worse for some people, and poor sleep posture might contribute to these issues. Pillows that are too firm or two high can result in neck problems – if you experience neck or shoulder pain or tension, it’s worth seeing a physiotherapist who will be able to assess the problem and give you advice on whether you might need to alter your sleep position.

Some people also grind their teeth at night and then wake up with a headache. If you suspect you might be doing this, take a trip to the dentist. If they think you’re grinding your teeth too much, they should be able to give you a special mouth plate that will help.

I get migraine attacks during sleep, what can I do?

If you find yourself waking up during the night or in the morning with a migraine attack in full swing, there a few things you can try:

  • Go to sleep and wake up at the same time each day, aiming for seven to nine hours of sleep. Try to avoid very late nights or sleeping in late.
  • Avoid looking at screens right before bed.
  • Drink plenty of water in the evening so that you’re not dehydrated during the night.
  • Sleep in a dark, quiet room if you can. Try to keep the room cool and make sure your pillows are comfortable and not hurting your neck.
  • Keep a diary of your migraine symptoms, when they happen, your sleep pattern, and things like what you’ve eaten and drunk and how stressed you’ve been during the day. You can then take this to your GP who will help you work out what might be triggering your attacks.

If you’re regularly waking up feeling unwell, it’s worth speaking to your GP who will be able to advise you on what to do and prescribe any necessary treatments.

If you experience headaches at night, it may not necessarily be migraine. Some people get a type of headache called hypnic headache, which happens when you’re asleep and causes you to wake up. Some people experience it every night. It’s rare and more common in people over 60. If you think you might have hypnic headache, speak to your GP. You can read more about this condition here.

Can sleep apnoea cause migraine?

Sleep apnoea is when your breathing stops and starts again while you’re asleep.

Research about whether the two conditions are linked is mixed. For example, this study published in The Journal of Headache and Pain found no relationship between migraine sleep apnoea in the general population after assessing 40,000 people in Norway. Meanwhile, this study published in Nature found that sleep apnoea and poor sleep quality appear to be more common in people with chronic migraine than people with episodic migraine, suggesting there may be some connection. Further research will tell us more.

If you do have sleep apnoea and experience headaches, particularly in the morning, you may be experiencing sleep apnoea headache. The symptoms of this type of headache differ from migraine – the pain tends to be on both sides of the head, the headache has a pressing quality, and it is not accompanied by nausea or sensitivity to light or sound. These headaches can resolve within four hours and can occur frequently, happening on multiple days each month. If you think you might have sleep apnoea headaches or migraine, it’s important to see your GP for a diagnosis. Sleep apnoea headaches tend to improve with treatment of the sleep apnoea itself.

Read more about migraine and sleep here. Read about the link between your sleep/wake cycle and migraine here.