If you experience migraines regularly, you know how intense and debilitating they can be.
Something you may not know about migraines, though, is that they are closely tied to sleep. Growing research shows that there is a delicate balance between the “right amount” of sleep and migraines.
The good news is, if you can address the underlying sleep issues, there is a good chance you’ll also address the migraines. In this article, we’ll talk about the difference between headaches and migraines, how sleep is related, how to better sleep if you live with migraines, and questions for your doctor, so that ultimately, you can improve your sleep, your migraines, and your quality of life.
Headache vs. Migraine: What’s the Difference?
Headaches and migraines are sometimes used synonymously, but there are some key differences between the two.
There are different types of headaches1, including cluster, tension, sinus, hypnic, and migraines. As such, a migraine is actually a specific type of headache.
Most of us think of migraines as very painful headaches, however, a headache is just one of several symptoms of a migraine. Additional migraine smptoms2 can include nausea, increased sensitivity to light or sounds, dizziness, and extreme fatigue.
In fact, migraines are classified as a neurological disease.2 Unlike another type of headache, such as a tension headache, a migraine involves changes in brain activity that affect the blood in the brain and surrounding tissues.2
Oftentimes, migraine headaches cause pain on one or both sides of your head, rather than the forehead area.2 A migraine will likely get worse if you’re active or exposed to certain lights, and it could last anywhere from several hours to several days3.
There are several different types of migraines, which can be divided into two main categories: those with an aura (a complicated migraine) and those without an aura (a common migraine).3 An aura is a group of symptoms that act like a warning signal before the migraine headache fully hits. Sometimes the symptoms can be severe enough to be mistaken for a stroke or seizure and can last up to 60 minutes.3
These symptoms can include:
- Seeing spots or stars, zigzagging lines, or flashing lights
- Loss of vision
- Numbness or tingling, especially in the hands or face
- Muscle weakness
- Difficulty speaking
Only about 10 to 15 percent of people who get migraines experience auras beforehand.3 Those who don’t experience auras will have the same painful symptoms of a migraine – severe head pain, nausea, dizziness, fatigue, light sensitivity, etc. – but without the warning period, an aura can give you.3 It’s thought of as a warning because sometimes the migraine can still be prevented at this point.
Whether a person experiences the aura phase or not, the stages of a migraine typically look like this3:
Source: “The Timeline of a Migraine Attack”, American Migraine Foundation4
The headache itself can last up to several days, and, as if that isn’t enough, a postdrome phase can bring tiredness, depression, and difficulty concentrating for a day or two afterwards.4
Can Too Much or Too Little Sleep Cause Migraines?
Although some of the reasons behind migraines are out of our control – for example, women are more likely to get migraines than men, and there can be a genetic predisposition to migraines – there are certain daily triggers you can control.3 For example, you can manage stress, make sure not to miss a meal or eat any foods you’re sensitive or allergic to, avoid caffeine, and avoid certain types of strobing or fluorescent lights.3
You can also make sure to prioritize getting the right amount of sleep, as growing research5 shows a connection between migraines and getting too much or not enough sleep.
The Migraine Trust6 of England explains it this way:
“The balance of sleep and wakefulness, and its correct timing, relies on a finely tuned system … referred to as homeostasis. If too much overloads this system in favour of one state (sleep or wakefulness) versus the other … the system will try and compensate to redress the balance.”
Jet lag, sleeping in on weekends, staying up late, or taking naps can throw off this balance, and your body will try to readjust. One theory is that migraines could be your body’s way of attempting to get back to homeostasis.6
For example, if you’re sleep deprived, a migraine later that day will force you to keep still and lie down in the dark, which some theorize could be your body’s way of trying to get you some more sleep.6
If you’ve had too much sleep, on the other hand, a migraine later in the day might be your body’s attempt to keep you awake to get less sleep. In both cases, the body is trying to reach a state of homeostasis.6
Migraines and Sleep Disorders
Globally, chronic migraines are the second largest contributor7 to years lived with a disability and are more prevalent than asthma, diabetes, and epilepsy combined.
Not only that but migraines and headaches in general seem to be increasing year after year.5 One study8 in South Korea showed this increase and its correlation with sleep disorders like insomnia.
The study concluded that migraines are closely connected with insomnia and other sleep disorders like sleep-related breathing disorders.8. The less quality sleep you get, the study says, the more likely you’ll get migraines.8
Source: “The Association between Migraine and Types of Sleep Disorder”, MDPI5
For those with regular migraines, insomnia is the most frequently occurring disorder; in fact, most patients complaining of headaches also have insomnia.8 Additionally, many who experience both insomnia and migraines had some kind of past mild head injury.6
Read More: Best Mattresses for Insomnia
In a University of North Carolina, Chapel Hill study9, researchers surveyed 147 migraine patients. For those who had more than 15 headache occurrences a month (including migraines), insomnia was the most common complaint. Two-thirds of the participants had trouble falling asleep.9
Many people who have sleep apnea do not actually know it since it doesn’t always wake the sleeper fully up. However, sleep apnea does lower the quality of rest. If you struggle with headaches, snore, and wake up feeling tired, you may have sleep apnea, and you should talk to your doctor.
If you already know that you have sleep apnea, you might be able to improve symptoms by switching out your mattress. Take a look at our list of best mattresses for sleep apnea.
Restless Legs Syndrome
People with restless legs syndrome11 (RLS) have an uncontrollable need to move their legs (or other limbs), and this condition is often more intense during the night or while resting.
Restless leg syndrome is more common12 among people who get frequent migraines. A 2021 study13 found an interesting connection between migraines, restless leg syndrome, and vitamin D. The study concluded that a deficiency in vitamin D was a common underlying factor for those with both RLS and migraines.13
Aside from supplementing with vitamin D, addressing the underlying sleep disorder should help with both sleep quality and migraine frequency.
For More Information: Best Mattresses for Restless Leg Syndrome
Circadian Rhythm Disorder
Various circadian rhythm disorders are also associated with migraines. Our circadian rhythm is how our bodies know what time of day it is and whether we should be awake or sleeping. It’s what gives us an “off” feeling when we turn the clocks forward for Daylight Savings Time or when we travel across time zones.
When a person’s circadian rhythm is thrown off, rest can come and go at odd times of the day and night, making a good night’s sleep more challenging. Since migraines are associated with poor sleep quality, circadian rhythm disorders could be associated with them as well.
Will Sleeping More Help?
If lack of rest is the most common problem associated with migraines, you might think that sleeping as much as possible would be the solution, but it’s not so straightforward. We mentioned earlier that sleep deprivation is a common cause of migraines5; however, too much sleep can also lead to these debilitating headaches.6
The best solution is to get to the root of the sleep problem. Why is it that you’re sleeping too much? Why is it that you’re sleeping too little? If you can figure this out and treat your sleep issues at the root, there is a good chance you’ll see an improvement in your migraines.
How to Sleep With a Migraine
When the University of North Carolina, Chapel Hill surveyed people who experience migraines to look for habits and patterns, they found some similarities among participants.9 Almost 80 percent of participants watched television or read in bed, 70 percent woke up at night to go to the bathroom, 60 percent napped during the day, and over 50 percent used sleeping pills regularly.9 The researchers decided to put these habits to the test to see if making changes reduced the frequency and intensity of migraines.
After six weeks, the group who had changed their bedtime behavior noted that their migraines had significantly improved in severity and frequency, whereas the group that did not make these bedtime changes didn’t see an improvement.9
For those with migraines, this is very promising news. By changing some simple bedtime habits, the frequency and severity of migraines could be greatly reduced.
Have a Consistent Sleep and Wake Time
Have you ever noticed that you start getting tired at the same time every night? This is normal; in fact, it is the perfect queue to listen to, which means you should go to sleep when you start feeling sleepy. When your bedtime waivers, your body may struggle to predict when it is time to go to bed, which can lead to problems falling asleep and staying asleep.
Going to bed at the same time every night gives your body a chance to self-regulate its biological clock and expect when sleep is coming each night. In the same way, waking up at the same time each morning allows your circadian rhythm to become more regulated. Try to plan your bedtime and wake time to allow for eight hours of sleep – even on the weekends.
The Bedroom Is Just for Sleeping
For people who struggle to sleep, one of the most important rules is that the bedroom should be used for sleep and sex only. This helps train your body15 and mind to associate the bedroom with sleep, rather than the stress of checking emails, watching television, or lying awake trying to get to sleep.
In fact, if you can’t sleep, experts recommend getting up after 15 minutes, going to another room, and doing something relaxing until you get sleepy.15 Then return to bed to go to sleep. Don’t lie in bed trying to sleep for more than 15 minutes.
Practice a Bedtime Routine
You can also watch something (that isn’t too exciting or stressful), but be sure you’re putting away all screens and turning off the television at least one hour before bed, as the blue light emitted from these devices can negatively impact your ability to fall asleep.
Don’t Eat a Large Meal Within Two Hours of Bedtime, and Limit Fluids Before Sleeping
Eating big or fatty meals late at night can make it difficult to fall asleep16. Additionally, waking up frequently to use the bathroom in the middle of the night can disrupt sleep quality. For this reason, you should avoid drinking too much water in the two hours before bed as well. Experts recommend less than one glass17 during this time frame.
Additionally, you should avoid any caffeinated or alcoholic beverages. Caffeine can stimulate your brain and body for up to six hours18 after consumption, and although alcohol may bring on an initial feeling of tiredness, it can prevent19 you from getting deep rest.
No More Napping
Although napping can seem like a short-term solution for migraines, long term, it may lead to some bigger problems like insomnia. Too much daytime rest can get in the way of your nighttime sleep, especially if napping has become a regular habit. If you really need a nap, however, try to keep it between 10 and 20 minutes, and do not nap after 3:00 p.m.
Try Some Supplements
Studies show that both melatonin20 and magnesium21 are effective at treating and preventing migraines. Melatonin and magnesium are also commonly used sleep aids, so introducing one or both of these into your nighttime routine could create an improvement all around. Either supplement should be taken one to two hours before you plan to go to sleep.
Questions For Your Doctor
Can a lack of sleep be a cause of migraines?
Commonly, sleep deprivation is a cause of migraines. Even if you think you are getting the right amount of sleep every night, you could actually be struggling with the quality of rest you’re getting. Talk to your doctor about the possibility of a sleep disorder; many people do not even know that they have one.
Even if you do not have a sleep disorder, consider making quality, restful sleep a priority each night. You’ll also want to make sure you’re getting neither too little nor too much sleep, in order to keep your body in homeostasis and mitigate migraines.
Are my medications keeping me up at night?
Certain medications can cause sleeping problems, and side effects can include both insomnia and lethargy. As we’ve covered, sleeping too little or sleeping too much can lead to migraines, so be sure to ask your doctor about this possibility.
Can you suggest ways to improve my sleep habits?
Along with the tips mentioned above, be sure to check with your doctor for more personalized suggestions. Since your doctor has your full medical history, they will be able to help diagnose possible disorders, prescribe medications, and discuss other treatment options.
Could cognitive behavioral therapy (CBT) help?
For some, the best treatment for migraines is Cognitive Behavioral Therapy22 (CBT), with 30 to 60 percent of patients reporting fewer headaches than before when using CBT to cope. This treatment can include stress management, understanding and avoiding certain migraine triggers, as well as altering physical habits (such as eating, exercising, and sleeping).22
Additionally, Cognitive Behavioral Therapy for Insomnia23 (CBT-I) is a popular and effective treatment for sleep issues.
Final Word of Advice
The connection between sleep and migraines is undeniable, and it can actually be a much more delicate balance than you might think. It’s important to get enough sleep – but not too much. It’s also important to get good quality sleep, and sleep disorders like sleep apnea or substances like caffeine or alcohol could be preventing you from getting quality sleep without you realizing it.
By treating the underlying issues behind too little or too much sleep, there’s a good chance that you’ll also improve your migraines and ultimately, your quality of life.
Also, we advise that you talk to your doctor before introducing any new medications or supplements for sleep or migraines.
- “Types of Headache”. Stanford Medicine. Webpage accessed July 10, 2023.
- “Migraine vs. Headache: How to Tell the Difference”. Penn Medicine. 2021.
- “Migraine Headaches”. Cleveland Clinic. Last modified March 3, 2021.
- “How Long Does a Migraine Last?” American Migraine Foundation. 2021.
- Kim, Seung Ju., et al. “The Association between Migraine and Types of Sleep Disorder”. National Library of Medicine. 2018.
- “Migraine and sleep”. The Migraine Trust. Webpage accessed July 10, 2023.
- “Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016”. Global Health Metrics. 2016.
- Rains PhD, Jeanetta C. “Sleep and Migraine: Assessment and Treatment of Comorbid Sleep Disorders”. Headache: The Journal of Head and Face Pain. 2018.
- “Sleep, Insomnia, and Migraine”. American Migraine Foundation. 2016.
- Buse, Dawn C., et al. “The Relationship Between Sleep Disorders and Migraine: Results from the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study (S43.007)”. Neurology. 2018.
- “Restless legs syndrome”. Mayo Clinic. Last modified March 1, 2022.
- Ghasemi, Hooman., et al. “The Prevalence of Restless Legs Syndrome in Patients with Migraine: A Systematic Review and Meta-Analysis”. National Library of Medicine. 2020.
- Sun, Shuning., et al. “Association Between Migraine Complicated With Restless Legs Syndrome and Vitamin D”. National Library of Medicine. 2021.
- Leso, Veruscka., et. al. “ Shift work and migraine: A systematic review”. National Library of Medicine. 2020.
- “How to Create a Sleep-Friendly Bedroom”. UNC Health. 2017.
- “Sleep tips: 6 steps to better sleep”. Mayo Clinic. Last modified May 7, 2022.
- “Is It Healthy To Drink Water Before Bed?”. Cleveland Clinic. 2022.
- Drake PhD, Christopher., Roehrs PhD, Timothy., et. al. “Caffeine effects on sleep taken 0, 3, or 6 hours before going to bed”. National Library of Medicine. 2023.
- “Why You Should Limit Alcohol Before Bed for Better Sleep”. Cleveland Clinic. 2020.
- Long MD, Rujin., Zhu MD, Yousheng., Zhou MD Shusheng. “Therapeutic role of melatonin in migraine prophylaxis: A systematic review”. National Library of Medicine. 2019.
- Maier, Jeanette A., et al. “Headaches and Magnesium: Mechanisms, Bioavailability, Therapeutic Efficacy and Potential Advantage of Magnesium Pidolate”. National Library of Medicine. 2020.
- “Behavioral Treatment of Headache and Patients with Migraine– Making Referrals”. American Migraine Foundation. 2017.
- “Insomnia treatment: Cognitive behavioral therapy instead of sleeping pills”. Mayo Clinic. Last modified August 5, 2023.
Jess is only serious about a few things in life: sleeping, writing, and making the perfect chocolate chip cookie. In her free time, you’ll probably find her having a dance-off to ‘80s pop with her family or watching scary movies with her cat, Waffles.