Headache specialist Deborah Tepper, MD explains the links between headache and sleep disorders in Headache: The Journal of Head and Face Pain…..
Insomnia, difficulty with falling asleep or staying asleep, is the most common sleep complaint among patients with frequent headaches. Insomnia can be related to conditions common among headache patients, such as depression, anxiety, lack of exercise and medications that make good sleep harder to achieve.
Patients with chronic migraine, which includes headache 15 or more days per month, report having almost twice the rates of insomnia as those with less frequent headaches. Rates of sleepiness in the daytime and snoring are also more frequent in those with frequent headaches.
Clues to there being a primary sleep disorder in addition to a headache disorder include snoring, gasping during the night, falling asleep during the day, and not feeling rested upon awakening. The overwhelming need to move one’s legs when trying to sleep can further disrupt sleep, and is frequently associated with restless legs syndrome.
Many times, consistent behavioral changes are needed for those with headaches and sleep problems. Those with chronic headache tend to cut back on physical activity because exercise temporarily seems to worsen headaches. People with frequent headaches often spend more time resting, lying down, or sitting. This in turn results in being less tired at night. Naps during the day are common. Lack of activity and exercise can worsen depression and anxiety, further adding to difficulty sleeping and staying asleep.
Computer activities, mobile phone devices and stress-producing work should be avoided in the hour before sleep. The aim is to set aside enough time for 7-8 hours of sleep. This is better achieved by going to bed within an hour of the same time every night, and getting up at similar times.
A not uncommon migraine problem is sleeping in on weekends after a long week of not getting enough sleep. Catching up on sleep often leads to a wake-up weekend headache, which is frustrating, as this is the time people want to be with their families, run errands, and have fun. This headache coming on after stress has decreased is called let-down headache, and is unfortunately common.
Also common is wake-up headache. The most common time for migraine to occur is in the early morning, and many times people will sleep through the time when a headache is beginning to emerge. By missing the best time to take migraine medicines, which is early in the headache, the medicines are less likely to be effective. Individuals who take their pain and headache medications too frequently, that is, have medication overuse headache, can experience their medications wearing off during the night, triggering a headache. Most over-the-counter and narcotic pain medications wear off in 4-8 hours, making people most vulnerable during the early morning, particularly if overusing these medications.
Headache: The Journal of Head and Face Pain