The Headache and Sleep Connection
Though sleep is a root cause for many ailments, the connection between sleep and common issues like headache is often overlooked. However, in my neurology practice of several decades I discovered something:
Virtually all headaches are related to an underlying sleep disorder.
When I say “virtually all headaches,” I mean just about any headache you might experience except those related to brain tumor, head trauma, brain hemorrhage or meningitis.
(Important sidenote: if you’re experiencing headaches that don’t go away easily with rest or over-the-counter medication, talk to your doctor and get a CT scan of the head to rule out these more serious conditions).
Headaches Related to Sleep Issues: Symptoms
To briefly recap what could be a new perspective: Outside of some extreme conditions, most headache symptoms and what you might refer to as “migraine,” are usually related to your sleep.
As a headache suffer, even if you don’t experience severe headache, you might be wondering:
You may have headaches related to sleep issues without even knowing that your sleep is abnormal.
Even if you have the experience of falling asleep quickly and sleeping for 8-10 hours a night, you could still have a sleep disorder.
In spite of your total sleep hours, when you don’t go into the deeper, restorative phases of sleep, your body and brain are not achieving optimal repairs overnight.
One of the signs that your sleep is not completely restorative can be headache pain.
In my neurology practice, I performed thousands of sleep studies on headache patients and they were ALL abnormal, some in mild and some in very severe ways. When these patients achieved proper restful sleep, poof! Their headaches improved or went away completely.
The following is a list of names used by doctors to describe the timing or symptoms that accompany headache.
Regardless of the name all of the following headaches are related to a lack of consistent, restorative sleep.
- Awakening headache or morning headache: Headache when you wake in the morning is frequently related to how successful you are in getting into REM sleep. Other sleep experts may say that morning headaches can be related to sleep apnea, but you do not need to have sleep apnea to experience morning headaches.
- Headache from oversleeping: Headache when you wake after sleeping in.
- Hypnic headache: Headache that wakes you from sleep. This type of headache occurs more often if you try to sleep in on a weekend.
- Tension headache or muscle contraction headache: Mild headache with muscles of the head and neck tender to the touch or with muscle stiffness.
- Headache with jaw pain or neck pain: Headache that involves other areas of the head and neck.
- Medication overuse headache: This is a label that doctors have used to suggest a correlation between medicine use and headache. I don’t think that headaches are caused by using the medication that you were given to help your headache.
- Headache from ‘’dehydration’’: Headache that is correlated to not drinking enough water. I don’t think that these headaches are really from dehydration, but that’s what you may think, or be told by others.
- “Normal” headache: Headache that is not severe and goes away with an over the counter medicine.
- Migraine (and Migraine in its various forms, “with aura”/”with paralysis”/”with vertigo”): Headache that has other accompanying symptoms of several kinds including ‘’foggy-headed’’ and nausea and light or sound sensitivity.
Though we have many names for “kinds” of headaches, it is my belief that all of the headaches above are slightly different versions of the same thing – poor sleep quality leading to headache in a person who has a genetic risk factor. They should all be considered a sleep-related headache.
The Migraine – Headache Connection
Something else that might surprise you:
Whether you consider yourself to be a “migraine sufferer” or not, most of the headaches we all have are “migraine” in mechanism.
The graphic below visually describes what is really going on.
This is important to understand for a few reasons: First, the short-term medications for migraine headache work best when the headaches is in its earliest stages.
“My medicine works if I get it in soon enough” is something many headache sufferers have experienced and learned from. The triptan medications (medications commonly prescribed to use at onset of migraine) work best when used in the earliest stages of the headache intensity when it feels just like a “normal headache’’.
Second, when you are sleeping better and your headaches are almost gone, you may still have headache-like episodes that are greatly diminished in intensity For example, the sensation may no longer qualify for what you’d consider “headache,” but it is, a feeling that your brain is “not right” or a feeling of “foggy headedness,” with or without mild head pain.
If we recognize that this is still migraine, just ‘’baby migraine’’ then we also realize that we haven’t fully accomplished our goal – achieving consistent, restful sleep so our headaches are completely gone.
In other words, whether you are experiencing what you would consider a “migraine,” a “normal headache,” or even more accurately, a “baby migraine,” all of these symptoms point to the same root cause and therefore the same solution.
The Migraine – Sleep Connection
For most people, the connection between headache, migraine and sleep is new information. However, intuitively, if you’ve experienced regular headaches or migraines you probably have sensed some kind of connection.
For example, if you have had a migraine, you know it is not just head pain. There is often an accompanying feeling of “I can’t think straight” or “my brain doesn’t feel right” that makes it difficult or impossible to function, so the migraine sufferer goes to bed, often to “sleep it off.” Often, with a good night’s rest, the migraine subsides. So looking at this sequence of events, we can see a link between migraine, it’s connection to the brain, and a desire to sleep as an intuitive solution.
Did you know that sleep and migraine have always been intertwined? For example, most teenagers with daily headaches or migraine often suffer from a sleep issue, even when not experiencing headaches, such as difficulty falling asleep. Most women in menopause who have regular headaches often can’t stay asleep through the night.
Women who wake with a headache in the middle of the night usually do so at a time they are transitioning into REM sleep, which is the phase of sleep meant to heal the brain. This type of sleep disturbance which limits your REM sleep can cause more serious sleep disorders long-term.
On the opposite end of the spectrum, sleep deprivation itself, which can start with just one or two nights of bad sleep, can mean you’re much more likely to get a headache the following day.
Short-term Solution: Pain Medicine
Headache medications can be an effective short-term solution for many people. They can temporarily manage or even resolve the pain.
That said, these medications will not solve the root of the headache problem, so they are best used only in the short term while the true source of healing (restorative sleep) is pursued.
The over-the-counter (OTC) headache medications that contain milder pain relievers (acetaminophen, aspirin, ibuprofen, naproxen) work for most people with mild headaches.
If they are not successful for your headaches then talk to your doctor about something stronger. Usually that will be a medication called a “triptan”, (zolmitriptan, naratriptan, eletriptan, sumatriptan, almotriptan, frovatriptan, rizatriptan) one of 7 medications that are specific for migraine.
They work on serotonin receptors, they are not pain relievers, yet they are much more effective for the treatment of all types of headaches than the OTC medications such as aspirin or acetaminophen.
How to use prescription headache medication:
All of the “triptan” prescription headache medications act on the migraine “pain center” to make the brain chemistry return to normal. They work better if taken at the beginning of the headache, and a bigger dose will be needed if the headache is already severe.
If the medication doesn’t work for you, it usually means that either you took it too late or the root problem (lack of restorative sleep) is so severe that even prescription medications won’t work for you yet.
Long-term Solution: How to Prevent Headaches & Migraines
So how do you heal your frequent or daily headaches, or even your migraines, over the long term?
Except in the case of the headaches listed earlier in this article (cluster headache and headaches associated with brain hemorrhage, brain tumor, and meningitis), there is always a sleep disorder behind headaches.
Whether you are aware of having an abnormal sleep pattern or not, your headache indicates that the healing phases of sleep are not long enough to allow you to wake with your pain center in the normal ‘’off’’ position.
When your need for restorative sleep isn’t met, you are more likely to have a headache from a ‘’headache trigger,” a food or a bright light or a stressful encounter. The worse your sleep issues are in the background, the harder it will be to get your headache to go away.
When your headaches are very severe and your headache frequency is daily you may need to rely on what is called a preventative medicine, given to you by your doctor.
Some of the preventive medications that are commonly used by neurologists to prevent headaches or migraines include verapamil, zonisamide, valproate, topiramate, propranolol and atenolol.
As long as you have your eye on the long term goal of sleep repair, any medication that helps you move toward a resolution with less pain and easier sleep is valuable.
The Ultimate Solution: Restore Your Sleep
How do you successfully restore the deep healing ability of your sleep, so your headaches resolve for good?
RightSleep is a 100% natural, step-by-step, self-study program with weekly and monthly protocols to restore your sleep quality over a year.
This program guides you in how to give your brain what it needs in order for your body to do what it was meant to do – sleep well and heal well.
The key to this all-natural approach is replacing vitamins that have become deficient. Over time, by following the guidelines and listening to your body, you’ll get back to sleeping well naturally.
I’ve created a RightSleep Workbook to guide you through a process that has helped restore the sleep of thousands of people. Click here to learn more.