Sleep Disorders and Headaches

Is it the headaches that cause sleep disruptions, or are they simply a symptom of these disorders? The truth is somewhere in the middle, as our bodies are incredibly complex, and it seems that there isn’t an easy answer to this question. Read on to find out more.

Sleep is one of the most critical aspects of our lives, and health professionals are urging people to pay more attention to it. Everybody knows how important diet and exercise are for our health, and it seems that a proper rest deserves an equal spot among these two, as one of the essential factors for a long and happy life.

With people today leading more stressful lives, it is no wonder that there is an increasing number of sleep disorders and headaches. It seems that these events are somehow connected, as it is not rare that they appear at the same time. Many insomnia patients often experience migraines that additionally make it harder to fall asleep. That poses an important question that looks like the famous “chicken and egg” problem. Is it the headaches that cause sleep disruptions, or are they simply a symptom of these disorders? The truth is somewhere in the middle, as our bodies are incredibly complex, and it seems that there isn’t an easy answer to this question.

One thing is sure, headaches are widespread, and they affect more than 50% of the population on any given year. Everybody has experienced it at some point in their lives, but those unfortunate ones have to deal with it a lot more often than the rest of the population. It appears that around 3% of people have chronic headache, meaning that they experience it for more than 15 days each month. That can be truly disabling, especially when you take into consideration that most of the times, doctors don’t know what is causing them. 

There are many available medications for potential treatment, and the effectiveness of each one depends on the individual. Some people find certain drugs to be miracle cures, while others regard them as not helpful at all. If you are experiencing headaches regularly, and they seem to affect your everyday life, you should speak to your medical care provider. They can do closer examinations to try and determine what is causing them and propose the right treatment.

In some cases, simple lifestyle changes can go a long way, and they can be extremely helpful in eliminating or lessening these painful events. Let’s take a closer look into the connection between adequate rest, sleep disorders, and headaches, and see what we can do to prevent them from happening.

Types of Headaches

There are many types of headaches, and health professionals recognize more than 150  different ones. They are divided into two main categories, primary ones that are the condition itself and are not caused by some other event, and the secondary ones that can occur due to some other disorder, head trauma, or substance abuse.

Primary Headaches:

  • Migraines: People experiencing them feel the intense throbbing pain on one side of the head. It can be accompanied by heightened sensitivity to light, smell, and sound, with the feelings of nausea and sometimes vomiting. Some other disruptions may arise like numbness, muscle weakness, pins and needles sensation, difficulty speaking, flickering lights, or partial loss of vision. Migraines tend to last up to 3 days, and they are reoccurring. Unfortunately, most people who are experiencing them have these episodes throughout their whole lives, while the frequency can vary from once a year to several times a week. The causes of migraines are not fully understood, but they appear to be more common with people who have some disorders like depression and epilepsy, and they also seem to run in families. Some other triggers may include stress, anxiety, hormonal changes, sleep disruptions, dehydration, skipped meals, some drugs, and more. To treat them, physicians prescribe certain medications for the attacks, as well as suggest making lifestyle changes that should help with the prevention.
  • Tension headaches: They are very common, and all people experience them from time to time. They are characterized by a dull, persistent pain on both sides of the head. People may also experience a feeling of pressure behind the eyes and the sensitivity to light and sound. Although the severity of these events can vary, they usually last up to several hours, and shouldn’t keep people from their regular activities. The cause of these events is not entirely known, but some triggers include stress, anxiety, dehydration, skipped meals, poor sleep, loud noise, lack of exercise, bad posture, and eye problems. It seems that they are also more prevalent among people suffering from depression. Treatments include medications and lifestyle changes that aim to remove all the potential triggers.
  • Cluster headaches: They are described by a very sharp, unbearable piercing pain around or behind one eye. For some reason, they are six times more likely to develop in men than in women. These severe events can be accompanied by a watering eye, swollen eyelids, blocked or runny nose, increased sensitivity to light and sound, and restlessness. The attacks come without warning, and they often take place at the same time each day, usually in the part of the night just before the dawn. The cause of these events is unclear, but it seems to affect smokers and regular alcohol drinkers more. Treatment aims to reduce these occurrences, and doctors usually prescribe certain medications for that. In some severe cases, they might suggest surgery.
  • Exertional headaches: They occur during strenuous physical exercise and can be caused by running, jumping, lifting weights, sexual intercourse, or intense coughing and sneezing. They manifest as a throbbing pain throughout the whole head and are usually short-lived. Over the counter (OTC) painkillers should take care of them, and you should always make sure to do the adequate warm-up exercises before any intense activity.
  • Hypnic headaches: These mostly occur in people over 50 years old, and they are more prevalent among women. The episodes are characterized by a mild pain on both sides of the head, that usually appears at the same time each night, which got it a nickname of “alarm clock” headaches. It can last up to three hours, and symptoms may include sensitivity to sound and light, and nausea. Unfortunately, causes and triggers of these events are not known. Some researchers speculate that since the elderly are getting less slow wave sleep, which is essential for proper brain restoration, it is somehow connected with these events, but the proposed mechanisms are yet to be described. The leading treatment choice is surprising – caffeine. It is a brain stimulant that doctors usually recommend avoiding too close to bedtime, as it is known to disrupt sleep. But in these cases, it appears to be useful, and people can take it in the form of tablets, or they can drink coffee in the evening.

Secondary headaches:

  • Medication-overuse: These painful events resemble migraines or tension headaches and are caused by the withdrawal of certain medications such as opioids, triptans, and acetaminophen. They can be accompanied by nausea, vomiting, increased heart rate, restlessness, anxiety, and sleep disturbances. 
  • Sinus headaches: Sinusitis or the swelling of the sinuses causes these headaches, and it is usually the result of infection or allergy. The symptoms consist of dull aches around the eyes, cheeks, forehead, and can sometimes spread to the jaw and teeth. They often go hand in hand with thick green or yellow nasal discharge, blocked nose, fewer, light sensitivity, and nausea. Treatments include painkillers, nasal decongestants, antihistamines, and corticosteroids in the case of allergy, and antibiotics if the infection is the problem.
  • Caffeine-related: Consuming more than 400 mg of caffeine per day, which is around four cups, is harmful to your health and can induce migraines. Also, withdrawal after some time of heavy consumption can have the same effect and can also be accompanied by poor mood, irritability, fatigue, nausea, and difficulty concentrating.
  • Head Injuries: You should always seek professional help if the head injury seems to have caused unconsciousness, confusion, memory loss, seizures, vision or hearing problems, and vomiting. Usually, a headache will develop soon after the event, but in some cases, it can develop months later, making them difficult to diagnose.
  • Menstrual headaches: In women, migraines are often linked with periods and are related to the change in hormone levels. They can also be caused by oral contraceptives, pregnancy, and menopause. 
  • Alcohol: Everybody has experienced a hangover at some point in their life, with a throbbing pain on both sides of the head that seems to be worsened by movement, bright light, and loud noises. The risk of getting a hangover can be reduced by drinking in moderation, not doing it on an empty stomach, and consuming water between beverages and before going to bed to ensure proper hydration.

Sleep and Headache – The Connection

Sleep is essential for proper functioning, and lack of sleep can lead to numerous health conditions, impaired memory, inability to focus, poor work performance, and more. The internal clock in our brain is responsible for deciding when to rest and when we should be active. It is all part of circadian rhythms, which are cyclical changes that we go through every day. Our brain adjusts this clock by perceiving external stimuli like light and temperature. It then releases different neurotransmitters and hormones like melatonin, that tell the rest of the body to go to sleep.

It is clear by now that there is some connection between sleep and headaches. For instance, migraines usually appear between 4 am and 9 am, which might suggest a mechanism that correlates with sleep or circadian rhythm or both. Sleep deprivation, as well as sleeping too much, are among the most common triggers of these events. Also, shift work and jet lag can be common triggers, which suggest the influence of both circadian systems and sleep. 

Cluster and hypnic headaches appear almost exclusively during the night slumber, which additionally strengthens the idea of this close relationship. Migraines and insomnia usually appear together, and they are more likely to affect people who have suffered mild head injuries, as a part of post-concussion syndrome. 

Morning headaches usually go hand in hand with other symptoms like daytime sleepiness, and they are often a clear sign of an underlying sleep disorder like obstructive sleep apnea. Also, people with narcolepsy are more prone to migraines than the rest of the general population, and so are the individuals with restless legs syndrome. Night terrors and sleepwalking are somewhat more common in migraine sufferers, especially children. 

The balance between sleep and wakefulness is essential for keeping our bodies in optimal state and maintaining homeostasis. That may explain such a close relationship between headaches and sleep. Some researches suggested that the migraines are our body’s way of telling us that something is wrong. When you are not getting enough sleep, and you are faced with a sharp pain that disables you from doing anything, it might force you to slow down and catch up on your rest. Additionally, when you sleep in too much, migraines can keep you up at night, preventing you from falling asleep, which could lead to the restoration of balance between rest and activity.

Common Sleep Disorders

Insomnia is the most common sleep problem for people suffering from migraines. It refers to difficulty falling (sleep onset) and staying asleep (sleep maintenance insomnia). People usually wake up in the morning with a headache and not feeling refreshed. That leads to daytime fatigue, poor attention, inability to concentrate, lack of motivation, and impaired overall functioning. Sometimes a nap can help contain a daytime migraine, but that can later lead to difficulties falling asleep, so it’s a two-edged sword. If you suspect that you have insomnia, you should pay a visit to your medical provider. They can run a series of tests to determine the reasons for your sleep disruptions, and with the right treatment, your migraines should disappear as well.

Obstructive sleep apnea is a condition where something is blocking the upper airway and preventing regular ventilation. The most apparent symptom of this disorder is snoring, which occurs when the air is running over a relaxed tissue that then vibrates and produces that familiar sound. Sleep apnea contributes to disrupted sleep patterns as people often wake up in the middle of the night gasping for air. Sleep fragmentation leads to waking up with the morning headache, and people usually feel sluggish and not at all well-rested. Luckily, this condition is successfully treated with positive air pressure therapy, and all the symptoms, including migraines, should improve with regular use of prescribed treatment.

Teeth grinding can lead to waking up with a headache and sore jaw. If it is not treated, it can lead to a temporomandibular disorder, and chronic teeth grinding, which is also known as bruxism. Most common causes of this condition are excessive stress and poor sleep, and simple lifestyle adjustments, and the use of a mouthguard can improve symptoms and prevent migraines.

Improving Sleep Hygiene

If your symptoms are persistent and are preventing you from doing your daily activities, you should visit your doctor. They can carefully examine you and determine the cause of your problems, and advise further treatment accordingly. However, there are some things you can do on your own to improve many aspects of your life, including sleep quality, productivity, and fewer headaches. 

  • Create a regular bedtime routine. You should try to go to bed and wake up at the same time every day. Most people like to sleep in on weekends and try to catch up on the lost sleep, but that doesn’t seem like a good idea. Instead, try maintaining a schedule where you will regularly get 7 to 8 hours of rest every night, and try to resist the urge to sleep in on the weekends. That way, your brain will know exactly when is the time to go to sleep, and when it should be active, which will lead to less time spent falling asleep, lifted energy levels during the day, and no daytime sleepiness.
  • Understand your body’s need for rest. Adults should get between 7 and 9 hours of sleep each day. Don’t hesitate to take a nap, but don’t do it too late in the afternoon, and keep in under 40 minutes. If you sleep for longer, you are risking to enter deep sleep and feel disoriented after waking up, and that has an opposite effect on boosting productivity, which should be a goal of every nap.
  • Incorporate exercise in your weekly routine, as it can boost the production of melatonin and help you enjoy more restorative sleep. Even a light 30-minute walk can go a long way, but it seems that moderate exercise has the most benefits. You should try to be active at least three times a week, and you can even try some weight lifting, as it seems to have some extra benefits. Make sure not to do it too close to bedtime though, as it can be counterproductive, and leave you awake in bed, unable to fall asleep.
  • You should always aim to eat healthily. Fruits and vegetables should be the main focus of your meals, and you should cut down on alcohol, nicotine, and caffeine consumption, especially close to bedtime. They are stimulants that can disrupt your sleep, and cause more problems.
  • Create a pleasant sleep environment free of any distractions. Your bedroom should be dark, cold, and noise free. You should ban all electronic devices from your sleeping area, and leave it just for that. Avoid using your smartphone or laptop before bed, because it emits blue light that can trick your brain into thinking it is the morning, and it can stop the production of melatonin, which can lead to poor sleep. 
  • Try to spend some time outdoors in the natural light, as it can help your brain understand better when it is daytime, and adjust your internal clock accordingly. 

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