Despite debates over daylight saving time, everyone can agree that changing the clocks twice a year is a real headache. For the 40 million Americans who suffer from cluster headaches and migraine, many believe that losing sleep causes their pain. But according to one of the top headache specialists in the world, the disruption to our sleep schedules is the actual problem.

There have been recent studies that show specifically that changes in sleep habits, not just a decrease in sleep, can trigger a migraine attack,” says Dr. Fred Cohen, Assistant Professor of Medicine and Neurology at the Icahn School of Medicine at Mount Sinai in New York and published headache researcher. “There have been many theories to why, but the main component comes back to melatonin.”

Dr. Cohen explains that melatonin has many functions, not just regulating our sleep patterns. Melatonin has been linked to having effects on various neuro-peptides, including ones related to migraine attacks such as Calcitonin gene-related peptide (CGRP). Throughout the day, our brains use neuro-peptides to function. These peptides then turn into waste by-products that are pro-inflammatory.

“Sleep serves as our brain’s way of ‘cleaning itself’,” says Dr. Cohen “When we sleep our brain removes these waste products. Sleep deprivation can lead to the accumulation of these by-products, and result in more headache/migraine attacks.”

If a person suffers from chronic sleep deprivation, Dr. Cohen says it should be determined if a sleep disorder, such as sleep apnea is present. Do you snore or do you find yourself waking up throughout the night? These symptoms are correlated to obstructive sleep apnea. A sleep study can determine if you have apneic events during the night. Insomnia and sleep bruxism (grinding your teeth at night) have also been correlated with headache and migraine attacks.  If no other conditions are present, improving your sleep hygiene is the first step to improving your sleep.

Everyone can benefit from better quality sleep with these ten tips to get your ZZs:

1. Maintain a regular bedtime: avoid marked variations in bedtime and awakening (even on weekends)

2. Avoid use of electronic devices at least one hour before bedtime and avoid use during the middle of the night.

3. Do not drink alcohol after dinner; If you consume alcohol try to keep it at least 3-4 hours prior to bedtime.

4. Do not nap during the day-especially if you have difficulty falling asleep at night.

5. Regular exercise in the morning or afternoon may deepen sleep. Avoid strenuous physical activity just before bedtime.

6. Find a comfortable bedroom temperature and maintain it throughout the night. Avoid temperature extremes.

7. Avoid heavy meals within 2 hours of bedtime. A light snack at bedtime, such as milk, cheese and crackers, may help you to sleep.

8. Avoid stimulants and caffeine (i.e. coffee, cola drinks, cocoa, chocolate) after 3pm.
9. Avoid the use of tobacco.

10. If you have difficulty falling asleep, don’t stay awake in bed for more than 30 minutes. Instead get up and engage in some quiet activity, such as reading, until you become sleepy, then return to bed. Do not watch the clock.

“If these adjustments do not improve your sleep, you should see your primary care doctor to discuss next steps,” concludes Dr. Cohen. “You may require medication or insomnia cognitive behavioral therapy to help treat your sleep deprivation.”

Since each person’s sleep needs are unique, adjust your total sleep time to fit your needs. That will also allow you to feel alert and energetic during the day.

For more information visit Dr. Cohen’s website and follow him on Twitter, Instagram and TikTok.

About Dr. Fred Cohen

Fred Cohen, MD, is one of the few headache specialists in the U.S. trained in both Internal Medicine and Headache Medicine. Based in New York, NY, the world-renowned Headache Specialist is Assistant Professor of Medicine and Neurology at the Icahn School of Medicine at Mount Sinai. ​Dr. Cohen is Assistant Editor of Headache: The Journal of Head and Face Pain and Current Pain and Headache Reports. His research and expertise have made him a highly sought after presenter at headache conferences around the world. For more information visit www.fredcohenmd.com.

Feature Image Courtesy of Fred Cohen MD