Morning Migraines
There are a significant number of individuals who suffer from morning migraines. And experts believe that in most of these cases, poor sleep hygiene may be a major contributory factor.
In most people with migraine rest, quiet and darkness allows for a headache to subside. However, in the past few years, a significant number of individuals with a migraine complain that they have a headache first thing in the morning. Often this headache persists for many hours, leads to absenteeism from school or work, and creates a real havoc on lifestyle.
How does a morning migraine present?
Most people who wake up with a morning migraine claims that they feel exhausted and tired as the day goes on. The one universal observation among these morning migraine sufferers is that they often have some type of sleep problem. A morning migraine may or may not present with an aura but often while the individual is asleep. Surveys indicate that a morning headache tends to be most common between the hours 4 am and 9 am.
In some cases, it is a migraine that wakes up the individual. Morning migraines tend to occur with equal frequency in both men and women. These migraines can occur any day of the week and tend to be worse in individuals who have had little or no sleep.
You should keep a diary
- In order to treat morning migraine headaches, it is vital to keep a diary of the following:
- What time did you go to bed?
- What did you eat at bedtime?
- What did you drink at bedtime?
- What unusual thing did you do the night before?
- How many times week do you get a morning migraine?
- How long does a morning migraine last and what makes it better or worse?
The more details you record about your morning migraine, the easier it is for the healthcare provider to help you manage it.
When should I see the doctor?
If you suddenly start to develop a morning migraine, it is important to see your healthcare provider. The reason is that besides a migraine, there are other causes of a morning headache which include the following:
- Cluster headaches typically occur in clusters and often wake up the person from sleep. These headaches are intensely painful and may mimic a migraine. The clusters can last weeks or even months and are slightly more common in men. During remission, the headache may disappear for months or even years.
- Brain tumors can also present with a morning headache. Often the pain is not severe and may be associated with nausea and vomiting. Brain tumors can occur in people of all ages and usually, they may be associated with other features like weakness or blurred vision or blindness.
- Bruxism or teeth grinding is a very common condition that typically occurs at night. The individual grinds the teeth without having any idea that they are doing it. Regular teeth grinding can wear down the teeth and often cause jaw pain and a headache.
- Excessive consumption of caffeine itself does not cause a headache but once one develops an addiction to this beverage, it leads to withdrawal symptoms, of which one of them can be a headache.
- Low blood sugar or hypoglycemia is a serious disorder that often occurs in diabetics. The low blood sugar can cause alteration of mental status, headache, nausea and even loss of consciousness.
Sometimes the cause of a morning headache is the overuse of pain medications, sometimes referred to as drug-rebound headaches. There are some individuals who repeatedly use opiates for pain and develop an addiction. When asleep the individual develops a rebound headache when the drug is no longer in the body. A headache is often intense and may be associated with profuse sweating, nausea, tremor, agitation, and insomnia.
In fact, a sleep disorder like obstructive sleep apnea can also cause a morning headache. People with obstructive sleep apnea do not get adequate oxygen at night and develop long pauses where the breathing shuts down. In the morning, they often present with fatigue and a headache. Each of these morning headaches requires a different treatment.
How is a morning migraine treated?
More evidence is accumulating that morning migraines can be reduced significantly by developing good sleep hygiene. Several studies have shown that when sleep is adequate and people develop good sleep hygiene, the intensity and number of a migraine also lessens.
So how does one develop good sleep hygiene?
If you have been having morning migraines then start doing the following:
- Develop a strict sleep schedule; try, and get at least 7-8 hours of sleep daily.
- Try and go to bed and wake up at the same time consistently – this reinforces your sleep-wake cycle.
- Pay attention to what you drink and eat before bedtime. Avoid all caffeinated beverages late in the evening. Not only can caffeine cause insomnia, you will have to get up frequently to urinate.
- Make your bedroom a place to sleep. It should be quiet, dark without too many distractions like a TV, loud music, or excess light.
- Limit daytime naps to no more than 30 minutes. Take your nap early in the day.
- Start some type of exercise as physical activity can promote good sleep.
- If you have worries and stress, practice deep breathing or yoga before sleep.
In most cases, if you develop good sleep hygiene, the morning migraine frequency will lessen. If they continue to persist, your medications may need some adjustment.
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