What is the role of sleep in migraine?


Consistency is important in migraine control. Sometimes too little sleep or too much sleep can trigger a migraine attack.


“Yes, so sleep has a very interesting bidirectional role in migraine. What I mean by that, is that, as patients you can imagine that sometimes too little sleep can trigger a migraine attack. Sometimes too much sleep can trigger a migraine attack. Then other times patients will say "When I have a migraine attack, I need to take my migraine medications and go to sleep and when I wake up I feel better." So sleep can sometimes be a treatment for migraine as well. Some of the medications that we use to treat an as-needed attack are medications that can be sedating because we know that sleep can sometimes be very beneficial. Overall as far as lifestyle changes to empower yourself against migraine, it's good to practice good sleep hygiene.

So what does that actually mean? It means consistency. Really the theme in all of these things is going to be consistency. Migraine disorder does not like peaks and valleys of anything. It wants to be nice and steady and stable and consistent. With regards to sleep, going to sleep around the same time, waking up around the same time on a daily basis. Then practicing good sleep hygiene where you're not Drinking stimulating things like caffeine, not smoking, or having nicotine, any of those stimulating agents anywhere near bedtime. Even alcohol. Alcohol can sometimes promote sleep but if you actually drink too close to bedtime yes you fall asleep quickly but it actually disrupts your sleep in the second half of the night. So caffeine, nicotine, alcohol, nowhere near bed time is ideal. Then also with all of our electronics, it's important to make sure that they're turned off, on do not disturb, or even placing them in a different room. All those things are so key for having good sleep hygiene.”


Take control of your migraine attacks by practicing good sleep hygiene. It’s important to stay on a regular sleep schedule and avoid alcohol, caffeine, nicotine and use of electronics near bedtime. While poor sleep habits can trigger attacks, sleep during an attack can be beneficial.

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Amaal J. Starling, MD, FAHS, FAAN

Mayo Clinic, Arizona

Dr. Amaal J. Starling is an associate professor of neurology at the Mayo Clinic College of Medicine. She joined Mayo in 2012 and is currently a consultant within the department of neurology. Dr. Starling received her MD from the Drexel University College of Medicine in Philadelphia. She completed a transitional year residency, a neurology residency, and a headache fellowship at the Mayo Clinic College of Medicine in Scottsdale, Arizona.

Dr. Starling is an active member of numerous migraine advocacy organizations, including the American Headache Society (AHS), the American Migraine Foundation, the American Pain Society, and the American Academy of Neurology. Annually, she is involved in events supporting migraine, including Headache on the Hill, Miles for Migraine, and the Alliance for Headache Disorders Advocacy. Dr. Starling is currently serving as chair of the advocacy committee of the AHS; Diversity, Equity, and Inclusion Taskforce member of the AHS; and she is a member of the Scientific Advisory Board of the International Concussion Society. Dr. Starling has been the recipient of numerous awards, including the AHS Above and Beyond Award for Service, Manfred D. Muenter Award for Excellence in Clinical Neurology, the American Academy of Neurology Annual Meeting Residency Scholarship, the 2012 Spirit of Mayo Clinic Award, and the Mayo Brothers Distinguished Fellowship Award.

Dr. Starling has several peer-reviewed publications and abstracts related to her fields of interest, which include migraine, concussion, post-traumatic headache, trigeminal autonomic cephalalgias, secondary headaches, telemedicine and teleconcussion, neurology resident education, and professionalism and clinical ethics. Dr. Starling’s hope is that her research and advocacy will advance care for people with migraine, post-traumatic headache, and other headache disorders. She envisions a future in which all people with headache disorders receive personalized, effective, and well-tolerated treatment options to improve their quality of life.

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