Sleep is a common way to find relief from a migraine attack, and many people report that sleeping through the pain helps end the episode. A migraine is a complex neurological event, not a typical headache, characterized by moderate to severe, often unilateral and throbbing, head pain. This pain is combined with debilitating symptoms like nausea and heightened sensitivity to light (photophobia) and sound (phonophobia). While sleep is often considered the best medicine for an attack, the intensity of the pain and sensory symptoms frequently make achieving restorative rest difficult.
The Sleep-Migraine Cycle
The connection between sleep and migraine is bidirectional: poor sleep can trigger an attack, and an active migraine can destroy sleep quality. Sleep deprivation is a recognized migraine trigger because insufficient rest heightens the brain’s sensitivity to pain signals. A lack of sleep impairs the brain’s natural mechanisms for dampening pain, making a person more vulnerable to an attack.
When a migraine is underway, the pain and sensory overload often fragment sleep, preventing the brain from entering deep, restorative stages. Studies indicate that individuals with migraines may experience less quality Rapid Eye Movement (REM) sleep time. Since REM sleep plays a role in pain sensitivity modulation, this disruption creates a cycle where poor sleep increases pain sensitivity, which further interferes with sleep.
Strategies for Falling Asleep During an Attack
Creating an environment that minimizes sensory input is a primary strategy for attempting to sleep through a migraine. This involves modifying the environment to address photophobia (light sensitivity) and phonophobia (sound sensitivity).
Environmental Control
Aim to make the bedroom as dark as possible, using blackout curtains to block all external light sources. A cool room temperature, typically between 60 to 67 degrees Fahrenheit, is recommended for promoting sleep and may help soothe the throbbing pain. Minimizing sound is equally important, which may mean using earplugs or a white or pink noise machine to mask sudden, disruptive noises.
Physical Relief and Positioning
Non-pharmacological techniques can provide localized relief. Applying a cold pack or ice to the forehead, temples, or the back of the neck can help constrict blood vessels and numb the area, offering a temporary reduction in pain. Finding the right physical position can also make a difference in managing pressure. While lying flat may increase throbbing for some, elevating the head and neck slightly with a supportive pillow can reduce pressure on the occipital nerves. Maintain a neutral spinal alignment, avoiding positions that twist the neck or place the head significantly lower than the chest.
Relaxation Techniques
Focusing on relaxation techniques can help disengage the mind from the pain signals. Simple practices like the 4-7-8 breathing technique, which involves specific counts for inhaling, holding, and exhaling, can activate the body’s parasympathetic nervous system. This technique promotes a sense of calm and can make it easier to drift off despite the discomfort.
Sleep-Induced Migraines and Oversleeping
Paradoxically, while a nap may sometimes abort an attack, too much sleep can also act as a migraine trigger. This phenomenon, often described as “weekend headache,” is linked to oversleeping and sudden changes in the sleep schedule. Oversleeping disrupts the body’s circadian rhythm, altering levels of neurotransmitters like serotonin that regulate the sleep-wake cycle and pain perception.
When the brain’s internal clock is thrown off by sleeping significantly longer than usual, it can initiate a neurological cascade leading to an attack. Maintaining a consistent sleep schedule, even on days off, helps stabilize the body’s homeostasis. Going to bed and waking up at approximately the same time every day, aiming for seven to nine hours of sleep, is a foundational preventive measure. This consistency keeps the neurological system in equilibrium and reduces the overall migraine threshold.
Recognizing Red Flags and When to Seek Help
While sleep is often therapeutic for a typical migraine, certain symptoms indicate a more serious underlying condition requiring immediate medical attention. A “thunderclap headache,” defined as pain reaching maximum severity within sixty seconds, is a red flag that should override any attempt to sleep it off. A headache accompanied by new neurological deficits also warrants urgent care.
These deficits include difficulty speaking, confusion, or weakness or numbness on one side of the body. Other warning signs include a severe headache combined with a high fever and a stiff neck, which can suggest meningitis. Any significant change in the pattern of a typical migraine, or a headache that is progressively worsening, should prompt a conversation with a healthcare provider.