Migraines are a neurological disorder characterized by moderate-to-severe head pain, often accompanied by nausea, sensitivity to light (photophobia), and sensitivity to sound (phonophobia). When an attack occurs, minimizing discomfort and facilitating recovery through rest is essential. Optimizing the laying position and adjusting the environment significantly reduces the sensory input that exacerbates the pain.
Finding the Optimal Position
The most effective laying position maintains a neutral alignment of the spine and neck to avoid muscle tension that can worsen a migraine. Lying on the back is generally a favorable position, as it distributes body weight evenly and promotes spinal alignment. Place a small cushion beneath the knees to gently flex the hips, which helps relax the lower back muscles and stabilize the spine.
A slight elevation of the head can be beneficial, as it may help reduce intracranial pressure. Propping the head and shoulders up to about 30 degrees can assist in fluid drainage without straining the neck. Avoid using a pillow that is too high, as this increases tension in the cervical spine.
Side-laying is often preferred, especially for those experiencing nausea or vomiting, as it reduces the risk of aspiration. When resting on your side, ensure the pillow height is adequate to keep your head level and aligned with the spine. Placing a pillow between the knees prevents the upper leg from rotating and maintains a neutral spinal curve.
Stomach sleeping is discouraged because it requires the head to be turned sharply, leading to prolonged rotation and strain on the neck muscles. This strained posture can activate trigger points and increase muscle tension, potentially prolonging the migraine. The chosen position should prioritize maximum comfort and minimal pressure on the head and neck.
Essential Environmental Adjustments
Migraine attacks heighten sensory perception, making external stimuli painful, so adjusting the environment is a primary step toward relief. Light control is paramount due to photophobia. Absolute darkness, achieved by drawing blackout curtains or blinds, is ideal, as light can activate pain pathways. If darkness is not possible, opt for warm, soft, non-flickering light sources instead of harsh fluorescent or bright LED bulbs.
Sound management addresses phonophobia. Eliminating noise is most helpful, but if complete silence is distracting, use white or brown noise generators. These mask sudden, jarring sounds by providing a steady, low-level auditory background.
Controlling air quality and temperature contributes significantly to comfort. Strong odors (osmophobia) are a common migraine trigger, so remove scented candles, air fresheners, and perfumes. Maintaining a cool room temperature, typically between 60–65 degrees Fahrenheit, is preferred, as excessive heat can exacerbate symptoms.
Utilizing Supportive Tools
Supportive tools enhance the therapeutic benefits of lying down during a migraine attack. Pillow selection should prioritize proper cervical support; contoured memory foam or cervical pillows are recommended to cradle the neck and maintain its natural curve. For side-sleepers, the pillow must be firm and thick enough to keep the head aligned with the spine without sagging.
Temperature therapy is a common tool for localized relief, with cold application being the preferred choice for many sufferers. Applying a gel cold pack or specialized ice hat to the forehead, temples, or neck provides a numbing effect that constricts blood vessels and dampens pain signals. Conversely, a warm compress or heating pad on the neck and shoulders can help relax muscle tension.
To fully address light sensitivity, a high-quality eye mask that ensures 100% blackout is beneficial. Some individuals find relief from weighted eye masks, as the gentle pressure over the orbital region may offer a comforting sensation that distracts from the throbbing pain. A weighted blanket draped over the body can provide a grounding, calming pressure that helps reduce feelings of anxiety and restlessness.
Relaxation Techniques While Lying Down
Once an optimal position is achieved, specific relaxation techniques help calm the nervous system and manage pain perception. Controlled breathing is a powerful tool that shifts the body from the sympathetic “fight-or-flight” response to the parasympathetic state. Diaphragmatic breathing involves inhaling slowly and deeply through the nose, allowing the abdomen to rise, and then slowly exhaling through the mouth.
A common technique is the 4-7-8 method: inhale for a count of four, hold for seven, and exhale completely for eight. Practicing this pattern can slow the heart rate and promote deep relaxation. This focused effort provides a mental anchor, redirecting attention away from the pain.
Progressive Muscle Relaxation (PMR) involves the systematic tensing and then relaxing of muscle groups while lying down. Focusing on the contrast between tension and release helps consciously relax muscle groups that often hold tension during a migraine, such as the jaw, neck, and shoulders. The process begins with peripheral muscle groups, such as the feet and hands, and gradually moves inward toward the core and facial muscles. Mental imagery or guided meditation provides a cognitive distraction, deepening the state of rest.