by Josh Turknett, MD
Getting adequate sleep is a critically important issue for the migraineur (and for every human!).
In some ways, given how much our modern lifestyles deviate from the ancestral environment as it relates to sleep, it’s kind of a miracle we’re able to sleep at all.
Personally, I’m militant about my sleep schedule these days. For one, it’s one of the most critical components of the ancestral lifestyle, and so not surprisingly important for keeping us a away from migraine threshold. It also seems pretty clear that the downsides of not sleeping well are amplified with age.
Two, I just feel so much better when I’m sleeping well – it promotes better mood, parental patience, productivity, and so on.
So for the migraineur, optimizing sleep is a great opportunity to fortify yourself against beastly attacks, and we should probably work as hard as optimizing sleep as we do our diets. I also think getting consistently good sleep is a good marker of overall health, as many other things have to be in line for that to be true.
Many of the problems folks have these days has to do with the accumulation of bad sleep habits, which ultimately leads to conditioning your brain to sleep poorly. The upside is we can use the conditioning to our advantage in several ways to reverse this.
With that preamble out of the way, here are multiple things you can do to ensure better sleep. If you’re struggling at all to get a consistent night’s rest, then these are all potential avenues to explore.
1. Sleep in a dark room — as close to pitch black as possible.
No lights from devices or clocks. Use black out shades if need be. A sleep mask is an alternative.
2. Keep it on the cold side.
We sleep better when it’s a little chilly, worse when we’re a little hot.
3. Minimize or eliminate blue light after sunset.
One huge problem these days are all the screens (indoor lights too, but devices and modern TVs are heavy in the blue light spectrum), which the brain perceives as the sun, and so this suppresses melatonin secretion. If you must look at a computer after sunset, you can get the f.lux app which will remove the blue light after dark.
The iPhone now also has a “night shift” feature that you can enable to automatically turn on at sunset and off at sunrise.
4. As the adage goes, the bed should only be used for sleep and sex.
This is where conditioning comes in. If you only use the bed for sleep, your brain will associate it with that. If you spend long periods of time in bed without sleeping (watching TV, etc.), then you will eliminate that conditioning effect.
5. Leave the lights off when going to the bathroom.
If you need a little light to guide your way, use a nightlight (motion activated preferably). Turn on the bathroom light and your brain thinks the sun just came up.
6. Be consistent.
The more militant your schedule (same time to bed, same time to rise, etc.), the better.
7. Use white noise.
This is especially great for folks who wake up in the middle of the night often. There are several benefits of white noise, one of which is that it will mask all external noises – the brain adapts quickly to sustained background noises, but alerts quickly to sudden, novel ones. White noise also helps to entrain the brain waves that are associated with the sleep state.
Play it louder than you think you should.
White noise also provides a great conditioning effect. I now get sleepy as soon as I hear it. And it’s fantastic for vacations, hotels, etc. – it blocks external noise, and your brain thinks you’re sleeping at home.
We use an iphone app called “white noise” and use the “air conditioning” sound. We play it over a speaker.
Physical activity, especially outside, is clearly associated with better sleep. Ideally in the morning or early afternoon, to help with entertainment of sleep/wake cycles in the brain, but any activity is better than none!
9. Have a sleep routine.
Again, reap the benefits of conditioning by doing the same 10-15 minute of routine every night before bed.
10. Melatonin supplement.
If your sleep has been out of whack, taking a 4 week course of melatonin can help get it back on track – 3-5 mg taken 1-2 hours before your desired bedtime.
Some folks report improved sleep quantity taking Magnesium (also a migraine preventative) before bed.
Lastly, I should say that if you’re having problems either with frequent awakenings or with not feeling rested despite adequate time asleep, it can also be the sign of a sleep disorder.
Obstructive sleep apnea (symptoms would be snoring, breathing pauses or choking episodes witnessed by a bedmate) and paroxysmal limb movements (symptoms would be frequent leg movements during the night reported by bedmate, or covers all strewn about in the morning, often accompanied by restless legs at night before sleep). So it would be worth getting checked for that if there are symptoms.