Improved Sleep Quality May Transform Chronic Migraine

Chronic migraineurs endure more than 15 days of migraine headache each month. When you also consider that post-headache days, often described as postdrome, are not exactly pleasant either and often dominated by fatigue and the anxiety about when the next attack is coming, it is easy to see how this is an incredibly debilitating condition. It is not only the pain that affects patients, but the profound impact it has on social and work relationships as well as and psychological burden it imparts. Migraine sufferers are more likely to develop mental health issues such as depression than the rest of the population. It is ranked as the third most common disease in the World and around 1 in 7 adults population in the UK suffer with migraine headaches. Females are more likely to develop migraine during their reproductive years indicating a hormonal influence in migraine aetiology in some cases.

We know that medical options for migraine have quite limited efficacy. Patients may not want to try medical options in the first place and many of those that do attempt drug options either do not tolerate their side effects or, when one type of drug perhaps hasn’t helped give up on medical help altogether, quickly losing confidence in pharmacotherapy as a treatment option.

Increasingly, patients are turning to non-medical options to help with their pain and it turns out that there are lots of lifestyle variables that relate to most types of headache.

Sleep quality has long been associated with migraine, although it is not entirely clear which direction the relationship moves in. Does migraine stop patients from getting good quality sleep, or does poor sleep quality in the first place predispose people from developing migraine?

In a study by Calhoun in 2007, a randomized, placebo‐controlled study assessed the impact of Sleep Behavioural Modification on women with chronic migraine.  By establishing healthier evening and bed time routines, the researchers were eager to see if there were improvements in headache frequency and intensity.

Compared to a placebo group, those improving their bedtime routines were statistically more likely to reduce headache frequency and intensity with nearly 50% reverting to episodic migraine only i.e. less that 15 headache days per month.  None of the control group were transformed back to episodic migraine.

When you consider all the other health benefits that accompany better sleep quality, this represents a completely life changing therapy that improves quality of life and reduces medication and healthcare use.