Waking up with a Migraine attack is a common experience and it’s something we should discuss with our doctors. Sleep disruptions can be a potent Migraine trigger. Consistently waking up with Migraine may be our first clue that a sleep disorder is complicating our Migraine treatment, making it more difficult to get good results. In many cases, as sleep study can identify or rule out sleep disorders. Confirming a diagnosis and starting treatment for these problems can improve the effectiveness of our Migraine treatment.
Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is one of the more common sleep disorders that can worsen Migraine. Snoring is the most common symptom, but not all snoring is caused by OSA. Because its symptoms disrupt sleep many times each night, we can’t get the restful benefits of sleep.
Untreated, we may wake up with Migraine attacks and feel tired throughout the day. Self-treatment with sleep aids at bedtime or caffeine during the day are counterproductive and may create more problems.
Getting a diagnosis
Sleep disorders are diagnosed by a polysomnograpy, more commonly referred to as a “sleep study.” A sleep study involves an overnight stay in a sleep lab. Non-invasive sensors are applied on the head, face, neck, chest, arms, and legs to monitor body function during sleep. Movement, oxygen saturation, respiration, heart rate, and neurological activity are all recorded to help identify any sleep-related abnormalities.
- Obstructive sleep apnea is confirmed when there are more than five apneas or hypoapneas per hour during sleep.
- An apnea is the absence of airflow through the mouth and throat of at least 10 seconds while inhaling.
- A hypoapnea is reduced airflow under the same circumstances.
- Some patients experience 100 or more apneas each hour.
- These apneas cut off oxygen to the brain.
- The brain responds by waking us up just enough to breathe deeply.
The repeated nighttime waking results in poor sleep quality, daytime sleepiness, and often, morning Migraine attacks.
Treating sleep apnea
The most common treatment for OSA is the use of a CPAP machine. CPAP is an abbreviation for continuous positive airway pressure. It involves wearing a mask during sleep that produces airflow at sufficient pressure to keep the airway open to prevent the apneas and hypoapneas that disrupt restful sleep. Please see our tips for using Using CPAP Therapy for Sleep Apnea to learn more.
Causes of sleep apnea
The most common cause of OSA is obesity. Weight loss can reverse OSA in up to 60 percent of patients. Another 30 to 40 percent of patients with OSA have structural abnormalities of the jaw or throat that contribute to the development of OSA. A small and/or recessed jaw, enlarged tongue, tonsils, or uvula can also cause OSA.
Untreated OSA is a risk factor for:
- Cardiovascular disease
- High blood pressure
- Auto accidents
Impact on Migraine
Sleep disruptions of any kind can be a potent Migraine trigger. If we experience snoring and/or wake up with headache pain, it’s probably a good idea to ask about a sleep study. Eliminating this trigger can dramatically improve our energy levels and Migraine attack frequency. Imagine waking up refreshed and pain-free. If untreated OSA is triggering Migraine attacks, using a CPAP may be the next treatment option to consider. Talk to your doctor about scheduling a sleep study to identify what sleep problems might be affecting your Migraine management.
- Javaheri S, Barbe F, Campos-Rodriguez F, et al. (2017). Sleep Apnea. Journal of the American College of Cardiology, 69(7), A1-A42.
- Yang C, Wang S. (2017). Sleep in Patients with Chronic Migraine. Current Pain and Headache Reports, 21(9), 1-7.