 Headache and Sleep Disorders
Frequently Asked Questions
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Headache and Sleep Disorders (by James R. Weintraub, DO)
Why after a full night's sleep do I awaken with headache?
It is clear that the physiology
of sleep may provoke headaches. Sleeping later than expected on the weekends or
holidays is frequently associated with the development of a headache. Awakening
and retiring to sleep at or about the same time each day is very important and can
help prevent headaches in some individuals. What is also interesting is that when
a person has a severe headache, falling asleep may relieve it. We do not think that
dreams or psychological factors are the primary reason for the headache but rather
changes in the brain which bring on dreaming, including intense, maddening, or frightening
dreams, and provoke a headache at the same time.
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What are the common sleep disorders?
Insomnia—Problems
falling asleep or staying asleep, which can be the result of many different problems
(e.g., medical problems, lifestyle, psychological problems, or poor sleep habits).
Chronic insomnia is defined as sleep disturbance lasting longer than three weeks.
Obstructive sleep apnea—A
disorder characterized by loud snoring during the night, periods in which a person
may stop breathing during the night, and significant daytime sleepiness. This disorder
usually results when the person is lying on their back and the oropharynx (or airway)
becomes partially obstructed. Obstructive sleep apnea may result in medical problems
such as hypertension and heart problems.
Periodic limb movement disorder—A
disorder characterized by jerking or restless movements of the legs that are severe
enough to disrupt sleep during the night.
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How does sleep affect headaches?
Either too much sleep or too little
sleep can aggravate headaches in any individual. Researchers believe that fluctuations
in serotonin and other brain neurotransmitters occur during sleep, which in turn
can influence the onset or aggravation of head pain. When a person vulnerable to
headache sleeps late on the weekend, beyond the time they usually awaken during
the week, that extra amount of sleep may aggravate head pain. On the other hand,
some patients discover that sleep is a relieving and therapeutic agent for their
headache condition. Although some headache sufferers observe that napping during
the day can reduce headache pain (especially in adolescence), most adults find that
daytime sleeping triggers headache. Also, frequent naps during the day may reduce
sound sleep at night resulting in a morning headache. Patients should attempt to
restrict daytime hours for activity and reserve night time hours for sleep. This
approach, whereby an individual goes to bed and awakens at the same time each day,
is an important component in managing headaches.
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What is a sleep study and when are they ordered by physicians?
A sleep study (or polysomnography
study) involves the measurement of a number of bodily responses during night time
sleep (e.g., EEG or brain waves, EKG or heart rhythm, leg movements). These measures
help the physician to make a diagnosis for the type of sleep disorder, if any. A
related test, called a multiple sleep latency study, is performed during the day
to measure how long it takes someone to fall asleep during the day and to assess
the degree of daytime sleepiness.
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Are there any specific rules or specific
guidelines regarding good sleep habits?
Below are listed eleven rules for better sleep hygiene.
- Sleep as much as needed to feel refreshed and healthy during the following day,
but not more. Curtailing the time in bed seems to solidify sleep; excessively long
times in bed seem related to fragmented and shallow sleep.
- A regular arousal time in the morning strengthens the body's sleep-awake cycles.
- A steady, daily amount of exercise probably encourages healthier sleep patterns;
occasional exercise does not necessarily improve sleep the following night.
- Occasional loud noises (e.g., aircraft flyovers) disturb sleep in people who are
not awakened by noises and cannot remember them in the morning. Sound-protected
bedrooms may help those who must sleep close to noise.
- Although excessively warm rooms disturb sleep, there is no evidence that an excessively
cold room helps sleep.
- Hunger may disturb sleep; a light snack may help sleep.
- An occasional sleeping pill may be of some benefit, but chronic use of sleep medications
is ineffective in most insomniacs.
- Caffeine in the evening disturbs sleep, even in those who feel it does not
- Alcohol helps tense people fall asleep easily, but the ensuing sleep is then fragmented;
alcohol also can worsen headaches and provoke them.
- People who are angry and frustrated because they cannot sleep should not try harder
and harder to fall asleep but should turn on the light, get up, and perhaps read
in another room. Individuals can eventually return to bed and try to sleep again.
- The chronic use of tobacco disturbs sleep.
Reprinted by permission by P. Hauri, The Sleep Disorders, Second Edition,
Kalamazoo, Michigan. The Upjohn Company, 1982.
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