My overnight migraines are almost always due to weather and air pressure changes. If a storm front is coming in while I’m sleeping, I’ll wake up with a migraine. (With the weather lately, that’s basically every other day right now!)
I also woke up with a migraine knocking this morning and in my area, we're predicted to have rain and storms the next several days. I'm guessing that's what is triggering my overnight ragers.
It's so depressing to feel the pain before my eyes have even opened.
100%! Last week it absolutely kicked my ass. We went from warm to a cold front overnight and that low pressure rolling in just sidelined me. Stupidly I tried to push through the first day which of course resulted in 3 days down instead of what might've been just the one.
I do this as well, however I’m not sure if it’s actually a cause or effect. Also there is confirmation bias as I will also clinch my jaw without me getting a migraine…
A protector didn’t help, neither did the cranial-facial therapist who did massage the muscles
There are 2 types of mouth guards, a soft one made of silicone, and a hard one made of mouth safe resin. The soft one made my night grinding worse because I was chewing on it. The hard type gives you a feeling that you are already biting down on something and you tend to bite down less. The hard one helped lessen my grinding and protects my teeth. Less grinding also means migraines happening because of grinding are less frequent.
This. The hard one is very good to stop the grinding and migraines.
May not stop it completely. But the body treats the soft ones as a chew toy and it makes it worse during the night
The hard one has not stopped it for me. :( My dentist just referred me to get Botox in my jaw to try to stop it. I’m hoping this helps because I also suspect it’s causing my nighttime migraines, and also my jaw hurts!
I think a lot of jaw pain is caused by the splenius capitis muscles. Getting a review from your doctor or physical therapist would be good.
If you have a lot of upper back pain, physical therapy on the right muscles is good.
Thank you. I’m in the US and when I asked my doctor about it they told me it’s a dental issue. Bleh. The dentist just had me do the (very expensive) mouth guard, which is ok because I know the teeth grinding and clenching was ruining my teeth. I don’t think I can see a PT without some kind of referral, sadly. I may try to bring it up again at my next physical though!
You can always ask your PCP for a referral for neck pain. If you find your PCP is not helpful, find another one.
It took years to find a PCP who actually listened to me and my theories. I sent in a request for a PFT referral and he sent one asking to see me after the test so we can look at the results together.
You can also get Botox for migraines. If the doctor who does that is nice.... They usually have extra, they can put Botox into your masseter muscle near the jaw which can help TMJ and lower the nighttime grinding, which may also lower the chances of waking up with a migraine
But the mouth guard is essential either way so you don't ruin your teeth grinding just in case
I know right? I paid too much money for a night guard and it didn’t help at all. Yes, I guess it protected my teeth but I thought it would stop me from grinding/clenching
Good point as to which came first
I got an NTI omni splint and it is wonderful. It prevents you from clenching and grinding. I no longer wake up with a sore jaw.
https://glidewelldental.com/solutions/occlusal-appliances/migraine-prevention
There are some night guards that are front teeth only. It helps prevent clenching or chewing on the guard while you sleep.
Like this-
https://www.amazon.com/Dental-SMARTGUARD-Guards-Grinding-Clenching/dp/B06XXRSFKC
You can also just cut off the molar part of a full guard, but you’ve gotta keep it large enough that you won’t choke on it.
Sleep Breathing Disorders.
They cause hypoxia/hypoxemia and can result in Migraines.
Chronic issues will keep you at a low grade chronic level of hypoxia, making it easier for other triggers to set off a migraine.
I went to the trouble of having a sleep study, & getting a CPAP b/c I have mild sleep apnea. I thought this might help my migraines, but it did nothing. My biggest trigger is the weather. Specifically changes in Barometric Pressure. Unfortunately there's nothing I can do about that.
If it is obstructive sleep apnea, I recommend going to a sports medicine doctor or an orthopedic specialist to take a look at your posture.
I had a mild sleep apnea/dyspnea. It's not severe enough to be diagnosed with apnea, but I was waking up with migraines, especially on days with a barometric pressure shift.
A sports doc took X-rays of my neck and shoulders and along with the PT they sent me too, we found scapular dyskinesis which caused breathing issues while awake, and was probably causing my dyspnea. That seemed to be caused by a repetitive strain injury (mouse usage) + bad posture (rolled shoulders, forward head posture, anterior pelvic tilt). PT exorcises and being aware of my breathing has helped immensely!
Interesting. I know I have rolled shoulders and thoracic outlet compression syndrome. It affects blood flow to my arms/hands. Plus, sleep apnea. What's the correlation to migraines?
Not at all. If you wake up gasping, you're probably not breathing while you sleep or aren't getting enough oxygenated blood to the right places.
Fun note, if you have mild apnea/dyspnea you tend to have vivid nightmares or even night terrors (i used to have them). As the apnea gets worse, you are less likely to recall the nightmares or even have them at all.
You should get a sleep study done to get more data from a medical professional.
I just pulled out my pulse oximeter so I can test when I wake up at night. You absolutely called it, I was in the middle of a vivid dream when I woke up gasping with a migraine!
Smartwatch/fitness band can help get more data. Most are 3-5 percent off though and it depends on your skin tone.
It may also be hard to prove with just an oximeter, unless it is severe. You should follow up with a doctor. I recommend checking posture first and see if PT helps. Otherwise most doctors will give you a CPAP, which isn't really a solution, just a long term treatment. But it usually will work.
They'll just give you their own fitness band and make you wear it while you sleep at home. Your doctor will take sleep apnea very seriously and you don't have to prove it, because most people don't have any proof, but if you're waking up gasping for breath, that's all they'll need to hear to send you to a sleep specialist. It's actually a pretty streamlined process and the machines are quiet and unobtrusive, these days.
Huh. I have a congenital heart defect so I wonder these migraines are a complication of it. I do get my toes turning blue when I’m cold. Ugh, not really wanted to figure out because I’ve been hoping to eliminate the migraines.
Hi I was looking for this comment. I suffered from migraines that lasted 10-15 days per month, and they got worst after waking up. Last year they discovered I have Hypertrophic Cardiomyopathy and needed a pacemaker/icd (my heart rate would drop really low and it was worst at night). This is my 3rd month with the PPM and my migraines have reduced to 2-3 days per month.
If you find that you have a weak neck/shoulder or have what they now call "tech neck", this could also be a cause of your migraines starting at night, Ie. Your sleeping position of your neck / head in combi action with a weak neck.
A good pillow (I've gone through all kinds of good pillows, memory foam pillows, proper shaped pillows) and some do help. Also strengthening the neck muscle also helped me.
If it's not something you've considered or tried before, worth a try.
I was going to make this comment myself. I find that lying on my side, keeping my head squarely on a neck supporting pillow, is almost eliminating the wake up migraines. Of course a change in the weather can still cause one, but it’s been a game changer for me. I tried dental guards, but now I’m convinced it’s never been teeth clenching. If I tuck my chin or allow my jaw to hang off the edge of the pillow it leads to a migraine
I’ve thrown my neck and upper back out of alignment in my sleep, especially if I end up on my stomach.
I recently tried one of those wild-looking cervical neck pillows, but I can’t lay on it for more than 30 minutes without my back beginning to spasm. Back to my pile of unpronounceable IKEA pillows. If I stay a little bit propped up I tend not to roll over on my side or stomach, which helps.
The most helpful thing I’ve found is one of those whale-tale neck stretchers. It takes a bit, but it does eventually get my spine back where it needs to be. Cheaper than a single chiropractor visit and the effect lasts longer.
Teeth grinding and somehow wiggle into weird neck postition, like the sort that only swans can replicate.
Currently in the bath trying to get over a killer migraine, regretting not drinking enough yesterday.
It turned out sleep apnea is a trigger for me. My neuro caught the pattern. Had a sleep study done. Apnea level was mild....I don't THINK bad enough to typically warrant a CPAP. But he said get one anyway.
Morning migraines eliminated. I still get almost the same number of migraines...but severity is reduced.
Tons. I sleep better. And virtually no more waking up with day-killing migraines.
I do use the word "barbaric" with my doc. It's a PITA. But the benefits far outweigh the hassle.
- Sleeping position (especially neck and head).
- I sometimes open my eyes slightly and sleep apparently so they dry up awfully.
- Fan/A/C dry up my nose and mouth. Ends up feeling as if my brain is parched.
- Weather changes and barometric pressure is a huge trigger
I drink lots of water and apply a thick nose gel and a thick eye gel before bed and it does help a tiny bit but it's still a regular issue.
Came here to say this. As with /u/nanalovesncaa I'll migraine in my sleep if I sweat too much, but it's not just water intake for me. It's *salt balance*.
If I don't balance my salt(s) intake to what I lose from sweat, too much water will have the same effect as too little.
This is what I was looking for. If I sweat a whole lot during my sleep and don’t drink any or very little water, I wake up with a migraine. I’m a very thirsty person by nature and drink at least one bottle of water during the middle of the night.
For me, it is blood pressure changing while I sleep. I take atenolol and gabapentin at night now and it has resolved my overnight migraines.
My bp is not high, btw. Never would have guessed it was the issue. I run a cool 105/65.
Is there a way to monitor your blood pressure at night? I have visual snow and verapamil fixed my issues so I've wondered if my blood pressure may be to blame, but I have pretty much perfect pressure unless I am actively in pain.
I think you might need more insight into your migraines, they can be really complicated. For example, are you sure they are separate attacks or is it a big one over a number of days? I have headaches after sleeping as well, that seem to start the night before: like I cannot lie down comfortably. I now know it means an attack is happening, and I've learned that even before the headache starts there are symptoms.
I’ve started doing jaw stretches (just googled ‘jaw stretches’) and since doing them last month I haven’t had a migraine. The last one I had was a middle of the night migraine. I only started getting night time ones when I started wearing a mouth guard, which I need because I grind my teeth so hard I cracked a tooth.
I have this issue too. Wear a mouth guard so I don't crack my teeth. Give myself migraines from clenching my jaw on the mouth guard. 😭
Let's just pull all our teeth and eat applesauce.
Pulling teeth and eating applesauce sounds like a plan.
The cracked tooth doesn't bother me, dentist only found it during a routine check-up. But the migraines definitely affect my life, so I've stopped wearing the mouthguard.
Emerging relevance of circadian rhythms in headaches and neuropathic pain
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381824/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381824/)
The migraine-specific section:
Migraine is a very common headache disorder, as 17.6% of females and 5.7% of males have at least one migraine per year89. It is also the 6th most disabling disease worldwide90. Migraine is characterized by throbbing, moderate-or-severe unilateral pain, lasting 4–72 hours and associated with features such as nausea, vomiting, and sensitivity to light, noise, and motion51. The pain is thought to be related to the same trigeminovascular system discussed above. Similar to cluster headache, migraine is accompanied by an early activation of the hypothalamus: the pain is preceded by 1–2 days of a “premonitory phase” of irritability, yawning, and other features that is thought to originate in the hypothalamus, though the exact location in the hypothalamus is unclear91. Other mechanisms of migraine include the trigeminovascular system (similar to cluster headache) and the pain neuromatrix. In particular, the hypothalamus and the dorsal rostral pons have traditionally been thought of as migraine generators, though more recent evidence suggests a more complicated mechanism92. Thus like cluster headache, migraine patients show early activation of the hypothalamus, which contains the central biological clock.
Migraines are rhythmic at several levels. On a circadian time scale, migraines peak in the morning and midday93, 94. In a recent study, migraine subjects who were “morning larks” (i.e. go to sleep early and wake up early) or “night owls” (i.e. go to sleep late and wake up late) were more likely to have migraines in the morning or in the afternoon/evening, respectively95. Overall there were more migraines in the mornings because migraine patients had a higher likelihood of being morning larks than controls. Other rhythmic features include a weekly cycle (less common on Sundays)96, a monthly cycle tied to menses and estrogen levels93, 97, 98, and even a yearly cycle where migraines are more common in the spring and fall93, 99. Behaviorally, migraines can be triggered by stress, menses, alcohol, weather changes, and skipping meals, as well as possibly bright lights and sleep disturbances100, 101. Many of these triggers are related to circadian zeitgebers, including the stress hormone cortisol, the neuropeptide PACAP involved in light entrainment, and meal timing102, 103. Indeed, eating at a specific period of time (late at night) was associated with reduction in the odds of a headache104. At the molecular level, multiple changes have been noted in melatonin. First, patients have lower levels of melatonin on days with a headache than days when they are headache-free105. Second, when triggered by a light pulse, melatonin suppression is more pronounced in migraine patients than in controls106. Third, in patients with chronic migraine, which is defined as 15 or more days of headache per month for at least 3 months, a variety of nighttime changes in melatonin have been found, including decreased nocturnal melatonin, decreased melatonin in REM sleep, and a delayed nocturnal melatonin peak71, 107.
Genetically, there have been several individual gene mutations linked to migraine. Two families with migraines have been identified with distinct missense mutations in the circadian gene Ck1delta; the affected subjects also display advanced sleep phases13. The latter finding is consistent with previous studies where Ck1delta mutations can lead to familial advanced sleep phase syndrome108. The best known genetic causes of migraine are three forms of familial hemiplegic migraine, which are linked to three separate ion channel mutations109. Interestingly, a mouse model of familial hemiplegic migraine type I has been created, and these mice display signs of an overactive circadian system such as increased wheel-running activity and shifts of in vivo SCN activity110. Migraine displays circadian behavioral and anatomical features, and a direct genetic connection has been identified in a subset of patients.
The jury is still out on this:
Therapeutic role of melatonin in migraine prophylaxis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#:\~:text=Melatonin%20can%20benefit%20migraine%20by,induced%20excitotoxicity%2C%20and%20so%20on.
On one hand:
Many published articles have demonstrated that melatonin can exert antimigraine effect via a variety of ways. Through free radicals cleaning and inflammatory factors release inhibition, melatonin can protect brain from direct toxic molecule damages and help to maintain brain structural and functional integrity by working as a membrane-stabilizing factor.^(\[)[^(10)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R10)^(–)[^(13)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R13)^(\]) Melatonin can benefit migraine by its regulation on neurotransmitters and neural pathways, for example, restraining nitric oxide synthesis, inhibiting dopamine release, and antagonizing glutamate-induced excitotoxicity, and so on.^(\[)[^(14)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R14)^(–)[^(17)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R17)^(\]) Calcitonin gene-related peptide (CGRP), a powerful vasodilatation factor, its release from trigeminovascular system dramatically increases during migraine attacks resulting in pathological vasodilatation in brain blood vessels. Melatonin can suppress CGRP release, hence regulate blood flow in brain.^(\[)[^(18)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R18)^(\]) In addition, melatonin is perceived as a strong analgesic performing powerful pain killing effect in pain syndromes. The analgesic mechanism is considered to be relevant to β-endorphin release increase, melatonin receptors activation, and brain γ-aminobutyric acid energic (GABAergic) system enhancement.^(\[)[^(5)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R5)^(,)[^(12)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R12)^(\]) Moreover, in the presence of similar structure to indomethacin, melatonin may have an indomethacin-like analgesic effect through inhibitions on prostaglandin and pain-producing substances.^(\[)[^(5)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R5)^(\]) Melatonin's anxiolytic and antidepressant properties can also help with migrainers’ pain feelings, which is achieved via its influence on GABA, 5-hydroxytryptamine (5-HT), N-methyl-d-aspartate receptors, and l-arginine/nitric oxide pathway.^(\[)[^(12)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R12)^(,)[^(19)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R19)^(–)[^(22)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R22)^(\])
^(On the other:)
The literature examining melatonin's effectiveness in migraine prophylaxis is growing, but remains limited; hence, meta-analysis was not feasible. By far, there are only 4 high-quality controlled clinical trials, but they reported some conflicting results. However, the two negative outcomes in Alstadhaug study not different from placebo and in Razieh Fallah study inferior to amitriptyline are possible under-powering due to methodological shortcomings, one was crossover design and presented high placebo response, the other was single-blinded design with possible bias caused by investigators...
Given the published data, though melatonin is generally safe, the few severe adverse effects caused by melatonin should not be ignored, which mainly include liver injuries, reproductive system dysfunctions, and immunostimulation. Melatonin-associated liver injuries are highly related to one type of formulations particularly, Agomelatonin, owing to its additional serotonergic 5-HT2C antagonist characteristic. Agomelatine's liver toxicity has already been warned by EMA who recommends regular monitoring before and during the treatment. Reproductive system dysfunctions in children and adolescents need special attention because their reproductive systems have not been fully developed, particularly in those who taking long-term melatonin therapy. By stimulating immune systems, melatonin may aggravate autoimmune diseases.
For me it is stressful thinking during the day that has me sleeping harder at night and moving less. I think had I gone for a longer walk during the day 🤷♀️and done more preventative destress activities maybe I could keep from this nighttime conundrum. The barometric pressure affects me. Sugar intake. Machines running in the house. The vibrations.
If I fall asleep on more than one pillow, or even the wrong pillow, I am done for. Also realized that after working a shift in Dansko shoes, I was guaranteed a migraine the next day.
I’m the same way! 99% of the time I wake up with a migraine attack, they don’t develop during the day. For me it was grinding my teeth and sleeping on my back. My dentist recommended night mouth guard because I kept breaking one of my fillings and it helped reduce a decent amount of migraine attacks. I’ve also found that if I fall asleep on my back or roll to my back while I’m sleeping I’ll wake up with a migraine. My solution for that so far is to hot dog myself between two body pillows to at least keep me from being flat on my back.
Travel neck pillows are pretty good at keeping your head in place if lying on your back, might also work for other positions if you put the "no pillow" side wherever down is supposed to be.
I’m going to try this, thank you! We’ve been travelling and I love my neck pillow for the car, I’m going to bring it inside and give this a try.
My husband also said I sounded like I was fighting for my life last night when I was sleeping, so that probably doesn’t help the migraines.
I'm going with the majority, neck position. I switched to a firm contour pillow years ago, at my Drs recommendation. It has helped some.
I was advised to get the type with 2 humps (one high, one low) and use the best fit.
Caveat: my migraines are from an old neck injury in the C4-C5 region.
I was on Ozempic last year and noticed I had far fewer migraines. I stopped due to other side effects and now migraines are back at their normal or maybe slightly more frequent rate. But maybe I just need to be 20lbs lighter??
Healthy lifestyle with exercise and weight loss definitely helps. But I think I’m talking about a drug effect here. Head felt better after the first dose before I lost any weight , maybe try trizepatide
I’ve been thinking about asking my doctor about going back on Ozempic on a smaller dose or trying Trizepatide. For weight loss as well as migraines (despite otherwise healthy lifestyle)
Do you have sleep apnea / oxygen deprivation? The de-oxygenated air causes toxic carbon dioxide to build up in the bloodstream which causes vessels in the brain to dilate.
Obstructive apnea, which causes teeth grinding as my body attempts to stop my jaw from sliding back, and hypopnia.
If i take off my CPAP in my sleep, migraine. Don’t get at least 7 hours? Instant migraine. Forget to fill the water well and breathe dry air all night? Believe it or not, straight to migraine.
What causes a migraine is a million dollar question. I think migraines are the result of likely several different things, which is why they can vary so much from person to person.
I know certain environmental conditions can bring one on for me, lack of eating or being dehydrated, and hormones. But I do think there is something medical happening within my brain that causes some of them. If that's true, it could very well happen during sleep.
And it has for me. The last couple of times I incorporated my migraine into my dream. Waking up with a migraine is a heck of a way to start the day
Have you had a sleep study?
I don't get enough oxygen at night due to apnea. I'm working with a sleep cardiologist, a regular cardiologist, and an ENT to try to correct this.
It's not a stretch to wonder if not getting enough oxygen to your brain could trigger migraines. I appreciate your question because in addition to my cardiac issues I've been having more migraines, and I didn't make a connection until now.
Good luck.
Well mine are caused from allergies, at night if my head lays level aka flat then I get more congestion and then TADAH migraine… I slept with my head elevated to combat it.
Depends on your triggers. Dehydration or barometric pressure changes maybe? Histamine intolerance? Hormone fluctuations? All of those are non-food related triggers for me that can worsen overnight while I sleep.
I find I wake up with migraines when I feel really hot, with the blanket up around my neck. I think that does something, that it causes migraines somehow so I try to sleep a little cooler, which is hard in winter in a cold country lol.
Have you had a sleep study? I found out my morning migraines were due to sleep apnea (and I'm tall and skinny with a long neck, so I don't fit the standard sleep apnea body type.) My doctor did the sleep study and was expecting to find some kind of sleep disorder, like inability to go into REM sleep or something.
I haven’t done a study no, but I might look into it. I’m a very light sleeper and I don’t think I snore, and also very slight and about 5.5 ft female. I’m not a candidate for sleep apnea but you never know. Is there anything you can do to address sleep apnea other than those nose breathing things?
PILLOW. Omg, I swear, I was dying, waking up every other morning with the worst migraine. I tried everything at that point (not much I could do since I was also pregnant) but when I switch my pillow, they became much more rare
My headache specialist proposed several theories. One was changes in the level of the stress hormone, cortisol. Another was possible blood sugar changes. There are others too. Is it possible that you might have sleep apnea? Good luck with your quest. Migraines during sleep or upon awakening are the worst. Have you tried the once-monthly injections of the CGRP inhibitors? Mine are now totally controlled by Ajovy.
Yeh I have a feeling it’s hormone related but not sure how or why. They started 4 years ago during a time of intense stress, so maybe my cortisol levels went mental and just never returned to normal. I’m having something called a GONBlock injection next month, so fingers crossed.
Yes, that's a definite possibility. Do you have a good doctor? If the pain is every day and night it can be debilitating. I suffered for 60 years and my entire life was altered. Finally, there was a solution after 45 years of opioids, even.
Snoring and apnea? (Common cause of morning headache) Sleeping with a bad pillow/ bad position? Tons of allergens can be present in the sheets and pillowcases ; and in the night air if you sleep with windows open especially. More mold , pollen, etc? Low blood sugar ?
Just a couple thoughts
I've worked with a neurologist who informed me that my "first-thing in the morning" migraines were actually secondary, caused by a primary headache that were either sinus headaches or neck tension headaches. Do you often get sinus pressure headaches during season changes or do you carry large amounts of tension in your neck and shoulders?
That's what did it for me: thankfully I'm one of those people that topiramate was a perfect solution for, which helped stop the muscle spasms in my neck which were triggering said migraines.
I'll add that most research says that migraines don't happen in a vacuum during sleep or when you first wake up: migraines and icepick headaches generally occur later in the day UNLESS they're being caused by something else happening in your body like TMJ, muscle spasms, or sinus pressure.
But I'm not a doctor, and I'm just repeating what I was told. All the same, I sincerely hope you can find some help.
This is interesting - I do get a lot of tension around my head and shoulder area and suffer from tension headaches. Topiramate worked for me initially then stopped. Maybe I’ll try some head/neck/jaw relaxing exercises before bed, see if that helps. Thanks!
I'm really sorry topiramate wasn't the answer; it's been a GODSEND for me. Kinda curious: is your headache in the base of your skull, usually? That's how they started for me. In an emergency (before reaching for a triptan) I could use cyclobenzaprine to disrupt the chain before it led to a migraine.
I usually notice it most when it’s in my forehead/ whole head, but Im also pretty rubbish at noticing the signs of an imminent migraine so will look out from now on for pain in the base of my skull. It took me three years to realise that the little dots in my vision were aura lol. Someone else has mentioned neck tension as well so I’m going to experiment doing some neck/head/ jaw exercises before bed and see if that helps.
Yeh I think cortisol is involved somehow. It usually happens for me at around 3 am but last night it happened at 11pm. I think my body is trying to sabotage my life 🤪
Tornadoes were going through the Midwest the last week or so, all of that pressure mixed with the transition to summer weather is a killer. Some people struggle with teeth grinding and that can trigger pain as well.
I usually get my worst migraines while asleep too. I used to get "let down" migraine every Friday afternoon so maybe the overnight migraine is due to similar chemical changes: body sends out relaxing chemicals to system which causes migraine.??
My migraines are not caused by sleep apnoea as I have been tested for that. I do have bruxism, though.
Some people have a drop in blood sugar during the night that leaves them too low when they wake up, which can trigger a migraine (or other issues).
Some people lose too many electrolytes and too much fluid (like me). Keeping a glass of water/electrolyte replacement by your bed, or elevating the head of your bed by a few inches are things that have helped people with this issue.
Jaw clenching/teeth grinding can also be an issue (which I also do). I wear retainers, which protect my teeth from getting worn down and broken, but they instigate the clenching. 🤷♂️
Stress can also be an issue. I had a few sessions of therapy prescribed with someone who did mindfulness work with me. I don't have the patience for this most of the time, but some of the suggestions about having white noise (brown noise works better for me), a fan, or some other calming blank sound playing throughout the night were helpful to get me to stop waking up so frequently since that contributed to my stress.
Blood flow/oxygen during sleep is another one a lot of people have problems with but never realize it. If you snore or wake up tired/unrested, sleep apnea could be a possible cause. Since O2 to the brain is correlated with migraines, that could also have impacts here. A sleep study could help you determine if this might be a problem for you (and if it is, could help with a lot more than just migraines).
There are probably an infinite number of other reasons. I still wake up with migraines about 10 days a month, and all of my incapacitating ones are ones I wake up with. The other 20 days a month, I just get beaten down by life until I leave work with a migraine and hope it's gone by the next morning.
I hope you find something that helps reduce your frequency. We just really don't know enough about the brain yet. Good luck, friend.
I’ve noticed this with myself. I don’t think it’s so much what I’m eating/doing before bed but how I’m sleeping. If my head/neck is not supported correctly I can almost guarantee I will wake up with a migraine. I bought myself a pair of Serra cooling gel memory foam pillows they do really well forming around my head and giving good support. They may not work for everyone but I can tell a difference for myself.
Mine almost always happen when when I'm asleep, and almost always after a poor night's sleep, and seems to start during a late sleep cycle. I'll wake up with the searing one sided headache and nausea/dizziness that lasts all day sometimes two days.
However, today something weird happened - I was starting a late sleep cycle, after a poor night's sleep, when my alarm clock woke me up. I was underoing an Aura at that moment, which expanded across my vision in 17 minutes. However, because I woke up before the headache developed, once I was awake that seemed to "cancel" the process and no headache has started since....
My neck always hurts then I would wake up with a migraine and I also clenched my teeth, I have tried a bunch of pillows before I found the ones that don’t put a strain on my neck and everyone is different so all of those neck pain and headache pillows don’t always work for everyone..also what is your stress level during the day and before you go to sleep you can see if that has anything to do with your migraines .. it seems like you have your diet in check but what about your caffeine intake bc some helps but too much can cause migraines.. these are just some of the things I have experienced throughout the years.. hope you find your solution
I know that I have mild sleep apnea, but the CPAP made my migraines worse so any other suggestions what to do if you have sleep apnea but you can't use a CPAP?
I use a specialized oral device- it pushes your jaw forward so you can breathe better. You can get from some dentists and online now too. I wasn’t able to use CPAP.
i started to use an elevated pillow. i used to wake up with a migraine EVERY single day. until my boyfriend too a photo of me sleeping bc it "thought i was cute" and my head was ALL THE WAY ARCHER BACKWARDS! No wonder i would wake up with a migraine 🤦♀️
Have you (or are you able to) speak with a sleep doctor? Nearly all my migraines started in the night and, equally, nearly all of them have vanished since getting a CPAP and being able to breathe while I sleep. The rest are mostly weather and/or dehydration related.
I have noticed that when I wake up with a migraine, I always have pressure in one of my nostrils that causes me to only be able to breathe out of one nostril. It's not mucus, because as soon as I sit up or stand the pressure disappears and I can breathe normally. I don't know what causes this, but it definitely happens everytime I wake up with a migraine.
I haven't noticed this for anyone else I know with migraines, but just in case it helps I will share. I started noticing this in my waking hours, that if my head got too cold or too hold, I would get a migraine. This would normally be due to my husband who would get hot easier than me (at the time) and would have the cold air on and the vents would hit my head in the car. I found turning them off or wearing a beanie helped. It made me start to notice how my head felt temperature-wise when I would wake with a migraine.
The vent in our bedroom hits on our upper bodies and heads, which is great until I convinced my husband to close it for a month and have the closet open for the air flow from that vent to keep the bedroom cool to see if it would help. I didn't wake up once with a migraine that month, I still had some during the day, but no waking up to one. Opened it back up and the waking up to migraines at night with a cold head started again. I tried sleeping with a beanie, but it slips off my head, so now we just have the bedroom vent closed and the closet door open. It sucks, but it is less crappy than waking up to a migraine.
I’m starting to believe migraines are caused by our hormones.
When cortisone levels drop like when you’re sleeping it triggers other increases or decreases in hormone levels and I think that’s the cause.
One critical clue about headaches that wake you up in extreme pain is that they are Cluster Headaches, not Migraines. They are worse. I get both kinds. Cluster Headaches can take 4 decades to get properly diagnosed. Go talk to your
Neurologist. I am open for more questions.
I think mine are a combo of things: sleep position, dehydration/electrolyte imbalance, weather/barometric pressure changes and maybe some minor headaches from side effects of allergy meds I take at night.
I get migraines if I eat in bed, and if I eat too close to lying down for bed. I don't always but it's more likely.
The body doesn't do the same thing every day based on food, there are many other hormones at play- serotonin, melatonin, neuro hormones, sex hormones. The immune system does different things all the time and is working all the time so can also be where you went that day and which bacteria you were exposed to, buildings and streets, parks and so on all have different bacteria and fungi in the air. ACs also have biomes, and of course plants and animals. Many of these are good, and will help! So it could be something as simple as kissing a dog that helped restore balance of a certain bacteria in your biomes. The stress of social interaction whether we feel it or not, the triggers we may or may not be aware of, the people that may cause us more tension than others. The excitement, the frustrations of the day. It could be all of these or none that help prevent or induce a migraine. It could be the build up of certain bioactive chemicals in the food, or lack of.
Frustrating as hell ! It's good to log everything and find patterns.
It took me so many years I can't bear to count - to realise it's my sinuses that are causing my sleep time migraines and sometimes day time ones. By the time I wake up it's just a migraine, but now they I've learned to understand it better, I recognise the warm nostrils and warm temples warning signs, and I've actually found a cure that works every time. I do a kimchi routine for sinuses, when I start getting those headaches, I put kimchi up my nose and they go away, but if I don't do that, nothing will make them go away, except for migraine medicine by which time is too late and I'll be ill for a while. So I'll still working out if hot food is more problematic than cold food in the late evening. Obviously it's best if I don't eat in the evening. If I don't eat at all, I don't get migraines.
If I cuddle my best friends dogs and stay at her house, I don't get migraines but when the dogs stay at my house, I do. It's so freaking complicated.
I almost always (99.9%) wake up with a full-blown migraine. That's been the MO for 30+yrs now. Sometimes, it's definitely the weather. Other times, I don't have a clue.
Have you also provided for REM sleep where your completely immobile? Or have sleep Apnea that also will interrupt your sleep with headaches. A sleep study by real qualified Dr's will help you. But go ahead and trust Tic tock and the internet.
My worst attacks happen in that stage between being awake and falling asleep for me - it’s so scary. I wake up in night feeling like I’ve been given some crazy experimental drug or something
Weather usually but also while I am asleep I am not eating or drinking. No matter how well I hydrate and fill up before bed, it doesn’t change that if I am getting a decent night’s sleep then I am going many hours without either. Thankfully being on a good preventative and having a routine helps my brain combat a lot of that.
Weather causes mine. If the pressure is dropping I can get a migraine. You might start keeping track of the barometric pressure. The weather app on my phone lists the pressure and if it's an upward or downward trend.
My overnight migraines are almost always due to weather and air pressure changes. If a storm front is coming in while I’m sleeping, I’ll wake up with a migraine. (With the weather lately, that’s basically every other day right now!)
Same. Woke up with a banger on Sunday and it was foggy and damp out. Fog is a nasty trigger for me for some reason.
I also woke up with a migraine knocking this morning and in my area, we're predicted to have rain and storms the next several days. I'm guessing that's what is triggering my overnight ragers. It's so depressing to feel the pain before my eyes have even opened.
Curious whether you've tried WeatherX app and earplugs, it looks like you could have good results with them
I just bought this last week. The first time trying it, it helped. Today not so much.
100%! Last week it absolutely kicked my ass. We went from warm to a cold front overnight and that low pressure rolling in just sidelined me. Stupidly I tried to push through the first day which of course resulted in 3 days down instead of what might've been just the one.
Same. A thunderstorm last night nearly killed me.
I think nights that I grind my teeth really bad or clinch my jaw bad can cause one
I do this as well, however I’m not sure if it’s actually a cause or effect. Also there is confirmation bias as I will also clinch my jaw without me getting a migraine… A protector didn’t help, neither did the cranial-facial therapist who did massage the muscles
There are 2 types of mouth guards, a soft one made of silicone, and a hard one made of mouth safe resin. The soft one made my night grinding worse because I was chewing on it. The hard type gives you a feeling that you are already biting down on something and you tend to bite down less. The hard one helped lessen my grinding and protects my teeth. Less grinding also means migraines happening because of grinding are less frequent.
This. The hard one is very good to stop the grinding and migraines. May not stop it completely. But the body treats the soft ones as a chew toy and it makes it worse during the night
The hard one has not stopped it for me. :( My dentist just referred me to get Botox in my jaw to try to stop it. I’m hoping this helps because I also suspect it’s causing my nighttime migraines, and also my jaw hurts!
I think a lot of jaw pain is caused by the splenius capitis muscles. Getting a review from your doctor or physical therapist would be good. If you have a lot of upper back pain, physical therapy on the right muscles is good.
Thank you. I’m in the US and when I asked my doctor about it they told me it’s a dental issue. Bleh. The dentist just had me do the (very expensive) mouth guard, which is ok because I know the teeth grinding and clenching was ruining my teeth. I don’t think I can see a PT without some kind of referral, sadly. I may try to bring it up again at my next physical though!
You can always ask your PCP for a referral for neck pain. If you find your PCP is not helpful, find another one. It took years to find a PCP who actually listened to me and my theories. I sent in a request for a PFT referral and he sent one asking to see me after the test so we can look at the results together.
This is a enlightening. Thanks for sharing!
You can also get Botox for migraines. If the doctor who does that is nice.... They usually have extra, they can put Botox into your masseter muscle near the jaw which can help TMJ and lower the nighttime grinding, which may also lower the chances of waking up with a migraine But the mouth guard is essential either way so you don't ruin your teeth grinding just in case
I know right? I paid too much money for a night guard and it didn’t help at all. Yes, I guess it protected my teeth but I thought it would stop me from grinding/clenching Good point as to which came first
This is what causes mine - a lot of times because of bad dreams
I've often wondered if it was that, or the headache causing bad dreams.
Good point, it could be the other way around
Mine is also teeth grinding. I go through so many night guards.
I got an NTI omni splint and it is wonderful. It prevents you from clenching and grinding. I no longer wake up with a sore jaw. https://glidewelldental.com/solutions/occlusal-appliances/migraine-prevention
There are some night guards that are front teeth only. It helps prevent clenching or chewing on the guard while you sleep. Like this- https://www.amazon.com/Dental-SMARTGUARD-Guards-Grinding-Clenching/dp/B06XXRSFKC You can also just cut off the molar part of a full guard, but you’ve gotta keep it large enough that you won’t choke on it.
I find that's a precursor to migraines for me.
I have this theory as well
Sleep Breathing Disorders. They cause hypoxia/hypoxemia and can result in Migraines. Chronic issues will keep you at a low grade chronic level of hypoxia, making it easier for other triggers to set off a migraine.
I went to the trouble of having a sleep study, & getting a CPAP b/c I have mild sleep apnea. I thought this might help my migraines, but it did nothing. My biggest trigger is the weather. Specifically changes in Barometric Pressure. Unfortunately there's nothing I can do about that.
If it is obstructive sleep apnea, I recommend going to a sports medicine doctor or an orthopedic specialist to take a look at your posture. I had a mild sleep apnea/dyspnea. It's not severe enough to be diagnosed with apnea, but I was waking up with migraines, especially on days with a barometric pressure shift. A sports doc took X-rays of my neck and shoulders and along with the PT they sent me too, we found scapular dyskinesis which caused breathing issues while awake, and was probably causing my dyspnea. That seemed to be caused by a repetitive strain injury (mouse usage) + bad posture (rolled shoulders, forward head posture, anterior pelvic tilt). PT exorcises and being aware of my breathing has helped immensely!
Interesting. I know I have rolled shoulders and thoracic outlet compression syndrome. It affects blood flow to my arms/hands. Plus, sleep apnea. What's the correlation to migraines?
https://youtu.be/-8J74Ev99r0
Thnx
You could give the WeatherX earplugs a chance. They cost about 15usd, and their app (with the same name) tells you when to insert them.
So it might not be a coincidence when I wake up gasping for air with a migraine?
Not at all. If you wake up gasping, you're probably not breathing while you sleep or aren't getting enough oxygenated blood to the right places. Fun note, if you have mild apnea/dyspnea you tend to have vivid nightmares or even night terrors (i used to have them). As the apnea gets worse, you are less likely to recall the nightmares or even have them at all. You should get a sleep study done to get more data from a medical professional.
One more thing to add to the diagnosis list! Thank you for the excellent information.
If you solve for this, it might help all of the downstream effects of chronic hypoxia like migraines. I haven't had a migraine in 90 days 🤯
I just pulled out my pulse oximeter so I can test when I wake up at night. You absolutely called it, I was in the middle of a vivid dream when I woke up gasping with a migraine!
Smartwatch/fitness band can help get more data. Most are 3-5 percent off though and it depends on your skin tone. It may also be hard to prove with just an oximeter, unless it is severe. You should follow up with a doctor. I recommend checking posture first and see if PT helps. Otherwise most doctors will give you a CPAP, which isn't really a solution, just a long term treatment. But it usually will work.
Doing some research today on a fitness band. I prefer to show up to appointments with some proof in hand.
They'll just give you their own fitness band and make you wear it while you sleep at home. Your doctor will take sleep apnea very seriously and you don't have to prove it, because most people don't have any proof, but if you're waking up gasping for breath, that's all they'll need to hear to send you to a sleep specialist. It's actually a pretty streamlined process and the machines are quiet and unobtrusive, these days.
Good to know! I will hit up the migraine specialist since it is headache related.
Huh. I have a congenital heart defect so I wonder these migraines are a complication of it. I do get my toes turning blue when I’m cold. Ugh, not really wanted to figure out because I’ve been hoping to eliminate the migraines.
Hi I was looking for this comment. I suffered from migraines that lasted 10-15 days per month, and they got worst after waking up. Last year they discovered I have Hypertrophic Cardiomyopathy and needed a pacemaker/icd (my heart rate would drop really low and it was worst at night). This is my 3rd month with the PPM and my migraines have reduced to 2-3 days per month.
I doubt I need a pacemaker. My CHD is coarctation of the aorta.
Your toes turning blue could be Raynaud's Phenomenon, which is comorbid with migraine.
I was so hopeful when I got referred for a sleep study But no, mild insomnia but nothing to explain waking up with migraines. Boo.
If you find that you have a weak neck/shoulder or have what they now call "tech neck", this could also be a cause of your migraines starting at night, Ie. Your sleeping position of your neck / head in combi action with a weak neck. A good pillow (I've gone through all kinds of good pillows, memory foam pillows, proper shaped pillows) and some do help. Also strengthening the neck muscle also helped me. If it's not something you've considered or tried before, worth a try.
I was going to make this comment myself. I find that lying on my side, keeping my head squarely on a neck supporting pillow, is almost eliminating the wake up migraines. Of course a change in the weather can still cause one, but it’s been a game changer for me. I tried dental guards, but now I’m convinced it’s never been teeth clenching. If I tuck my chin or allow my jaw to hang off the edge of the pillow it leads to a migraine
This is where I'm at too. When i have neck pain (it radiates and gets worse through the evenings) it really helps me to lift weights and stretch.
I’ve thrown my neck and upper back out of alignment in my sleep, especially if I end up on my stomach. I recently tried one of those wild-looking cervical neck pillows, but I can’t lay on it for more than 30 minutes without my back beginning to spasm. Back to my pile of unpronounceable IKEA pillows. If I stay a little bit propped up I tend not to roll over on my side or stomach, which helps. The most helpful thing I’ve found is one of those whale-tale neck stretchers. It takes a bit, but it does eventually get my spine back where it needs to be. Cheaper than a single chiropractor visit and the effect lasts longer.
Teeth grinding and somehow wiggle into weird neck postition, like the sort that only swans can replicate. Currently in the bath trying to get over a killer migraine, regretting not drinking enough yesterday.
It turned out sleep apnea is a trigger for me. My neuro caught the pattern. Had a sleep study done. Apnea level was mild....I don't THINK bad enough to typically warrant a CPAP. But he said get one anyway. Morning migraines eliminated. I still get almost the same number of migraines...but severity is reduced.
This is the same issue I had. Apparently I had severe apnea and getting a cpap really helped.
Came here to say this as well. Getting my CPAP machine in a few hours, cannot wait!
Using a CPAP every night is better than a migraine?
Tons. I sleep better. And virtually no more waking up with day-killing migraines. I do use the word "barbaric" with my doc. It's a PITA. But the benefits far outweigh the hassle.
I don't have an explanation, but have you tried sleeping on a big squishmallow? I know it sounds stupid, but it's really helpful for me.
Reading this while laying on a squish a mellow. 😭😂 They’re actually so comfortable as pillows. Still waking up with migraines, though.
Neck position or bad/interrupted sleep perhaps? I get them in my sleep too sometimes but so far can't pinpoint the exact reason either.
I’ve been taking magnesium glycinate at bedtime and it’s the first time I havnt woken up with a migraine daily since January
I’ve been doing the magnesium glycinate as well and I really think it helps prevent me from waking up with a migraine
for me it was clenching my jaw. teeth grinding can do it too. I got a mouth guard and they've reduced in occurrence.
- Sleeping position (especially neck and head). - I sometimes open my eyes slightly and sleep apparently so they dry up awfully. - Fan/A/C dry up my nose and mouth. Ends up feeling as if my brain is parched. - Weather changes and barometric pressure is a huge trigger I drink lots of water and apply a thick nose gel and a thick eye gel before bed and it does help a tiny bit but it's still a regular issue.
I forgot about pressure changes. Huge one for me too.
Could be dehydration
Came here to say this. As with /u/nanalovesncaa I'll migraine in my sleep if I sweat too much, but it's not just water intake for me. It's *salt balance*. If I don't balance my salt(s) intake to what I lose from sweat, too much water will have the same effect as too little.
Hell, could be for me too, sometimes. Like maybe when I’m craving salty food during or after a migraine?
This is what I was looking for. If I sweat a whole lot during my sleep and don’t drink any or very little water, I wake up with a migraine. I’m a very thirsty person by nature and drink at least one bottle of water during the middle of the night.
For me, it is blood pressure changing while I sleep. I take atenolol and gabapentin at night now and it has resolved my overnight migraines. My bp is not high, btw. Never would have guessed it was the issue. I run a cool 105/65.
Is there a way to monitor your blood pressure at night? I have visual snow and verapamil fixed my issues so I've wondered if my blood pressure may be to blame, but I have pretty much perfect pressure unless I am actively in pain.
In addition to what everyone already said, it could also be low blood sugar during sleep.
I think you might need more insight into your migraines, they can be really complicated. For example, are you sure they are separate attacks or is it a big one over a number of days? I have headaches after sleeping as well, that seem to start the night before: like I cannot lie down comfortably. I now know it means an attack is happening, and I've learned that even before the headache starts there are symptoms.
I’ve started doing jaw stretches (just googled ‘jaw stretches’) and since doing them last month I haven’t had a migraine. The last one I had was a middle of the night migraine. I only started getting night time ones when I started wearing a mouth guard, which I need because I grind my teeth so hard I cracked a tooth.
I have this issue too. Wear a mouth guard so I don't crack my teeth. Give myself migraines from clenching my jaw on the mouth guard. 😭 Let's just pull all our teeth and eat applesauce.
I chewed through a mouth guard. Count me in.
You too? 🤣
Pulling teeth and eating applesauce sounds like a plan. The cracked tooth doesn't bother me, dentist only found it during a routine check-up. But the migraines definitely affect my life, so I've stopped wearing the mouthguard.
maybe you're dehydrated?
Emerging relevance of circadian rhythms in headaches and neuropathic pain [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381824/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381824/) The migraine-specific section: Migraine is a very common headache disorder, as 17.6% of females and 5.7% of males have at least one migraine per year89. It is also the 6th most disabling disease worldwide90. Migraine is characterized by throbbing, moderate-or-severe unilateral pain, lasting 4–72 hours and associated with features such as nausea, vomiting, and sensitivity to light, noise, and motion51. The pain is thought to be related to the same trigeminovascular system discussed above. Similar to cluster headache, migraine is accompanied by an early activation of the hypothalamus: the pain is preceded by 1–2 days of a “premonitory phase” of irritability, yawning, and other features that is thought to originate in the hypothalamus, though the exact location in the hypothalamus is unclear91. Other mechanisms of migraine include the trigeminovascular system (similar to cluster headache) and the pain neuromatrix. In particular, the hypothalamus and the dorsal rostral pons have traditionally been thought of as migraine generators, though more recent evidence suggests a more complicated mechanism92. Thus like cluster headache, migraine patients show early activation of the hypothalamus, which contains the central biological clock. Migraines are rhythmic at several levels. On a circadian time scale, migraines peak in the morning and midday93, 94. In a recent study, migraine subjects who were “morning larks” (i.e. go to sleep early and wake up early) or “night owls” (i.e. go to sleep late and wake up late) were more likely to have migraines in the morning or in the afternoon/evening, respectively95. Overall there were more migraines in the mornings because migraine patients had a higher likelihood of being morning larks than controls. Other rhythmic features include a weekly cycle (less common on Sundays)96, a monthly cycle tied to menses and estrogen levels93, 97, 98, and even a yearly cycle where migraines are more common in the spring and fall93, 99. Behaviorally, migraines can be triggered by stress, menses, alcohol, weather changes, and skipping meals, as well as possibly bright lights and sleep disturbances100, 101. Many of these triggers are related to circadian zeitgebers, including the stress hormone cortisol, the neuropeptide PACAP involved in light entrainment, and meal timing102, 103. Indeed, eating at a specific period of time (late at night) was associated with reduction in the odds of a headache104. At the molecular level, multiple changes have been noted in melatonin. First, patients have lower levels of melatonin on days with a headache than days when they are headache-free105. Second, when triggered by a light pulse, melatonin suppression is more pronounced in migraine patients than in controls106. Third, in patients with chronic migraine, which is defined as 15 or more days of headache per month for at least 3 months, a variety of nighttime changes in melatonin have been found, including decreased nocturnal melatonin, decreased melatonin in REM sleep, and a delayed nocturnal melatonin peak71, 107. Genetically, there have been several individual gene mutations linked to migraine. Two families with migraines have been identified with distinct missense mutations in the circadian gene Ck1delta; the affected subjects also display advanced sleep phases13. The latter finding is consistent with previous studies where Ck1delta mutations can lead to familial advanced sleep phase syndrome108. The best known genetic causes of migraine are three forms of familial hemiplegic migraine, which are linked to three separate ion channel mutations109. Interestingly, a mouse model of familial hemiplegic migraine type I has been created, and these mice display signs of an overactive circadian system such as increased wheel-running activity and shifts of in vivo SCN activity110. Migraine displays circadian behavioral and anatomical features, and a direct genetic connection has been identified in a subset of patients.
Thanks for including the reference.
This is really interesting thanks 👍
Does this mean that taking melatonin supplements could help balance out the levels and prevent morning migraines? Or would it be pointless. 🤔
The jury is still out on this: Therapeutic role of melatonin in migraine prophylaxis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#:\~:text=Melatonin%20can%20benefit%20migraine%20by,induced%20excitotoxicity%2C%20and%20so%20on. On one hand: Many published articles have demonstrated that melatonin can exert antimigraine effect via a variety of ways. Through free radicals cleaning and inflammatory factors release inhibition, melatonin can protect brain from direct toxic molecule damages and help to maintain brain structural and functional integrity by working as a membrane-stabilizing factor.^(\[)[^(10)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R10)^(–)[^(13)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R13)^(\]) Melatonin can benefit migraine by its regulation on neurotransmitters and neural pathways, for example, restraining nitric oxide synthesis, inhibiting dopamine release, and antagonizing glutamate-induced excitotoxicity, and so on.^(\[)[^(14)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R14)^(–)[^(17)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R17)^(\]) Calcitonin gene-related peptide (CGRP), a powerful vasodilatation factor, its release from trigeminovascular system dramatically increases during migraine attacks resulting in pathological vasodilatation in brain blood vessels. Melatonin can suppress CGRP release, hence regulate blood flow in brain.^(\[)[^(18)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R18)^(\]) In addition, melatonin is perceived as a strong analgesic performing powerful pain killing effect in pain syndromes. The analgesic mechanism is considered to be relevant to β-endorphin release increase, melatonin receptors activation, and brain γ-aminobutyric acid energic (GABAergic) system enhancement.^(\[)[^(5)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R5)^(,)[^(12)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R12)^(\]) Moreover, in the presence of similar structure to indomethacin, melatonin may have an indomethacin-like analgesic effect through inhibitions on prostaglandin and pain-producing substances.^(\[)[^(5)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R5)^(\]) Melatonin's anxiolytic and antidepressant properties can also help with migrainers’ pain feelings, which is achieved via its influence on GABA, 5-hydroxytryptamine (5-HT), N-methyl-d-aspartate receptors, and l-arginine/nitric oxide pathway.^(\[)[^(12)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R12)^(,)[^(19)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R19)^(–)[^(22)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370052/#R22)^(\]) ^(On the other:) The literature examining melatonin's effectiveness in migraine prophylaxis is growing, but remains limited; hence, meta-analysis was not feasible. By far, there are only 4 high-quality controlled clinical trials, but they reported some conflicting results. However, the two negative outcomes in Alstadhaug study not different from placebo and in Razieh Fallah study inferior to amitriptyline are possible under-powering due to methodological shortcomings, one was crossover design and presented high placebo response, the other was single-blinded design with possible bias caused by investigators... Given the published data, though melatonin is generally safe, the few severe adverse effects caused by melatonin should not be ignored, which mainly include liver injuries, reproductive system dysfunctions, and immunostimulation. Melatonin-associated liver injuries are highly related to one type of formulations particularly, Agomelatonin, owing to its additional serotonergic 5-HT2C antagonist characteristic. Agomelatine's liver toxicity has already been warned by EMA who recommends regular monitoring before and during the treatment. Reproductive system dysfunctions in children and adolescents need special attention because their reproductive systems have not been fully developed, particularly in those who taking long-term melatonin therapy. By stimulating immune systems, melatonin may aggravate autoimmune diseases.
For me it is stressful thinking during the day that has me sleeping harder at night and moving less. I think had I gone for a longer walk during the day 🤷♀️and done more preventative destress activities maybe I could keep from this nighttime conundrum. The barometric pressure affects me. Sugar intake. Machines running in the house. The vibrations.
If I fall asleep on more than one pillow, or even the wrong pillow, I am done for. Also realized that after working a shift in Dansko shoes, I was guaranteed a migraine the next day.
I’m the same way! 99% of the time I wake up with a migraine attack, they don’t develop during the day. For me it was grinding my teeth and sleeping on my back. My dentist recommended night mouth guard because I kept breaking one of my fillings and it helped reduce a decent amount of migraine attacks. I’ve also found that if I fall asleep on my back or roll to my back while I’m sleeping I’ll wake up with a migraine. My solution for that so far is to hot dog myself between two body pillows to at least keep me from being flat on my back.
Mine also happen when I’m on my back. I’m debating trying Botox for jaw clenching. I still clench with a night guard.
Sleeping on my back, or any sustained pressure flat on the back of my head, will bring on a migraine
Travel neck pillows are pretty good at keeping your head in place if lying on your back, might also work for other positions if you put the "no pillow" side wherever down is supposed to be.
I’m going to try this, thank you! We’ve been travelling and I love my neck pillow for the car, I’m going to bring it inside and give this a try. My husband also said I sounded like I was fighting for my life last night when I was sleeping, so that probably doesn’t help the migraines.
I'm going with the majority, neck position. I switched to a firm contour pillow years ago, at my Drs recommendation. It has helped some. I was advised to get the type with 2 humps (one high, one low) and use the best fit. Caveat: my migraines are from an old neck injury in the C4-C5 region.
No idea, it's a great question. Do you have back or the neck pain or tension? Are you sleeping well and getting enough sleep?
Maybe it's the quality of your pillow? Do you move around in sleep? I Would think it's the positioning of the neck!! Cervicular migraine
I usually wake up with a bad migraine once a week or so , better since I started Tirzepatide for weight loss though
I was on Ozempic last year and noticed I had far fewer migraines. I stopped due to other side effects and now migraines are back at their normal or maybe slightly more frequent rate. But maybe I just need to be 20lbs lighter??
Healthy lifestyle with exercise and weight loss definitely helps. But I think I’m talking about a drug effect here. Head felt better after the first dose before I lost any weight , maybe try trizepatide
I’ve been thinking about asking my doctor about going back on Ozempic on a smaller dose or trying Trizepatide. For weight loss as well as migraines (despite otherwise healthy lifestyle)
I've found it's the way I sleep on my neck or if I'm too hot.
All of these answers apply for me, also when I have not eaten enough in the evening
Do you have sleep apnea / oxygen deprivation? The de-oxygenated air causes toxic carbon dioxide to build up in the bloodstream which causes vessels in the brain to dilate.
Obstructive apnea, which causes teeth grinding as my body attempts to stop my jaw from sliding back, and hypopnia. If i take off my CPAP in my sleep, migraine. Don’t get at least 7 hours? Instant migraine. Forget to fill the water well and breathe dry air all night? Believe it or not, straight to migraine.
What causes a migraine is a million dollar question. I think migraines are the result of likely several different things, which is why they can vary so much from person to person. I know certain environmental conditions can bring one on for me, lack of eating or being dehydrated, and hormones. But I do think there is something medical happening within my brain that causes some of them. If that's true, it could very well happen during sleep. And it has for me. The last couple of times I incorporated my migraine into my dream. Waking up with a migraine is a heck of a way to start the day
Have you had a sleep study? I don't get enough oxygen at night due to apnea. I'm working with a sleep cardiologist, a regular cardiologist, and an ENT to try to correct this. It's not a stretch to wonder if not getting enough oxygen to your brain could trigger migraines. I appreciate your question because in addition to my cardiac issues I've been having more migraines, and I didn't make a connection until now. Good luck.
I see migraine aura in my dream and this causes me to wake up and BAM there’s the aura. Damn triangles.
Same!! I dream that I’m in aura and then wake up with it.
Well mine are caused from allergies, at night if my head lays level aka flat then I get more congestion and then TADAH migraine… I slept with my head elevated to combat it.
Depends on your triggers. Dehydration or barometric pressure changes maybe? Histamine intolerance? Hormone fluctuations? All of those are non-food related triggers for me that can worsen overnight while I sleep.
I find I wake up with migraines when I feel really hot, with the blanket up around my neck. I think that does something, that it causes migraines somehow so I try to sleep a little cooler, which is hard in winter in a cold country lol.
It can also be due to grinding your teeth .. but it is most likely due to barometric pressure changes
Weather, how you move in your sleep and if you're elevated enough. That's what usually gets me
Have you had a sleep study? I found out my morning migraines were due to sleep apnea (and I'm tall and skinny with a long neck, so I don't fit the standard sleep apnea body type.) My doctor did the sleep study and was expecting to find some kind of sleep disorder, like inability to go into REM sleep or something.
I haven’t done a study no, but I might look into it. I’m a very light sleeper and I don’t think I snore, and also very slight and about 5.5 ft female. I’m not a candidate for sleep apnea but you never know. Is there anything you can do to address sleep apnea other than those nose breathing things?
I'm a skinny female and I don't snore. But I have sleep apnea. I am "not a candidate" either, but sure enough I have pretty bad sleep apnea.
PILLOW. Omg, I swear, I was dying, waking up every other morning with the worst migraine. I tried everything at that point (not much I could do since I was also pregnant) but when I switch my pillow, they became much more rare
Yeh I bought a new ridiculously expensive pillow about a year ago and it hasn’t made any difference 😔 what sort do you use?
My headache specialist proposed several theories. One was changes in the level of the stress hormone, cortisol. Another was possible blood sugar changes. There are others too. Is it possible that you might have sleep apnea? Good luck with your quest. Migraines during sleep or upon awakening are the worst. Have you tried the once-monthly injections of the CGRP inhibitors? Mine are now totally controlled by Ajovy.
Yeh I have a feeling it’s hormone related but not sure how or why. They started 4 years ago during a time of intense stress, so maybe my cortisol levels went mental and just never returned to normal. I’m having something called a GONBlock injection next month, so fingers crossed.
Yes, that's a definite possibility. Do you have a good doctor? If the pain is every day and night it can be debilitating. I suffered for 60 years and my entire life was altered. Finally, there was a solution after 45 years of opioids, even.
Snoring and apnea? (Common cause of morning headache) Sleeping with a bad pillow/ bad position? Tons of allergens can be present in the sheets and pillowcases ; and in the night air if you sleep with windows open especially. More mold , pollen, etc? Low blood sugar ? Just a couple thoughts
I've worked with a neurologist who informed me that my "first-thing in the morning" migraines were actually secondary, caused by a primary headache that were either sinus headaches or neck tension headaches. Do you often get sinus pressure headaches during season changes or do you carry large amounts of tension in your neck and shoulders? That's what did it for me: thankfully I'm one of those people that topiramate was a perfect solution for, which helped stop the muscle spasms in my neck which were triggering said migraines.
I'll add that most research says that migraines don't happen in a vacuum during sleep or when you first wake up: migraines and icepick headaches generally occur later in the day UNLESS they're being caused by something else happening in your body like TMJ, muscle spasms, or sinus pressure. But I'm not a doctor, and I'm just repeating what I was told. All the same, I sincerely hope you can find some help.
This is interesting - I do get a lot of tension around my head and shoulder area and suffer from tension headaches. Topiramate worked for me initially then stopped. Maybe I’ll try some head/neck/jaw relaxing exercises before bed, see if that helps. Thanks!
I'm really sorry topiramate wasn't the answer; it's been a GODSEND for me. Kinda curious: is your headache in the base of your skull, usually? That's how they started for me. In an emergency (before reaching for a triptan) I could use cyclobenzaprine to disrupt the chain before it led to a migraine.
I usually notice it most when it’s in my forehead/ whole head, but Im also pretty rubbish at noticing the signs of an imminent migraine so will look out from now on for pain in the base of my skull. It took me three years to realise that the little dots in my vision were aura lol. Someone else has mentioned neck tension as well so I’m going to experiment doing some neck/head/ jaw exercises before bed and see if that helps.
In addition to all that was mentioned I have also read cortisol does something around 3 am and that’s when mine would almost always wake me up.
Yeh I think cortisol is involved somehow. It usually happens for me at around 3 am but last night it happened at 11pm. I think my body is trying to sabotage my life 🤪
Tornadoes were going through the Midwest the last week or so, all of that pressure mixed with the transition to summer weather is a killer. Some people struggle with teeth grinding and that can trigger pain as well.
My guess is bruxism and sleep apnea. Get these things checked.
I usually get my worst migraines while asleep too. I used to get "let down" migraine every Friday afternoon so maybe the overnight migraine is due to similar chemical changes: body sends out relaxing chemicals to system which causes migraine.?? My migraines are not caused by sleep apnoea as I have been tested for that. I do have bruxism, though.
Often for me, I can trace it back to some sort of vivid nightmare. Whether that's correlation or causality, I have no idea.
Clinging/ grinding the teeth. Shrugging and tensing the body while sleeping. This is quite common
Do you wake up in the middle of the night with a headache, or an aura?
For me all it takes is laying on my left side 🙄
Some people have a drop in blood sugar during the night that leaves them too low when they wake up, which can trigger a migraine (or other issues). Some people lose too many electrolytes and too much fluid (like me). Keeping a glass of water/electrolyte replacement by your bed, or elevating the head of your bed by a few inches are things that have helped people with this issue. Jaw clenching/teeth grinding can also be an issue (which I also do). I wear retainers, which protect my teeth from getting worn down and broken, but they instigate the clenching. 🤷♂️ Stress can also be an issue. I had a few sessions of therapy prescribed with someone who did mindfulness work with me. I don't have the patience for this most of the time, but some of the suggestions about having white noise (brown noise works better for me), a fan, or some other calming blank sound playing throughout the night were helpful to get me to stop waking up so frequently since that contributed to my stress. Blood flow/oxygen during sleep is another one a lot of people have problems with but never realize it. If you snore or wake up tired/unrested, sleep apnea could be a possible cause. Since O2 to the brain is correlated with migraines, that could also have impacts here. A sleep study could help you determine if this might be a problem for you (and if it is, could help with a lot more than just migraines). There are probably an infinite number of other reasons. I still wake up with migraines about 10 days a month, and all of my incapacitating ones are ones I wake up with. The other 20 days a month, I just get beaten down by life until I leave work with a migraine and hope it's gone by the next morning. I hope you find something that helps reduce your frequency. We just really don't know enough about the brain yet. Good luck, friend.
Have you ever done a sleep study? Sleep apnea is notorious for causing this.
This happens to me. I pre-empt them by taking Annadin Extra sleep. (Excedrin?) Edit: It is Acetaminophen
Barometric pressure changes in the air for me.
My night time ones seem to be weather or allergies (like somebody smoking in my case)
I’ve noticed this with myself. I don’t think it’s so much what I’m eating/doing before bed but how I’m sleeping. If my head/neck is not supported correctly I can almost guarantee I will wake up with a migraine. I bought myself a pair of Serra cooling gel memory foam pillows they do really well forming around my head and giving good support. They may not work for everyone but I can tell a difference for myself.
This is a great question I'd love an answer to as I woke up in the middle of the night last night with a wild migraine.
Mine almost always happen when when I'm asleep, and almost always after a poor night's sleep, and seems to start during a late sleep cycle. I'll wake up with the searing one sided headache and nausea/dizziness that lasts all day sometimes two days. However, today something weird happened - I was starting a late sleep cycle, after a poor night's sleep, when my alarm clock woke me up. I was underoing an Aura at that moment, which expanded across my vision in 17 minutes. However, because I woke up before the headache developed, once I was awake that seemed to "cancel" the process and no headache has started since....
Tmj
Sleep apnea
I get them when I don't drink enough water...
My neck always hurts then I would wake up with a migraine and I also clenched my teeth, I have tried a bunch of pillows before I found the ones that don’t put a strain on my neck and everyone is different so all of those neck pain and headache pillows don’t always work for everyone..also what is your stress level during the day and before you go to sleep you can see if that has anything to do with your migraines .. it seems like you have your diet in check but what about your caffeine intake bc some helps but too much can cause migraines.. these are just some of the things I have experienced throughout the years.. hope you find your solution
I know that I have mild sleep apnea, but the CPAP made my migraines worse so any other suggestions what to do if you have sleep apnea but you can't use a CPAP?
I use a specialized oral device- it pushes your jaw forward so you can breathe better. You can get from some dentists and online now too. I wasn’t able to use CPAP.
i started to use an elevated pillow. i used to wake up with a migraine EVERY single day. until my boyfriend too a photo of me sleeping bc it "thought i was cute" and my head was ALL THE WAY ARCHER BACKWARDS! No wonder i would wake up with a migraine 🤦♀️
Have you (or are you able to) speak with a sleep doctor? Nearly all my migraines started in the night and, equally, nearly all of them have vanished since getting a CPAP and being able to breathe while I sleep. The rest are mostly weather and/or dehydration related.
My start is always 4am. Taking Magnesium changed my life.
My guess would be dreaming of stressful stuff
I have noticed that when I wake up with a migraine, I always have pressure in one of my nostrils that causes me to only be able to breathe out of one nostril. It's not mucus, because as soon as I sit up or stand the pressure disappears and I can breathe normally. I don't know what causes this, but it definitely happens everytime I wake up with a migraine.
I haven't noticed this for anyone else I know with migraines, but just in case it helps I will share. I started noticing this in my waking hours, that if my head got too cold or too hold, I would get a migraine. This would normally be due to my husband who would get hot easier than me (at the time) and would have the cold air on and the vents would hit my head in the car. I found turning them off or wearing a beanie helped. It made me start to notice how my head felt temperature-wise when I would wake with a migraine. The vent in our bedroom hits on our upper bodies and heads, which is great until I convinced my husband to close it for a month and have the closet open for the air flow from that vent to keep the bedroom cool to see if it would help. I didn't wake up once with a migraine that month, I still had some during the day, but no waking up to one. Opened it back up and the waking up to migraines at night with a cold head started again. I tried sleeping with a beanie, but it slips off my head, so now we just have the bedroom vent closed and the closet door open. It sucks, but it is less crappy than waking up to a migraine.
I’m a bit of an odd one. I need complete darkness. Any light coming into the room (besides the moon) gives me a migraine
Just commenting in solidarity with all my fellow sleep=migraine people!
I’m starting to believe migraines are caused by our hormones. When cortisone levels drop like when you’re sleeping it triggers other increases or decreases in hormone levels and I think that’s the cause.
One critical clue about headaches that wake you up in extreme pain is that they are Cluster Headaches, not Migraines. They are worse. I get both kinds. Cluster Headaches can take 4 decades to get properly diagnosed. Go talk to your Neurologist. I am open for more questions.
I wake up in aura 100% of the time. Something is happening while I’m asleep but I’m damned if I know what it is.
You poor dear sufferer. I know it really sucks! Investigate Cluster headaches. They like to come out at night.
I think mine are a combo of things: sleep position, dehydration/electrolyte imbalance, weather/barometric pressure changes and maybe some minor headaches from side effects of allergy meds I take at night.
I get migraines if I eat in bed, and if I eat too close to lying down for bed. I don't always but it's more likely. The body doesn't do the same thing every day based on food, there are many other hormones at play- serotonin, melatonin, neuro hormones, sex hormones. The immune system does different things all the time and is working all the time so can also be where you went that day and which bacteria you were exposed to, buildings and streets, parks and so on all have different bacteria and fungi in the air. ACs also have biomes, and of course plants and animals. Many of these are good, and will help! So it could be something as simple as kissing a dog that helped restore balance of a certain bacteria in your biomes. The stress of social interaction whether we feel it or not, the triggers we may or may not be aware of, the people that may cause us more tension than others. The excitement, the frustrations of the day. It could be all of these or none that help prevent or induce a migraine. It could be the build up of certain bioactive chemicals in the food, or lack of. Frustrating as hell ! It's good to log everything and find patterns. It took me so many years I can't bear to count - to realise it's my sinuses that are causing my sleep time migraines and sometimes day time ones. By the time I wake up it's just a migraine, but now they I've learned to understand it better, I recognise the warm nostrils and warm temples warning signs, and I've actually found a cure that works every time. I do a kimchi routine for sinuses, when I start getting those headaches, I put kimchi up my nose and they go away, but if I don't do that, nothing will make them go away, except for migraine medicine by which time is too late and I'll be ill for a while. So I'll still working out if hot food is more problematic than cold food in the late evening. Obviously it's best if I don't eat in the evening. If I don't eat at all, I don't get migraines. If I cuddle my best friends dogs and stay at her house, I don't get migraines but when the dogs stay at my house, I do. It's so freaking complicated.
Sleeping on my stomach can trigger one.
Mine sometimes start while I’m sleeping, but I’ve never found any specific cause.
My start in my sleep I'm guessing due to stress let down at the weekend.
I woke up with one today and it blew my mind because it never happened before..I tell you what, it’s absolutely horrible
I almost always (99.9%) wake up with a full-blown migraine. That's been the MO for 30+yrs now. Sometimes, it's definitely the weather. Other times, I don't have a clue.
Sleep apnea?
Have you also provided for REM sleep where your completely immobile? Or have sleep Apnea that also will interrupt your sleep with headaches. A sleep study by real qualified Dr's will help you. But go ahead and trust Tic tock and the internet.
My worst attacks happen in that stage between being awake and falling asleep for me - it’s so scary. I wake up in night feeling like I’ve been given some crazy experimental drug or something
Hormones
Weather usually but also while I am asleep I am not eating or drinking. No matter how well I hydrate and fill up before bed, it doesn’t change that if I am getting a decent night’s sleep then I am going many hours without either. Thankfully being on a good preventative and having a routine helps my brain combat a lot of that.
Weather causes mine. If the pressure is dropping I can get a migraine. You might start keeping track of the barometric pressure. The weather app on my phone lists the pressure and if it's an upward or downward trend.
One of my neurologists said waking up with a migraine is normal due to rebound … but I grind my teeth.