If you’ve ever woken up with a migraine, you’ll know it’s a massive pain in the neck (and head). It’s not just bad luck: the U.S. National Library of Medicine says that morning migraines are one of the most common kinds. And neurologists say they aren’t trying to crush your daily routine randomly. Migraines show up when you wake up because of a combination of things like sleep disturbances, genetics, dehydration, medications, and hormone fluctuations.
"Migraines can occur at any time of day," Dr. Sara Crystal M.D., a neurologist at the New York Headache Center, tells Bustle. She says that a lot of people might be experiencing extra migraines right now because of the strain of working at home, extra screen time, and the added stresses of the coronavirus pandemic.
"Most migraine sufferers can expect to experience a migraine attack between the hours of 4 a.m. and 9 a.m.," Dr. Cara Pensabene M.D., medical director at EHE Health, tells Bustle. "Unfortunately, this can greatly affect your sleep, which in turn enhances your risk of experiencing more migraines."
In one study published in 2016 in Medicine, people who slept terribly were much more likely to get migraines in general. Another study of migraine patients, published in 2017 in Cephalalgia, found that morning migraines were associated with disturbances in peoples’ body clocks, or chronotypes. The research says that if you have early morning migraines, you might also have slightly abnormal circadian rhythms, the natural signals that dictate when you sleep and wake. Migraines also become more common when your sleep cycle goes haywire. "Sleep pattern changes such as jet lag or too much or too little sleep can also lead to migraines," Dr. Pensabene says. This is why hormonal changes around your period might make your head hurt; during the menstrual phase, people often find it harder to sleep, triggering migraines.
Other things can contribute to morning migraines, too. Dr. Pensabene says that fasting and dehydration make migraines more likely, and in the early morning, most of us have been without food or water for at least eight hours, barring a midnight snack. The body’s own painkillers can also be a factor. The National Headache Foundation notes that during 4 a.m. and 8 a.m., the body’s production of endorphins and enkephalins, which reduce pain, is at its lowest, and adrenaline is at its highest. Adrenaline is known to kick-start migraines, because it constricts blood vessels and alters the brain’s blood flow. Any painkillers you may have taken before bed have likely also worn off by the early hours. Result: killer migraine.
Waking up into a glaringly bright room? Dr. Pensabene says that sudden changes in your environment, like bright lights, sun glare, loud sounds, or shifts in the weather or barometric pressure overnight can make a migraine pop up. Unfortunately, having a genetic history of migraines also makes you more vulnerable; if other members of your family get morning migraines, you’re more at risk.
If you tend to wake up to a cracking headache, a migraine treatment plan with your doctor or a headache specialist might be a good way to help. Regular sleep schedules, a cool, calm sleeping environment, and attempts to reduce stress in the daytime could be beneficial too. And maybe getting your housemate to turn down their techno alarm clock.
Dr. Sara Crystal M.D., neurologist
Dr. Cara Pensabene M.D., medical director
de Tommaso, M., & Delussi, M. (2018). Circadian rhythms of migraine attacks in episodic and chronic patients: a cross sectional study in a headache center population. BMC neurology, 18(1), 94. https://doi.org/10.1186/s12883-018-1098-0
Gori, S., Morelli, N., Maestri, M. et al. (2005) Sleep quality, chronotypes and preferential timing of attacks in migraine without aura. J Headache Pain6, 258–260. https://doi.org/10.1007/s10194-005-0201-2
van Oosterhout, W., van Someren, E., Schoonman, G., Louter, M., Lammers, G., Ferrari, M., & Terwindt, G. (2018). Chronotypes and circadian timing in migraine. Cephalalgia, 38(4), 617–625. https://doi.org/10.1177/0333102417698953
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