How Does Sleep Impact Migraine?

January 26, 2024
March 29, 2022
How Does Sleep Impact Migraine?

Many people with migraine notice that poor quality, reduced duration and even irregular timing of sleep can be significant for their attacks. And although that is definitely a part of the story, the relationship between sleep and migraine is actually much more complicated.

The common denominator of migraine triggers

Having a migraine means that your brain is particularly sensitive to changes of all kinds. These changes can be external to you, like changes in weather patterns, or internal, such as hormonal fluctuations. Even small changes - like being late to a meal or dehydrated - can also be triggers.

Sleep is an essential brain function - and for this reason, you spend about a third of your life asleep. Adequate duration, timing, and quality of sleep play a role in every body system to keep you mentally, physically, and emotionally well. Appropriate sleep health promotes a normal immune system and helps your brain consolidate information and memories, as well as optimize mood. It also has been found to have a significant contribution to several metabolic processes that can be affected when sleep is disturbed.

How much sleep should people with migraine get?

The average adult needs 7-9 hours of sleep nightly. Consistently getting less than 7 hours of sleep is associated with a higher migraine frequency. Studies have shown that although the amount of sleep is important, getting that sleep at the same time is necessary as well.

If you notice that inadequate sleep is a trigger for you, it may not just be that you aren’t sleeping enough. If you sleep 7-9 hours, you should also make sure that you go to bed and fall asleep at similar times each day.

Can too much sleep be a migraine trigger?

Strangely, sleeping in can also be a trigger for many people. This can lead to weekend and vacation migraines and is primarily due to varying from the sleep schedule that your brain is used to. Try to sleep in no more than an hour later than your normal wake-up time. Most headache specialists recommend that you stick to the same sleep schedule, and not vary more than one hour later than the time you typically go to sleep or wake up.

Sleep quality for migraine

If you have identified that you are getting the right amount and timing of sleep but still feel unrested, there may be an issue with the quality of your sleep. Several sleep conditions can trigger migraines, including sleep apnea and restless leg syndrome. If you snore at night, notice a need to move your legs throughout the night, or just wake up very tired or with a headache, your doctor may want to consider referring you to a sleep specialist to help improve your sleep.  


Some migraine treatments may also make you feel sleepy, and in the short term may help get your sleep on track. Some preventive medications that may be sleep-promoting are amitriptyline and nortriptyline, cyproheptadine. Diphenhydramine (over-the-counter Benadryl), is sometimes used as an acute medication for migraine that frequently makes people drowsy. Although it promotes sleep, it is not recommended to routinely use this for sleep needs. On the other hand, some medications meant to help address insomnia, such as Ambien, Sonata, Lunesta or trazodone can make migraine worse.

If you experience sleep difficulties, Neura can help! We have a sleep specialist on staff and you can discuss which options may be best suited for you considering all your medical needs. Neura’s board-certified neurologists would be glad to help determine the right treatment for your migraine and sleep when you schedule a video consultation. Join Neura Health today!

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Thomas Berk, MD FAHS and Anne Marie Morse, DO
Thomas Berk is Medical Director at Neura Health and a former Clinical Assistant Professor at the Department of Neurology at NYU Grossman School of Medicine. Dr. Anne Marie Morse is a board-certified and fellowship-trained pediatric neurologist at Geisinger in Pennsylvania..
About the Author
Dr. Thomas Berk is a board-certified neurologist and headache specialist in New York City and serves as Medical Director at Neura Health. Dr. Anne Marie Morse is a board-certified and fellowship-trained pediatric neurologist and is currently Director of Child Neurology at Geisinger in Pennsylvania. Her clinical interests include sleep-wake disorders in neurologic disease, narcolepsy and hypersomnia disorders and neuroimmunology.

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