Thursday, 24 January 2013

Sleep, perchance to dream...I wish!

This is a typical scenario if I don't sleep well:

Scene: Tube Station, Morning. 

Innocent Bystander: Miss, I think you dropped your train ticket.

Me: WHY GOD, WHY!!!?!!! [starts sobbing hysterically on Innocent Bystander]
         I'm not normally like this, I just didn't sleep properly.

Innocent Bystander: Your nose is dripping on my suit. I'm very sorry, but that's my train so I need -

Me: I just can't sleep [sobbing harder now] Do you understand? I HAVE to sleep.

Innocent Bystander: I've just missed my train and I'll be late for work now, so I -

Me: Why do you hate me?!

And so on and so forth....


Just to be clear, the above hasn't actually happened, but similar scenarios nearly have. If I don't sleep I'm a wreck. I'll pour orange juice into my morning tea instead of milk. I'll cry if someone asks me a totally innocent question but more importantly, a buggered up sleep pattern leaves me vulnerable to migraines. I think migraines also make me cry.

We migraineurs are told from birth (well from the moment we are diagnosed) that a 'regular sleep pattern', or (this is my favourite) 'good sleep hygiene' is VITAL TO OUR LIVES. Too little or too much sleep can trigger a migraine! See it's stressful already!

I was also brought up by a mother who believed that lack of sleep was the root of all evil in the world, and most illness.  As such, I do actually believe that there are very few problems that can't be solved by the mighty power nap. Try it - it's especially good if accompanied by a cup of tea, a copy of a trashy magazine such as Hello! or OK and chocolate (which I can't eat anymore). But apparently naps are bad for 'sleep hygiene'. Or long ones are because they ruin your chances of getting to sleep again at night. So I try not to indulge too often.

This is my cat, Chipster, asleep!!  

He sleeps so heavily I could do this to him! Serves him right!

Recently, however, I have been plagued by insomnia. This is not a new problem for me. I've blogged here about how a rude interruption in sleep triggered a migraine. When I was at my worst migraine wise, in '04, I had no regular sleep pattern. The first thing my incredible physio rehab lady did was get me to write down when I went to bed and when I got up. She told me to stop obsessing about how many hours of sleep I got but to become aware of trying to regulate the times, to keep them as similar as possible. i.e the aim is to get up at the same time every day, even on weekends. Many migraineurs get 'weekend migraines' and the theory is it might have something to do with a variation in routine. i.e they sleep in longer, suddenly eat/drink do different things. Every migraine specialist will tell you that the migraine brain likes routine. Dull I know. 

My problem with all of this is HOW THE HELL DO I GET TO SLEEP AT NIGHT
and when you wake up at 4am with a raging migraine, have to give yourself an injection, the last thing your body wants to do is get up at 7am when the alarm goes off. Sleep does help you heal after all. Similarly, when a migraine starts  it's often wise to try and get to sleep, for me that's the best treatment (along with my triptan) so I'll get myself to bed if it's the afternoon or morning. Obviously, this can mean it's harder to make yourself go to bed again at a sensible time later that night. I do try to, however. I know I feel and function far better when I achieve this ideal pattern.

When a migraine has disrupted my routine I like to think of it as migraine jet-lag. So even if I've spent the afternoon in bed with a migraine, I'll still make myself go to bed and get up at a sensible time. If I do get a migraine in the middle of the night I won't, however, force myself to get up early as that could risk the migraine worsening. But treating it like jet-lag, i.e trying to get back to 'normal' time as soon as possible is how I try to approach it. But I do wish more specialists would recognise this aspect of sleep difficulties for us migraineurs. I do know I need to keep a regular routine, I do! But it's not that simple.

What drives me crazy are the thousands of really un-helpful tips that abound. When I was frantic with lack of sleep, which I'd like to point out is used as torture by war criminals, I asked a G.P for help and they actually printed off an information sheet from Google!! I can do that myself!! I do know all the sensible things one is meant to do. Another Doctor I saw told me not to drink any liquids two hours before bed, as needing to pee can wake you up, not to drink alcohol 4 hours before - see the recent study that was released earlier this week saying alcohol disrupts our sleep cycle. This Doctor also told me not to go to bed before midnight, rubbishing the rule I'd heard that the hours before midnight count for 2 after? I know to keep my bedroom a cool temperature, but not too cool, to try to unwind before bed, I've tried all the different sorts of herbal night remedies and made my room stink with Valerian. I've tried meditating, which I should try again as I so want to be Julia Roberts in EAT, PRAY, LOVE but my fail safe is usually the good old Audio Book.

I think at the moment Christmas and New Year, and all the fun they entail, maybe derailed my pattern? I've noticed many other migraineurs are having a tough January and sleep troubles too. So, basically I just wanted to moan. Last year I attended a fascinating talk hosted by The Migraine Trust at the EHMTIC conference on Sleep and Migraines by Alex Nesbitt (a specialist Registrar in Neurology and Research Fellow at a sleep centre). To be honest I"m too tired to summarise his talk now but read this brilliant article which will tell you lots of important and useful things about the relationship between migraines and sleep. For example, did you know there's even a 'sleep' headache, 'Hypnic Headache', that migraines are more likely to occur between 4am and 9am - and lots of other clever things our body's are designed to do at night.

Now if only I could get to sleep in the first place.....

p.s Tips & info below as usual - and more spelling & grammar mistakes than usual as I'M NOT SLEEPING!

Further Info & Advice:


  1. I'm quite lucky with my Dr. I get insomnia twice a year or so. At first they tried giving me leaflets then I met my recent Dr. Now when it happens I get a 2 week supply of Zopiclone to reset my system, he says like rebooting a computer. Works a treat!

    1. So you take it every day for 2 weeks? Randomly that kept me awake! When I lived in the states I had Ambien which is Zolpidem which my Neuro lets me have for severe migraines - so might try that - as you say to get me back into the right cycle!

    2. Yeah, though I don't usually need the full 2 week course, 10 days usually sorts me out then I have a few left over as back up haha. Unbelievable that it kept you awake, it knocks me out cold! I love my Dr, last time he asked me if I wanted the strong ones or the weak ones... duh! The strong ones!

  2. Ugh the big old sleep issue .. its like I KNOW being able to make a routine and stick to it would help my migraine but its just so hard to get to that stage :( I always oversleep (but don't fall asleep till like 6 am) and wake up with a migraine :/ my mum keeps telling me to wake up a certain time no matter when I fall asleep but with the propranolol and all, it just makes me too tired and unable to do anything :(

    1. Yup - I reckon it takes 3 weeks to get it sorted - i.e get the pattern right but it is worth it. And nothing is more annoying than when our Mum's tell us to get up. Mine is doing the same thing at the moment too - but they mean well, bless them and they're probably right.... though obviously medication side effects don't help at all! :) x

  3. Another great post and so apt! I always hear from people about how my migraine would improve if I kept to a strict sleep pattern and I do really try but its just not that simple. Most of the time for me the only way I can recover from I migraine is to take my medication and the lie down in a darkened room, ice on my head and try to sleep. If I try to resume normal activities too soon the migraine only comes back with avengence and I'm having to take more pills which I really try to avoid (MOH and all that). I also often wake up with migraines around 5am - 6am and as you say it is often not possible to get up at your normal time in these cases (very interesting about that time of the day being a peak time for migraine).

    I'll add this to the list of things to discuss with my Neurologist at my appointment next month, poor guy!

    I use a relaxation tape when I can't sleep but often it doesn't help nor does meditation which I find wakes me up, I will try the audiobook method!

    1. Hi Betty, yeah knowing all the theory but putting it into practise are two very different things aren't they! And I think it's great to have a good list to discuss with your neurologist - it's their job to work with us to get us better right! I'm exactly the same as you re migraine onset too - and re your below post that is a very normal sign of a migraine prodrome i.e that a migraine is on it's way - and an aura is often (not always) the next stage so that makes sense. Lucky you! Hope you're well today though and having a relaxing weekend and able to get some sleep! Audio books are fabulous! Let me know how you get on with them :) x

  4. "I think migraines also make me cry"

    I think this is true, it is for me I am normally fairly laid back but I often become very weepy and irritable prior to a migraine, often even before I experiance any aura.

  5. I had terrible migraine 'jet-lag' after Christmas this year. It took me ages to get back into a routine. Getting up early at the weekends really helps me.

    I find that if I do manage to sleep through a migraine, I always have the weirdest most intense and sometimes disturbing dreams. It makes me more exhausted when I wake up if this happens.

    As for your cat however, he looks so relaxed. I am going to channel Chipster!


    1. Hey Claire, would be interesting to know if other people had weird dreams during a migraine - bet they do. I know it's really common for people with migraine to wake up feeling tired and un-rested. Restless leg syndrome is actually a random migraine feature for some - which disturbs sleep too!

      And you know, I think the world would be a better place if we all channeled Chipster!

      Hope that head of yours is behaving today xx

  6. Victoria,
    I love this post so much, especially because I've had such terrible sleep problems since the holidays. I love your idea of beginning a sleep journal, and I think I will start one tonight. I need to mark down when I am going to bed and when I am waking up.

    I found this holistic site (I'm not affiliated - not spam!) that says what time each of your organs restarts ( For example, it suggests you should be asleep by 11 so your liver can process correctly. If you can't sleep, it might mean your liver is unable to process something. I have ZERO medical training but I've heard this from my medical friends before. Pretty cool stuff!

    Thanks for sharing an entertaining and relatable post. As always, you are one of my all-time favorites!

    1. I was actually think of you Emily when I wrote this as I know you've been having trouble sleeping too recently! I'll have a look at that site it sounds really interesting. You should check out the talk by Alex Nesbitt as he told us about all the different functions our body is programmed to do throughout the night - it's so incredible - and I was once told by a Dr that our livers do exactly that - process etc too in the night etc - which is why I always try to stay in bed even if I can't sleep rather than get up and work or something - at least if I'm lying flat my liver can do it's thing...???? ha.... xx

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