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Sleep as a trigger

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Dr Pav Khaira
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Post by Tee Tue Dec 13, 2011 7:03 am

Do you have to keep to a regular sleep pattern?

Changes in sleep patterns eg napping, oversleeping, too little sleep have all shown to be triggers - are they yours and how to you manage it?
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Post by Nekoha Tue Feb 14, 2012 5:47 pm

Yes, sleep is a major trigger for me. I have pretty severe insomnia and it is virtually impossible to keep a "regular" pattern. But I am usually okay as long as I get 7 to 9 hours of sleep. Any less or any more and I will get a migraine.

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Post by Dr Pav Khaira Tue Feb 14, 2012 8:06 pm

You already know my thoughts on this Razz
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Post by Nekoha Tue Feb 14, 2012 8:24 pm

Dr. Pav,
I watched your video and it makes quite a lot of sense to me. I grind my teeth so much at night that I broke several teeth and have actually woken up my husband because the noise was so loud! I don't have any jaw problems, and I use a dentist-made mouth guard on my top teeth every night (and have for about 5 years). Is a mouth guard enough to stop or at least lower the sensory input or does it just protect against tooth damage?
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Post by Dr Pav Khaira Tue Feb 14, 2012 8:29 pm

Hi Carla,

CERTAIN types of mouth guards to exactly that, the WRONG type of guard will make the problem worse!!

Soft bite guards are the worst for this.

No disrespect intended to any dentist, but the vast majority of dentists really don't understand much about bite guards and in my experience usually make the wrong type. Even if the correct type is made, unless it is PERFECT, you may not get resolution of symptoms!

Allergan have asked my to approach the local PCT and discuss an NHS referral pathway which includes my treatment modalities.

In fairness, they want me to teach the Botox protocol and my rep is absolutely brilliant, she want to do the right thing for the patients and is excited about the other stuff I do, not just the botox
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Post by Nekoha Tue Feb 14, 2012 8:40 pm

My night guard is really hard. Not sure of the actual material, but I am guessing a type of acrylic.
I heard a lot of people say that Botox is best for migraines. It isn't done in Japan for migraines, though. (Or so my neurologist keeps insisting!)

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Post by Dr Pav Khaira Tue Feb 14, 2012 9:05 pm

Botox CAN be helpful for migraines, but in my opinion it's not the best! There is no one 'magic bullet', but there are a number of things which can help.

I always start with the thing which will have the biggest impact, then move onto the next IF NEEDED or indicated by other signs and symptoms

If your bite guard covers all of your teeth then it's probably the wrong one for migraines, although it may protect your teeth from damage

It's a big and complicate world!
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Post by Tee Wed Feb 15, 2012 6:17 am

I agree - Migraine Management is not a one stop shop- you need to do many things......... popping a pill just will not do it in most cases..........I believe migraine is managed by 'Migraine Trigger Management' If you can work out your triggers and fix or avoid them you are half way there. Everyone is different, but the one thing we have in common is that migraine is triggered............ normal things make it worse and kick it off..........

I love Botox - had 3 rounds now and it blocks the pain.... but I still have to practice trigger management.

I have changed so much in the past few years and its not one thing that gave me some life back - it was the combination of things....



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Post by pīwakawaka Mon Mar 12, 2012 12:58 pm

Oversleeping in summer is a guaranteed way for me to wake up with a headache although only slightly increases the likelihood of waking up with a migraine.
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Post by Laura Mon Mar 12, 2012 2:05 pm

Not getting enough sleep is a major trigger for me. I try to keep a fairly regular sleep schedule - but insomnia and hot flashes can interfere. Do many people with migraines also suffer from insomnia?
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Post by pīwakawaka Mon Mar 12, 2012 5:18 pm

I don't so much suffer from insomnia, but I seem to be at my best during the night. I feel my mind is clearest around midnight. Whether that's actually true or simply an illusion, I'm not sure.

The biggest disadvantage of being a night person is that you are in a distinct minority Sad
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Post by Tee Tue Mar 13, 2012 12:09 am

Funny I find I am at my best at midnight too........ I wonder why?

Insomnia is quite common - or just just plain sleeping is a problem for a lot of migrainers - Pav has written about the stages of sleep above.

When I had my big HM I lost the ability to stay asleep and had to resort to medication to help for a while - I seem to have cracked that one over the years - but to be honest I am not sure how..... But defo could sleep late most days and work at midnight..........maybe we are vampires hee hee
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Post by fron Tue Mar 13, 2012 2:31 am

I am considering becoming nocturnal. Definitely better at bedtime, but tired.

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Post by sisterphonetica Fri Apr 06, 2012 1:37 am

I am officially a rubbish sleeper and it would appear from the classifications that I have nocturnal migraines. Most of my migraines come on in the wee small hours. I have a mouth guard and it's a hard acrylic thing - I don't think it helps, really. I clench rather than grind.

Staying up too late is a big trigger for me, but less now than when I didn't take the topiramate (poisonous though it is).

I'm always looking for more information! I'm new here so pointers are good!
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Post by Dr Pav Khaira Fri Apr 06, 2012 11:16 pm

Does your mouth guard fit over all of the teeth in either top or bottom jaw?
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Post by Nekoha Fri Apr 06, 2012 11:23 pm

I am really worried about the next few months. I have been on prescription sleeping medications for 12 years due to a diagnosed sleep disorder, and now my doctors and I have decided that I should try life without any medications, including my sleep meds! We're reducing all my meds slowly, and I will start reducing the sleep meds in 1 month... so apprehensive!! I hope to be successful, but what I am dreading the most is an increase in migraines. Sad

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Post by Dr Pav Khaira Fri Apr 06, 2012 11:25 pm

What sleep disorder were you diagnosed with? What tests did they do to get to that diagnosis?

Coming off meds is always nerve wrecking, especially if they work!!

Hope it goes well for you
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Post by Nekoha Fri Apr 06, 2012 11:38 pm

I've been to several sleep specialists who all diagnosed me as having insomnia due to PTSD and restless leg syndrome. Now that I am working on the PTSD, I am hoping that the insomnia will correct itself once I am over the withdrawal phase of the meds! We'll see about the RLS, too.

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Post by sisterphonetica Sat Apr 07, 2012 12:23 am

Yes, top teeth. I used to go to McTimoney chiropractor who said I needed something expensive done to my teeth to align them better but I couldn't afford it at the time.

I don't think the oral surgery department, or the ENT department, or my dentist really understand.

The oral surgeon said I would probably keep coming back to him over and over again with my slightly out of place jaw.
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Post by Dr Pav Khaira Sat Apr 07, 2012 5:20 am

If it covers all of your teeth it likely is the wrong one to help with migraines.

Very poolry understood subject I'm afraid!
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Post by sisterphonetica Sat Apr 07, 2012 10:36 pm

Pav, where's you info on triggers? I'd be interested to see it!
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