Sleep as a trigger

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?

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.

You already know my thoughts on this

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?
Carla

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

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!)

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!

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....

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.

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?

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

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

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

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!

Does your mouth guard fit over all of the teeth in either top or bottom jaw?

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.

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

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.

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.

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

Very poolry understood subject I'm afraid!

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