People are constantly asking me what is the one most important thing that they can do to improve their migraines. If the migraines are transformed (i.e., changed from episodes of migraines to a more chronic or much more frequent than an episodic presentation), then the migraineur's (the person who has migraines) quality of sleep is affected. In other words, the more frequent the migraines, the more the migraines influence sleep adversely. In such cases, sleep is the most important issue to address. There are five steps that are absolutely necessary to take in order to begin to have adequate quality sleep.
1.) Regular bedtime
2.) Regular get up time
3.) Regular exercise
4.) No naps'except if needed to treat a migraine
5.) Do not eat or drink anything within 3-4 hours of bedtime'so you do not need to go to the bathroom, and therefore, interrupt sleep
Adequate sleep may be accomplished by doing the above things alone; however, medications may be needed to facilitate the achievement of this list.
In individuals with transformed migraines eventually influences the quality of their sleep. The sleep pattern becomes constantly interrupted and the patient can become depressed. Usually there is early awakening with poor quality sleep in the remaining hours allotted to sleep, resulting in a depressive pattern of sleep. The deep sleep, instead of being predominantly over the first three to four hours of sleep, occurs primarily in the first 45 minutes to one and a half hour of sleep. The main REM (rapid eye movement) pattern which should be over three to four hours generally follows the deep sleep pattern. After the REM cycle is finished, the patient awakens and then just 'catnaps' to finish the night's 'rest.' Remember the first thing done to prisoners of war'sleep deprivation! This is severe torture. The patient is being tortured every night! Help! Hypnotics (sleep medicine) may be used, but they do not change the sleep architecture. Antidepressants help change the sleep architecture back to normal. No one particular medicine is the answer. Antidepressants can help with handling stress. Stress, remember, is a major trigger for migraines. Whether stress led to depression, or the brain dysfunction from transformed migraines led to depression does not matter at this point. The sleep disturbance must be addressed.
In general, the main need is that migraineurs do everything that they can to improve protective factors and reduce risk factors. Begin with the basics. The basics mean making healthy lifestyle choices. Successful migraine prevention depends greatly on understanding how lifestyle impacts the frequency and severity of migraine attacks. The body of the person who has migraines is more sensitive to stimulation. The migraineur, a person that has migraines, overreacts to light, sound, smell, food, and/or stress.
Avoid triggers. Triggers can be additive and total up to big trouble. The more trouble you have, the lower your threshold for developing symptoms. If your body is over-stimulated by triggers for a sufficient time period, then transformation of migraines occurs and more of the migraine syndrome is revealed. Transformation can ultimately lead to fibromyalgia. It is impossible to totally avoid triggers. Triggers are risk factors. Activities done to normalize the nervous system are protective factors. Lifestyle changes promoting protective factors and avoiding risk factors lead to good health.
Certainly, in the case of cigarette smoking, quitting smoking is the most important. If perfume or cologne is the offending trigger, then not wearing the fragrance is paramount. I can go on with numerous examples. Nevertheless, sleep is usually the most important issue to address. |
| Author: J. Wes Tanner, MD |
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Author Bio:
J. Wes Tanner, MD is a family practice and headache specialist who has been treating people for about 30 years. He has extensive experience in treating migraines and fibromyalgia with excellent success. In "Doctor, Why Do I Feel This Way?", Dr. Tanner exposes the secrets and myths about fibromyalgia and the migraine syndrome. To find out more, go to www.migrainesyndrome.net. |
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