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Sleep and Headaches: New Insights from Research

 

Sleep and Headaches: New Insights from Research 

People who struggle with headaches often report having poor sleep. Medical doctors and scientists alike recognize a strong link between sleep and headaches – but what is actually happening in the body that could explain this? Researchers are still busy exploring the causes. Let’s take a look at the latest findings.


Sleep and migraine: what does the science say?

A group of Italian researchers recently dug deep into the connection between migraine and sleep. In a major review of existing studies, they spotted a range of factors that raise the risk of migraine attacks. Across all ages, one major cause emerged: poor sleep. In the studies included in the assessment, as many as two-thirds of people with migraines said that a sleepless night could spark an attack. Around 10 to 15 percent even lived with chronic insomnia.

Poor sleep quality is closely associated with breathing issues at night. Frequent breathing interruptions can cause restless sleep and jolt people awake several times a night. Oxygen levels in the blood fluctuate dramatically, sometimes staying low for long stretches. This prevents the nervous system from getting the rest it needs. The next morning, people wake up drained and foggy, and are at increased risk of experiencing a migraine attack. Daytime sleepiness and trouble focusing add to the problem. The result is a vicious cycle: the migraines worsen, wrecking nighttime sleep. Bad sleep in turn may trigger migraines. Migraine attacks become more frequent and more severe.          

A study from Japan shows that the double burden of poor sleep and migraine attacks significantly interferes with quality of life. Using the well-established "MIDAS" questionnaire, a tool designed to measure disability caused by migraines, the researchers determined that sleep issues affect quality of life. The more severe the sleep disorder, the higher the migraine disability score.


Sleep is also a trigger for tension-type headaches

When it comes to migraine, the idea of specific triggers is nothing new. Scientists have been studying them for decades. Tension-type headaches flew under the radar for a long time. Research in this area has caught up, however, and we now know that tension-type headaches do have specific triggers. It is now well-established that poor, non-restorative sleep is a major factor in tension-type headaches – just as significant as stress, in fact. (Find a separate article on the connection between insomnia and tension-type headaches here).

A study by neurologists in Kaunas, Lithuania, looked at the role of sleep in both migraine and tension-type headache. The results were striking: people with tension-type headache struggled with sleep problems – including full-blown insomnia – even more than those with migraine. Breathing interruptions during sleep were approximately equally common in both groups, as were high scores on the Excessive Daytime Sleepiness scale. Three out of four people with tension-type headache, and more than half of those with migraine, said poor sleep could trigger a headache. The authors recommend a strategy combining pain relief, better emotional health, and a specific focus on combating insomnia.


Pathogenesis: why does this connection exist?

A Spanish research group set out to investigate the physical mechanisms behind the association between headaches and sleep. Their main question was this: what lowers the threshold at which we start to actually feel pain? One idea is that sleep and headache are controlled by the same parts of the brain, suggesting that sleep disorders and headaches might have common roots.

Interesting new findings suggest possible links to conditions like anxiety and depression as well. There are indications that these mental health conditions can also heighten sensitivity to pain throughout the body. The likely reason? Our pain receptors become more reactive, amplifying the signals we feel. Researchers are now asking whether these underlying mechanisms might feed into each other – with one making the other worse.  

Two natural messengers deserve special attention here: serotonin and melatonin. These hormones have long been known to play a role in sleep, the body’s day-night rhythm, mood regulation, anxiety, reward processing, and sensory perception. It makes sense, then, that serotonin and melatonin show up in such a wide range of conditions – especially where body and mind overlap – and very likely in the development of headaches, too.


Prevention: what can you do yourself?

The sheer number of studies on sleep and headache shows just how crucial good, restorative, uninterrupted sleep is for head health. This applies most of all to migraine, but it matters for tension-type headaches too. A regular daily routine is key. Any change in your usual sleep rhythm registers as a disturbance, forcing the body to adjust – and in the worst case, triggering a headache attack. For people with migraine in particular, sticking to the same sleep-wake times – even on weekends – is one of the most effective headache prevention strategies. Keeping a sleep diary can help you spot where you may be falling short and identify what you can do about it (tools like the Headache Hurts app make this easy).

Another reason why healthy sleep is so important: over the past decade, many studies have shown that the brain runs nightly cleaning processes while we are in deep sleep. Disposal of the waste materials that build up in the brain during the day mainly takes place at night. Among them are substances whose buildup has been linked with dementia. So good, restorative sleep is vital for our overall health – as well as being one of the most effective ways to prevent headaches.


Published: August 2025
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    Awaki E, Takeshima T, Matsumori Y, Hirata K, Miyazaki N, Takemura R, Osaga S, Tanizawa Y, Komori M. Impact of Migraine on Daily Life: Results of the Observational survey of the Epidemiology, Treatment, and Care of Migraine (OVERCOME [Japan]) Study. Neurol Ther. 2024 Feb;13(1):165-182. doi: 10.1007/s40120-023-00569-3. Epub 2024 Jan 4. PMID: 38175489; PMCID: PMC10787723.

    Bansod A, Meshram S, Ramteke S. A Study to Assess the Association Between Sleep and Migraine. Cureus. 2025 Mar 30;17(3):e81453. doi: 10.7759/cureus.81453. PMID: 40161428; PMCID: PMC11955155.

    Chen YM, Wang JH, Liang CS, Lin YK, Yang FC. Clinical and psychological predictors of sleep quality in chronic migraine: a preliminary retrospective analysis study. BMC Neurol. 2025 Apr 11;25(1):156. doi: 10.1186/s12883-025-04165-w. PMID: 40217165; PMCID: PMC11987233.

    Duan S, Ren Z, Xia H, Wang Z, Zheng T, Liu Z. Association between sleep quality, migraine and migraine burden. Front Neurol. 2022 Aug 26;13:955298. doi: 10.3389/fneur.2022.955298. PMID: 36090858; PMCID: PMC9459411.

    Fernández-de-Las-Peñas C, Fernández-Muñoz JJ, Palacios-Ceña M, Parás-Bravo P, Cigarán-Méndez M, Navarro-Pardo E. Sleep disturbances in tension-type headache and migraine. Ther Adv Neurol Disord. 2017 Dec 6;11:1756285617745444. doi: 10.1177/1756285617745444. PMID: 29399051; PMCID: PMC5784553.

    Iliff JJ, Wang M, Liao Y, Plogg BA, Peng W, Gundersen GA, Benveniste H, Vates GE, Deane R, Goldman SA, Nagelhus EA, Nedergaard M. A paravascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes, including amyloid β. Sci Transl Med. 2012 Aug 15; 4(147): 147ra111. doi: 10.1126/scitranslmed.3003748.

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