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There is evidence that sleep disruption and pain are reciprocal: that is pain can disturb sleep
and restless sleep can cause or intensify pain.
Studies link headaches to insomnia and poor sleep quality. Fundamental sleep quality strategies support headache prevention and improvement for at-risk individuals.
Insomnia is the most common sleep complaint in headache clinic populations. Insomnia can be transient, intermittent, or chronic. It can be caused by underlying physical or mental disorders and individual behavior.
Headache evaluation should include an exploration of patient sleep history, daily activities in relation to sleep schedule, and headache occurrence in relation to their sleep.
The methods to evaluate headaches and sleep and improve quality of sleep from a behavioral standpoint are mostly temporal and dietary related.
The temporal and dietary aspects are:
Time of day headaches occur - morning or night? Morning headaches are linked to sleep problems.
Does the patient have a regular sleeping routine? A consistent sleep schedule is necessary for circadian synchronicity. An out of phase biological clock is associated with headaches.
How long does it take to fall asleep? Inability to fall asleep easily may indicate insomnia.
How many hours does the patient sleep per night on average? Sleep debt can lead to headaches.
When does the patient eat and work in relation to their sleeping schedule? Staying in synch with circadian biological clock is important. Eating a meal less than four hours before bed can interfere with sleep.
Is caffeine or alcohol used near bed time? Both interfere with sleep and can lead to headache.
If the headaches are primarily in the morning after sleep, the headaches may well be related to the patient's sleep. Headache at any time of day may have a sleep related cause, but morning headaches have a greater association with poor sleep. The possibility of sleep disorders should be considered and an evaluation by a sleep specialist may be required. For example, recurring, loud snoring may indicate sleep apnea.
Following the iSleep Five Principles of Healthy Sleep will provide a good behavioral foundation for better sleep.
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