How To Take Control and Reverse Your Chronic Migraine

4 Habits You Can Undertake to Reverse Your Everyday Migraines

How Your Sleep Habits May Be Triggering Headaches
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There are a number of culprits that can trigger the transformation from an episodic migraine to a chronic migraine. Medication overuse is a major one, with other potential (maybe less obvious) ones being obesity, depression, excessive caffeine use, snoring, and sleep disorders.

It can be difficult determining exactly what triggers the "chronification" of your migraines. Also, for many people, it's not just one factor, but a complex interplay of multiple factors, which can be challenging to tease apart.

But adopting these four healthy habits may just reverse your chronic migraines -- and wouldn't a migraine that happens just once in awhile be a lot more manageable than one that happens almost daily?

Sleep Hygiene to Reverse Chronic Migraine

For those who suffer from poor sleep habits -- like oversleeping, insomnia, or disrupted sleep -- chronic migraines may be reversed with behavioral sleep modifications, according to a study in Headache.  These healthy behavioral sleep habits include:

  • Adhering to a consistent bedtime and one that allows for 8 hours time in bed (e.g., 10pm till 6am).
  • Eliminating television, reading, computers, phones, and music in bed. You might be surprised by reading. If you enjoy reading before bedtime, read in your living room to become tired and then hit the sack, leaving your book behind on the coffee table.
  • Using visualization technique to shorten time to sleep onset. Visualization is similar to self-hypnosis and meditation and entails creating an image in your mind that helps you unwind -- like tricking your mind into deeply relaxing and falling asleep.
  • Moving dinner to 4 or more hours before bedtime and limiting your fluid intake to within 2 hours of bedtime.
  • Stopping naps.

Take Your Migraine Preventive Medications

There are a couple effective chronic migraine preventive medications, like the anticonvulsant Topamax (topiramate) and Botox (onabotulinumtoxin A).

Other potential preventive medications include the anticonvulsant Neurontin (gabapentin), the antidepressant Amitriptyline (Elavil), or the muscle relaxant Zanaflex (Tizanidine). Finding the right medication can be tricky, either because of side effects or medical contraindications.

For instance, Topamax (topiramate) may have side effects like weight loss, numbness, and tingling, fatigue, difficulty concentrating, dry mouth, and nausea. Botox requires an injection into a facial muscle with potential side effects including:

  • neck pain
  • eyelid drooping
  • injection site pain
  • muscle weakness
  • headache

When finding the right preventive medication, the key is patience and good follow up with your doctor.  Your doctor will have to titrate up your dose to a therapeutic level (the dose at which the medication actually works to reduce your migraines) while minimizing the potential for side effects. It's a delicate process so try your best to not give up -- or if problematic, talk with your doctor. It's OK to re-address your medication, don't get discouraged.

Stop Overusing Your Migraine Medications

Overusing your pain-relieving migraine medications, whether that is a prescription medication (like a triptan) or an over-the-counter medication (like an NSAID), is a common trigger for the development of a chronic migraine. In addition, with the overuse of pain-relieving medications, migraine preventive medications are often ineffective -- a double whammy.

The great news is that stopping your overused medication can stop your headaches and reverse your chronic migraines. While most medications can be stopped immediately, be sure to talk with your doctor if your medication contains butalbital compounds or if you are taking large amounts of an opioid, as these medications need to be gradually stopped under the guidance of a physician.

Exercise to Reverse Chronic Migraine

It's hard to say at this time whether exercise can directly reduce your number of migraines per month. But scientific studies do support its use in reducing migraine pain intensity by changing the way pain is processed in the brain and by activating reward centers in the brain.

In addition, obesity may aid in the transformation from episodic to chronic migraines, and regular exercise can prevent obesity.

Remember, exercise does not necessarily mean going to the gym -- walking briskly with a friend, swimming, Zumba class, biking, hiking, or joining a competitive sports league can be invigorating and still counts as exercise. Choose an activity that is right for you, and that you enjoy.

Bottom Line

It feels good to take an active stance in your migraine health. Start by making a list, asking your partner to help motivate you, and devising a concrete plan with your doctor. You can reverse your migraines -- it may be more difficult for some, and you may have ups and downs, but the ups (no migraine days) will be glorious.

Sources:

Ahn, A. (2013). Why does increased exercise decrease migraine? Current Pain and Headache Reports, 17(12):379. .

Bigal, M.E., Lipton, R.B. (2006). Obesity is a risk factor for transformed migraine but not chronic tension-type headache. Neurology, 67(2):252-257.

Calhoun, A.H., & Ford, S. Behavioral sleep modification may revert transformed migraine to an episodic migraine. Headache, 47(8):1178-83.

Kikuchi, H., Yoshiuhchi, K., Yamamoto, Y., Komaki, G., Akabayashi, A. (2011). Does sleep aggravate tension-type headache?: An investigation using computerized ecological momentary assessment and actigraphy. BioPsychoSocial Medicine, 12;5:10.

Rains JC, & Poceta JS. (2012). Sleep-related headaches. Neurologic Clinics, Nov;30(4):1285-98.

Schwedt, T.J. (2014). Chronic migraine. BMJ, 24;348:g1416.

Silberstein SD, Holland S, Freitag F, et al. (2012). Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology, 78:1337.

DISCLAIMER: The information in this site is for educational purposes only. It should not be used as a substitute for personal care by a licensed physician. Please see your doctor for diagnosis and treatment of any concerning symptoms or medical condition.

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