Migraine is a kind of headache disorder that leads to recurrent episodes of moderate to severe headaches, either on one side of the head or the whole head. It may be associated with vomiting. Sound and lights also annoy patients who suffer from the said headaches. These headaches are usually triggered by hunger, sleep deprivation, sunlight, certain food items like chocolates and Chinese food, stress or strong smells. The diagnosis of Migraine is made basis the signs and symptoms. A brain scan is quite normal in this situation.
Migraine is one of the commonest causes of headache. It is not life-threatening, but could cause serious disruption as these headaches tend to get very disturbing and interfere with everyday routine.
Migraine is a treatable disease. Treatment cannot “cure” Migraine but the headache could be significantly reduced or completely removed with proper treatment. It constitutes of prophylactic treatment and rescue treatment. A Prophylactic treatment is given on a daily basis in order to reduce “attacks” of Migraine. In case of severe Migraine headaches, medicines to reduce the duration and severity are prescribed on “when required” basis. With simple treatment and avoidance of “triggers”, Migraine could be controlled in majority of cases. However a small percentage of patients may require sophisticated treatments. Controlling Migraine with proper treatment could be a life changing experience for good number of patients.
However, this disease is under-recognized and often mistaken for “sinus” or an “eye problem”, and is hence an undertreated condition due to lack of awareness.
I cannot sleep properly at night, due to which I am stressed the entire day, what should I do?
Sleep is an important “exercise” for restoration of health. Lack of sleep could lead to serious medical and psychological consequences. It could also decrease work output during the daytime. Hence, it’s crucial to find reasons for sleep disturbance and address it as soon as possible. Please refer to “Insomnia” below for details.
Is it ok to take medications when I cannot sleep, or does it have an impact on the health?
Medications for sleep should not be taken casually. Proper sleep hygiene is extremely important. However, they could be used in certain situations such as jet lag, shifting duty, recent psychological stressors like major incident in the family, sleep disturbance due to painful medical illnesses like fracture, or cardiac illness, for a short period of time. Make sure they are consumed only under medical supervision.
Medications for sleep on long term basis should only be taken when other measures to improve sleep cycle has failed (See below). With recent advances, medications for sleep have become safer with fewer side effects. Their use, under proper medical supervision is most important to minimize its health impact.
Why do I get headache even if I get exposed to light sunshine?
Headaches triggered by exposure to sunlight is an important symptom for Migraine. If this is the only trigger for headache, then avoid direct sunlight with the use of an umbrella, a cap or a hat. If it still does not get better, a proper evaluation by neurologist is recommended to find out if a Migraine treatment needs to be undertaken.
What are some remedies to prevent insomnia?
A disciplined sleep hygiene is key to prevent Insomnia. For a proper and refreshing sleep, bear in mind the following points:
- Maintain a regular sleep schedule: Changing your sleep timing on day to day basis could hamper sleep cycle
- Avoid day time sleep: Restrict afternoon nap to < 1 hour (Ideally 20 minutes). Avoid nap in evening
- Avoid tea/coffee/nicotine/alcohol after sunset
- Avoid eating a heavy meal just before sleep
- Bedroom/bed should be comfortable: Noise, uncomfortable temperature, inappropriate mattress or light could affect the quality of sleep
- Go to bed when sleepy: Lying on bed when alert can be counterproductive. Use the bed only for sleeping purpose. Avoid watching TV, internet surfing or other addictive and stimulating activity like gaming, chatting on mobile etc. whilst in bed
- Avoid engaging in active mental task like planning for next day after retiring to bed
- Stretching or deep breathing exercises prior to sleep could prove helpful. Although, avoid strenuous exercises right before sleeping
- Taking a bath with warm water prior to sleep may prove helpful too
- Don’t get anxious if you’re unable to sleep after going to bed. Get out of the bed, and engage in reading and then return once you’re sleepy again
- If there is a physical problem like pain, breathing difficulty or frequent passage of urine that is interfering sleep, get it looked into on priority
With these steps and a proper sleep duration (At least 6 hours; may vary between 6 to 9 hours), most of the sleep-related problems could be avoided. Some could even cure insomnia.
Dr. Haseeb Hassan | Consultant Neurologist | Rabindranath Tagore International Institute of Cardiac Sciences