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Headache Management: Sleep Strategies

Sleep Hygiene Strategies

Keep a Regular Sleep-Wake Cycle

If you don’t have regular bedtimes and wake times, it can upset your circadian rhythms. Keep a regular sleep-wake schedule 7 days a week. If you change the times on weekends or vacations, try to limit the change to 1 hour. It’s a good idea for everyone (even people who don’t work) to keep a regular schedule. Some people get frustrated because they go to bed at the same time every night, but still have trouble falling asleep. Other sleep hygiene strategies and stimulus control might help. You'll learn more about this later.

Plan to be in Bed for 8 Hours Each Night

Many people set aside time for work and family responsibilities, but don’t set aside enough time for sleep. It’s best for people with headaches to spend 8 hours in bed each night. Make sure to build that into your schedule.

Don’t Take Naps (If You Can Help It)

Napping can interfere with your body’s sleep pressure, which makes for a later bedtime and problems falling asleep and staying asleep. If you need to take a nap, have it before 3 p.m. and limit it to 20 to 45 minutes. Set your alarm so you don't nap longer.

Don’t Read, Watch TV, or Listen to Music in Bed

Your bedroom should be a peaceful place for sleep and intimacy only. Reading, watching TV, listening to music, or using a computer in bed can be stimulating and make it hard to sleep. You will learn more about this in the section called Electronics before Bed.

Don’t Eat Late or Drink Anything 2 Hours before Bed

If you can, it’s a good idea to have your evening meal about 4 hours before bed so the food is partly digested by bedtime. Try not to eat big portions of food. Have a light snack 1 or 2 hours before bed. It’s a good idea to have a carbohydrate and a protein (e.g. toast and peanut butter or cereal and milk). Make sure to stop drinking anything for 2 hours before bedtime. That way you won’t have to go to the bathroom during the night.

Do Regular Aerobic Exercise

Exercise helps you fall asleep faster, get more deep sleep, and wake up less during the night. Start with 20 to 30 minute aerobic exercise sessions (e.g., walking, cycling, swimming) 3 times a week and work up from that if you can. Exercise in the morning, afternoon, or early evening. Make sure you’re finished exercising at least 2 hours before bed. Talk to your healthcare provider for more information.

Cut Back or Stop Smoking

Nicotine increases heart rate and blood pressure, so if people smoke before bed, it might be hard to fall asleep. Sometimes nicotine withdrawal symptoms or cravings can wake people up during the night. If you smoke and have sleep problems, try to smoke less or quit. If you need help with this, talk to your healthcare provider.

Limit Alcohol or Don’t Drink

Drinking alcohol in the evening might make you fall asleep faster, but it can decrease deep sleep. It might also make you wake up to go to the bathroom or make night-time breathing problems worse. You might prevent these problems if you:

  • limit how much you drink
  • don’t drink alcohol at least 3 hours before bed

Limit Your Caffeine (or Don’t Have Any)

People use caffeine to help them wake up or stay alert. Caffeine can even make migraine headaches better for some people if it’s taken early in an attack. Unfortunately, caffeine can seriously affect sleep. Caffeine can bind to receptors and prevent adenosine from working like it’s supposed to. When this happens, it may take longer to fall asleep and there may be less deep sleep. Caffeine can also affect sleep because it might make you have to go to the bathroom at night. Try to limit your caffeine to no more than 2 cups a day. Don’t have caffeine after lunch because it stays in your system for many hours.

Remember, caffeine isn’t just in coffee. It’s in tea, cola, chocolate, hot chocolate, energy drinks, and some medicine like Excedrin®, Tylenol #1®, Tylenol #2®, or Tylenol #3® (Tylenol #4® does not contain caffeine).

Don’t stop or decrease your caffeine intake all at once. You might end up with a caffeine withdrawal headache. Instead, decrease it slowly by 150 mL (about 5 ounces) every 3 to 5 days.​​​​​