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Why Does Sleep Stop Migraine?

  • Migraine (R Cowan, Section Editor)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

An Erratum to this article was published on 07 January 2014

Abstract

The relationship between sleep and migraine headaches is complex. Changes in sleep patterns can trigger migraine attacks, and sleep disorders may be associated with increased migraine frequency. Furthermore, migraine patients and their doctors very consistently report that sleep relieves already established migraine attacks. Herein we will try to answer the question, “Why does sleep stop migraine?” Since evidence for this relationship is largely based on empirical clinical observation, we will not provide a clinical review of the association. Instead, we will focus on the pathophysiology of migraine attacks and its intersections with sleep biology.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Goadsby PJ, Lipton RB, Ferrari MD. Migraine–current understanding and treatment. N Engl J Med. 2002;346:257–70.

    Article  CAS  PubMed  Google Scholar 

  2. Bigal ME, Lipton RB, Stewart WF. The epidemiology and impact of migraine. Curr Neurol Neurosci Rep. 2004;4:98–104.

    Article  PubMed  Google Scholar 

  3. Leonardi M, Steiner TJ, Scher AT, Lipton RB. The global burden of migraine: measuring disability in headache disorders with WHO's Classification of Functioning, Disability and Health (ICF). J Headache Pain. 2005;6:429–40.

    Article  PubMed Central  PubMed  Google Scholar 

  4. • Houle TT, Turner DP, Penzien DB. How does the migraine attack stop? It is NOT the trigger: common headache triggers do not predict cessation of pain. Headache. 2012;52:189–90. Thought provoking paper conceptually discussing factors associated with the termination of migraine pain.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Martin VT, Behbehani MM. Toward a rational understanding of migraine trigger factors. Med Clin North Am. 2001;85:911–41.

    Article  CAS  PubMed  Google Scholar 

  6. Hauge AW, Kirchmann M, Olesen J. Trigger factors in migraine with aura. Cephalalgia. 2010;30:346–53.

    Article  CAS  PubMed  Google Scholar 

  7. Roth T, Roehrs T. Sleep organization and regulation. Neurology. 2000;54:S2–7.

    Article  CAS  PubMed  Google Scholar 

  8. Arruda MA, Guidetti V, Galli F, Albuquerque RC, Bigal ME. Childhood periodic syndromes: a population-based study. Pediatr Neurol. 2010;43:420–4.

    Article  PubMed  Google Scholar 

  9. Mollaoglu M. "Trigger Factors in Migraine Patients". J Health Psychol 2012 Oct 26.

  10. Fukui PT, Goncalves TR, Strabelli CG, et al. Trigger factors in migraine patients. Arq Neuropsiquiatr. 2008;66:494–9.

    Article  PubMed  Google Scholar 

  11. Prince PB, Rapoport AM, Sheftell FD, Tepper SJ, Bigal ME. The effect of weather on headache. Headache. 2004;44:596–602.

    Article  PubMed  Google Scholar 

  12. Bigal ME, Lipton RB. Modifiable risk factors for migraine progression. Headache. 2006;46:1334–43.

    Article  PubMed  Google Scholar 

  13. Jennum P, Sjol A. Epidemiology of snoring and obstructive sleep apnoea in a Danish population, age 30-60. J Sleep Res. 1992;1:240–4.

    Article  PubMed  Google Scholar 

  14. Scher AI, Lipton RB, Stewart WF. Habitual snoring as a risk factor for chronic daily headache. Neurology. 2003;60:1366–8.

    Article  CAS  PubMed  Google Scholar 

  15. Wilkinson M. Migraine–treatment of acute attack. Scott Med J. 1985;30:258–62.

    CAS  PubMed  Google Scholar 

  16. Wilkinson M. Migraine treatment: the British perspective. Headache. 1994;34:S13–6.

    Article  CAS  PubMed  Google Scholar 

  17. Silberstein SD. Practice parameter: evidence-based guidelines for migraine headache (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2000;55:754–62.

    Article  CAS  PubMed  Google Scholar 

  18. •• Scully T. Sleep. Nature 2013;(497):Suppl. S1–S20. Collection of articles discussing physiological and clinical aspects of sleep.

  19. Lauritzen M. Cortical spreading depression in migraine. Cephalalgia. 2001;21:757–60.

    Article  CAS  PubMed  Google Scholar 

  20. Cutrer FM, Sorensen AG, Weisskoff RM, et al. Perfusion-weighted imaging defects during spontaneous migrainous aura. Ann Neurol. 1998;43:25–31.

    Article  CAS  PubMed  Google Scholar 

  21. Sanchez DR, Bakker D, Wu O, et al. Perfusion weighted imaging during migraine: spontaneous visual aura and headache. Cephalalgia. 1999;19:701–7.

    Article  Google Scholar 

  22. Burstein R, Strassman A, Moskowitz M. Can cortical spreading depression activate central trigeminovascular neurons without peripheral input? Pitfalls of a new concept. Cephalalgia. 2012;32:509–11.

    Article  PubMed Central  PubMed  Google Scholar 

  23. • Levy D, Moskowitz MA, Noseda R, Burstein R. Activation of the migraine pain pathway by cortical spreading depression: do we need more evidence? Cephalalgia. 2012;32:581–2. There has been considerable discussion about the role of cortical vs. subcortical structures in the genesis of migraine pain. In this editorial, the authors strongly emphasize the role of cortical spreading depression in the etiology of migraine, highlighting the robustness of data.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Goadsby PJ. Migraine, aura, and cortical spreading depression: why are we still talking about it? Ann Neurol. 2001;49:4–6.

    Article  CAS  PubMed  Google Scholar 

  25. Schoenen J. Neurophysiological features of the migrainous brain. Neurol Sci. 2006;27 Suppl 2:S77–81.

    Article  PubMed  Google Scholar 

  26. Ayata C. Cortical spreading depression triggers migraine attack.: Pro. Headache. 2010;50:725–30.

    Article  PubMed  Google Scholar 

  27. Bolay H, Reuter U, Dunn AK, Huang Z, Boas DA, Moskowitz MA. Intrinsic brain activity triggers trigeminal meningeal afferents in a migraine model. Nat Med. 2002;8:136–42.

    Article  CAS  PubMed  Google Scholar 

  28. Ayata C, Jin H, Kudo C, Dalkara T, Moskowitz M. Supression of cortical spreading depression in migraine prophylaxis. Ann Neurol. 2006;59:652–61.

    Article  CAS  PubMed  Google Scholar 

  29. • Charles A. The Evolution of a Migraine Attack - A Review of Recent Evidence. Headache. 2012;53:413–9. Review paper discussing the several phases of migraine attacks in the light of neurophysiological changes.

    Article  PubMed  Google Scholar 

  30. Kelman L. The premonitory symptoms (prodrome): a tertiary care study of 893 migraineurs. Headache. 2004;44:865–72.

    Article  PubMed  Google Scholar 

  31. Denuelle M, Fabre N, Payoux P, Chollet F, Geraud G. Hypothalamic activation in spontaneous migraine attacks. Headache. 2007;47:1418–26.

    PubMed  Google Scholar 

  32. Valet M, Sprenger T, Boecker H, et al. Distraction modulates connectivity of the cingulo-frontal cortex and the midbrain during pain–an fMRI analysis. Pain. 2004;109:399–408.

    Article  PubMed  Google Scholar 

  33. •• Akerman S, Holland P, Goadsby PJ. Diencephalic and brainstem mechanisms in migraine. Nat Rev Neuroscience. 2011;12:570–84. Pivotal paper focusing on the role of subcortical structures in migraine. It highlights the role of the hypothalamus and of the orexin peptides in the modulation of pain.

    Article  CAS  Google Scholar 

  34. Weiller C, May A, Limmroth V, et al. Brain stem activation in spontaneous human migraine attacks. Nat Med. 1995;1:658–60.

    Article  CAS  PubMed  Google Scholar 

  35. Afridi SK, Giffin NJ, Kaube H, et al. A positron emission tomographic study in spontaneous migraine. Arch Neurol. 2005;62:1270–5.

    Article  PubMed  Google Scholar 

  36. Matharu MS, Bartsch T, Ward N, Frackowiak RS, Weiner R, Goadsby PJ. Central neuromodulation in chronic migraine patients with suboccipital stimulators: a PET study. Brain. 2004;127:220–30.

    Article  PubMed  Google Scholar 

  37. Bahra A, Matharu MS, Buchel C, Frackowiak RS, Goadsby PJ. Brainstem activation specific to migraine headache. Lancet. 2001;357:1016–7.

    Article  CAS  PubMed  Google Scholar 

  38. Raskin NH, Hosobuchi Y, Lamb S. Headache may arise from perturbation of brain. Headache. 1987;27:416–20.

    Article  CAS  PubMed  Google Scholar 

  39. Goadsby PJ. Neurovascular headache and a midbrain vascular malformation: evidence for a role of the brainstem in chronic migraine. Cephalalgia. 2002;22:107–11.

    Article  CAS  PubMed  Google Scholar 

  40. Obermann M, Gizewski ER, Limmroth V, Diener HC, Katsarava Z. Symptomatic migraine and pontine vascular malformation: evidence for a key role of the brainstem in the pathophysiology of chronic migraine. Cephalalgia. 2006;26:763–6.

    Article  CAS  PubMed  Google Scholar 

  41. Goadsby PJ, Edvinsson L, Ekman R. Vasoactive peptide release in the extracerebral circulation of humans during migraine headache. Ann Neurol. 1990;28:183–7.

    Article  CAS  PubMed  Google Scholar 

  42. Goadsby PJ, Edvinsson L, Ekman R. Release of vasoactive peptides in the extracerebral circulation of humans and the cat during activation of the trigeminovascular system. Ann Neurol. 1988;23:193–6.

    Article  CAS  PubMed  Google Scholar 

  43. Hargreaves R. New migraine and pain research. Headache 2007; Suppl 1:S26–S43.

  44. Markowitz S, Saito K, Moskowitz MA. Neurogenically mediated plasma extravasation in dura mater: effect of ergot alkaloids. A possible mechanism of action in vascular headache. Cephalalgia. 1988;8:83–91.

    Article  CAS  PubMed  Google Scholar 

  45. May A, Shepheard SL, Knorr M, et al. Retinal plasma extravasation in animals but not in humans: implications for the pathophysiology of migraine. Brain. 1998;121:1231–7.

    Article  PubMed  Google Scholar 

  46. Olesen J, Diener HC, Husstedt IW, et al. Calcitonin gene-related peptide receptor antagonist BIBN 4096 BS for the acute treatment of migraine. N Engl J Med. 2004;350:1104–10.

    Article  CAS  PubMed  Google Scholar 

  47. Cui Y, Kataoka Y, Inui T, et al. Up-regulated neuronal COX-2 expression after cortical spreading depression is involved in non-REM sleep induction in rats. J Neurosci Res. 2008;86:929–36.

    Article  CAS  PubMed  Google Scholar 

  48. Kalinchuk AV, Urrila AS, Alanko L, et al. Local energy depletion in the basal forebrain increases sleep. Eur J Neurosci. 2003;17:863–9.

    Article  PubMed  Google Scholar 

  49. • Faraguna U, Nelson A, Vyazovskiy VV, Cirelli C, Tononi G. Unilateral cortical spreading depression affects sleep need and induces molecular and electrophysiological signs of synaptic potentiation in vivo. Cereb Cortex. 2010;20:2939–47. Paper correlating the influence that unilateral cortical spreading depression would have on behavior.

    Article  PubMed  Google Scholar 

  50. Hastings MH, Herzog ED. Clock genes, oscillators and cellular networks in the suprachiasmatic nuclei. J Biol Rhythms. 2004; 400–413.

  51. Espana RA, Scammell TE. Sleep neurobiology from a clinical perspective. Sleep. 2011;34:845–58.

    PubMed  Google Scholar 

  52. Saper CB, Scammell TE, Lu J. Hypothalamic regulation of sleep and circadian rhythms. Nature. 2005;437:1257–63.

    Article  CAS  PubMed  Google Scholar 

  53. Siegel JM. Hypocretin (orexin): role in normal behavior and neuropathology. Annu Rev Psychol. 2004;55:125–48.

    Article  PubMed  Google Scholar 

  54. Gotter A, Webber AL, Coleman PJ, Renger JJ Winrow CJ. International Union of BAsic and Clinical Pharmacology. LXXXVI. Orexin receptor function, nomencalture and pharmacology. Pharmacol Rev. 2012;64:389–420.

    Article  CAS  PubMed  Google Scholar 

  55. Sakurai T. The neuronal circuit of orexin (hypocretin): maintaining sleep and wakefulness. Nat Rev Neurosci. 2007;8:171–81.

    Article  CAS  PubMed  Google Scholar 

  56. Hungs M, Mignot E. Hypocretin/orexin, sleep and narcolepsy. BioEssays. 2001;23:397–408.

    Article  CAS  PubMed  Google Scholar 

  57. Gotter AL, Roecker AJ, Hargreaves R, Coleman PJ, Winrow CJ, Renger JJ. Orexin receptors as therapeutic targets. Prog Brain Res. 2012;198:163–88.

    Article  CAS  PubMed  Google Scholar 

  58. Kajiyama S, Kawamoto M, Shiraishi S, et al. Spinal orexin-1 receptors mediate anti-hyperalgesic effects of intrathecally-administered orexins in diabetic neuropathic pain model rats. Brain Res. 2005;1044:76–86.

    Article  CAS  PubMed  Google Scholar 

  59. Mobarakeh JI, Takahashi K, Sakurada S, Nishino S, Watanabe H, Kato M, et al. Enhanced nociception by intraceebroventricularly and intrathecally adminsitered orexin A and B ( hypocretin 1 and 2) in mice. Peptides. 2005;26:767–77.

    Article  CAS  PubMed  Google Scholar 

  60. Bingham S, Davey PT, Babbs AJ, Irving EA, Sammons MJ, Wyles M, et al. Orexin-A an hypothalamic peptide with anlgesic properties. Pain. 2001;92:81–90.

    Article  CAS  PubMed  Google Scholar 

  61. Holland PR, Akerma S, Goadsby PJ. Orexin 1 receptor activation attenautes neurogenic dural vasodialtion in an animal model of trigeminovascular nocicpetion. J Pharm Exp Ther; 2005;315:1380–5.

    Article  CAS  Google Scholar 

  62. Holland PR, Akerman S, Goadsby PJ. Modulation of nociceptive dural input to the trigeminal nucleus caudalis via activation of the orexin 1 receptor in the rat. Eur J Neurosci. 2006;24:2825–33.

    Article  CAS  PubMed  Google Scholar 

  63. Benjamin L, Levy MJ, Lasalamdra MP, Knight YE, Akerman S, Classey JD, et al. Hypothalamic activation after stimulation of the superiro saggital sinus in the cat: a Fos study. Neurobiol Dis. 2004;16:500–5.

    Article  CAS  PubMed  Google Scholar 

  64. Bartsch T, Levy MJ, Knight YE, Goadsby PJ. Differential modulation of nociceptive dural input to [hypocretin] orexin A and B receptor activation in the posterior hypothalamic area. Pain. 2004;109:367–78.

    Article  CAS  PubMed  Google Scholar 

  65. Gatfield J, Brisbare-Roch C, Jenck F, Boss C. Orexin receptor antagonists: A new concept in CNS disorders? ChemMedChem. 2010;5:1197–214.

    Article  CAS  PubMed  Google Scholar 

  66. Hoffman J, Supronsinchai W, Akerman S, Winrow CJ, Renger JJ, Hargreaves R, et al. Nociceptive Trigeminal Neurotransmission Is Inhibited by the Dual Orexin Receptor Antagonist DORA-12. Cephalalgia. 2013;33(suppl):8–9.

    Google Scholar 

  67. Buijs RM, van Eden CG. The integration of stress by the hypothalamus, amygdala and prefrontal cortex: balance between the autonomic nervous system and the neuroendocrine system. Prog Brain Res. 2000;126:117–32.

    Article  CAS  PubMed  Google Scholar 

  68. Overeem S, van Vliet JA, Lammers GJ, Zitman FG, Swaab DF, Ferrari MD. The hypothalamus in episodic brain disorders. Lancet Neurol. 2002;1:437–44.

    Article  PubMed  Google Scholar 

  69. Trinder J, Kleiman J, Carrington M, Smith S, Breen S, Tan N, et al. Autonimic activty during human sleep as a function of time and sleep stage. J Sleep Res. 2001;10:253–64.

    Article  CAS  PubMed  Google Scholar 

  70. Chouchou F, Pichot V, Perchet C, Legrain V, Garcia-Larrea L, Roche F, et al. Autonomic pain responses during sleep. A study of heart rate variability. Eur J Pain. 2011;15:554–60.

    Article  CAS  PubMed  Google Scholar 

  71. Schwimmer H, Stauss HM, Abboud F, Hishino S, Mignot E, Zeitzer JM. Effects of sleep on the cardiovascular and thermopregulatory systems: a possible role for the hypocretins. J Appl Physiol. 2010;109:1053–63.

    Article  CAS  PubMed  Google Scholar 

  72. Lee MG, Hassani OK, Jones BE. Discharge of identified orexin/hypocretin neurons across the sleep-waking cycle. J Neurosci. 2005;25:6716–20.

    Article  CAS  PubMed  Google Scholar 

  73. De Lecea L. Hypocretins and the neurobiology of sleep-wake mechanisms. Prog Brain Res. 2012;198:15–23.

    Article  PubMed  Google Scholar 

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Conflict of Interest

Dr. Marcelo E. Bigal is a full-time employee and holds stock/stock options with Labrys biologics incorporation.

Dr. Richard J. Hargreaves is a full time employee and holds stock/stock options with Merck & Co.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Labrys Biologics Inc., 1810 Gateway Drive, Suite 230, San Mateo, CA, 94404, USA

    Marcelo E. Bigal

  2. Preclinical Research, Merck Inc., Whitehouse Station, NJ, USA

    Richard J. Hargreaves

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  1. Marcelo E. Bigal
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Correspondence to Marcelo E. Bigal.

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This article is part of the Topical Collection on Migraine

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Bigal, M.E., Hargreaves, R.J. Why Does Sleep Stop Migraine?. Curr Pain Headache Rep 17, 369 (2013). https://doi.org/10.1007/s11916-013-0369-0

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