Why Does Your Migraine or Cluster Headaches Always Strike at the Same Time?

If you find yourself having headaches at the same time every day, you are not alone. Recent research reveals a clear biological explanation for this occurrence, and it all revolves around the body's internal clock, the circadian rhythm. A meta-analysis and an accompanying editorial were published today in the online issue of Neurology, the official journal of the American Academy of Neurology. A circadian pattern is evident in 71% of cluster headache patients and 50% of migraine sufferers, according to data on migraine and cluster headaches. According to the study's author, the findings help explain why headaches occur at predictable times and may pave the way for novel circadian-based therapeutic options.

Headaches Might Occur On a Regular Basis

"We discovered that a lot of cluster headache patients had headaches at the same time every day," said study author Mark Joseph Burish, M.D., Ph.D., of the University of Texas Health Science Center at Houston in Texas and a member of the American Academy of Neurology. "I had one patient who was becoming angry because it was taking so long to ask all the questions, and they said, 'If you can just wait 15 minutes, you'll see what my headache looks like,'" Burish remarked. "I was startled by how certain they were about the time of the headaches."

The meta-analysis validated what Burish and others suspected: headaches frequently correspond to the body's circadian rhythms. Cluster headaches and migraine, on the other hand, followed distinct patterns. Cluster headaches were discovered to be more common in the spring and fall, with attacks most commonly happening between late at night and early in the morning. Migraine, on the other hand, had a steady low ebb, with few episodes late at night and a large peak spanning late morning to early evening.

Burish believes that a better understanding of how and when headaches occur will lead to new strategies to treat them. Cluster headaches and migraine were both linked to circadian genes. Furthermore, levels of circadian-related hormones such as cortisol and melatonin were altered in patients with these headache problems compared to those who did not have them. Cluster headache patients had higher cortisol and lower melatonin levels, whereas migraine patients had lower melatonin levels.

"Maybe there are other genes or drugs that affect some of these fundamental genes or their circadian rhythms," he speculated. "It is a completely novel treatment that we could employ to aid these people."

These prospective new therapy options could make use of well-known substances, such as steroids and melatonin, which both impact the body's circadian cycles.

Burish explained, "Both of these are existing medications for cluster headaches and migraine." "Steroids, in the correct quantities, can prevent both cluster headaches and migraines, and melatonin can do the same." These are not perfect medicines, but there is promising evidence that changing circadian rhythms can aid patients."

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While it is still too early to apply these findings to meaningful treatment choices, Burish believes the data can help patients better understand why headaches arise daily. "There are stories of individuals who think they are allergic to a math class or anything like that because they get headaches every time they go," he said. "So this explains that it's not about trying to get out of class at 10 a.m. every day." This is how a headache works."

Regulating the Body's Internal Clock

Having a good sleep pattern, and hence healthy circadian rhythms, will not cure your headaches. Having said that, it's still worthwhile to understand how this process works and how a healthy routine might help your body.

According to Azizi Seixas, associate director of the Center for Translational Sleep and Circadian Studies at the University of Miami Miller School of Medicine, the process is controlled by the body's internal biological clock and repeats itself every 24 hours.

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"Circadian rhythms play an important role in regulating numerous physiological processes, such as sleep-wake cycles, hormone secretion, metabolism, immunological function, and cognitive functioning," he said. "When circadian rhythms are interrupted, it can harm these systems, resulting in weariness, mood disorders, and health issues like obesity, diabetes, and cardiovascular disease."

Setting - and sticking to - a consistent sleep pattern is the greatest advice for folks who feel like their internal clock is out of sync. "Try to sleep and wake up at the same time every day, including on weekends," Seixas suggested.

Another issue to consider is how light can influence circadian cycles. Avoiding bright light in the evening might help the body feel more rested. Bright light in the morning can assist reset the circadian clock and encourage alertness.

"Avoid stimulating activities like watching TV, using electronic gadgets, and exercising before bedtime," Seixas advises. "It also helps to create a calming sleep environment and restrict coffee and alcohol intake, especially in the evening." It is feasible to establish and maintain a good sleep and circadian schedule by following these best practices, which can lead to enhanced general health and well-being."

Source-Medindia