Sleep Study

  • Recent studies show how a migraine can be predicted.

    Sleep quality and energy levels are two of the biggest indicators of an impending migraine attack, the study showed. Get inspired by a weekly roundup on living well, made simple.  

    Wouldn’t it be helpful to have a sense of when a debilitating migraine may be on the way?

    You may be able to do so, a new study has shown.


    “The major finding from this study was that changes in sleep quality and energy on the prior day were related to incident headache in the next day,” said Dr. Kathleen Merikangas, principal investigator of the study that published Wednesday in the journal Neurology.

    Migraines are nothing to shake your head at, and they certainly aren’t just nuisance headaches. Chronic migraines are the leading cause of disability in people younger than 50, according to a February 2018 study.

    More symptoms than you think may be tied to your migraines

    The study team found that sleep quality and energy were important indicators of a migraine attack on the following day.

    Those who had bad sleep quality and low energy one day were more likely to have migraines the next morning, the data showed. An increase in energy and greater-than-average stress usually foretold a migraine would appear later the next day.

    “It’s a very exciting study because of how well done and how detailed and how large it is,” said Dr. Stewart Tepper, vice president of the New England Institute for Neurology and Headache in Stamford, Connecticut. Tepper was not involved in the research.

    The differences point to the importance of your circadian rhythm — which regulates your cycles of sleep and wakefulness — in how headaches manifest. The findings may inform the treatment and prevention of migraine attacks.

    Migraine prevention

    Knowing when a migraine is coming can make all the difference — especially with growing interest in treating one before it starts, Tepper said.

    “If we can identify things in the environment that people can change, then we’d like to be able to prevent the attack in the first place,” Merikangas said. “If we can do that with behavioral interventions … then they may be able to prevent it by either going to sleep to offset it or some other intervention that would prevent us from having to use medication to prevent the attack.”

    Tepper, however, said he is not so sure if changes in behavior can always prevent a migraine attack.

    FDA approves new nasal spray to treat migraine headaches in adults, Pfizer says

    A migraine attack isn’t just a headache. And warning signs such as fatigue, neck pain and sleep disturbance may be early symptoms of an attack — not only a trigger of one, he added.

    Instead, Tepper advises intervening with medication before the head pain starts in hopes of warding off any pain at all.

    How much is too much?

    It makes sense that people might be conservative about using medication for migraine pain, Tepper said.

    An older class of medications, called triptans, was associated with more migraines and a resulting chronic migraine condition if used more than 10 days in a month, he said.

    But a newer option, rimegepant — sold as Nurtec — doesn’t seem to carry the same risk.

    “There’s no downside because rimegepant has almost no side effects and is not associated with transformation into chronic migraine,” Tepper said.

    What you can do about migraines

    Your doctor can recommend pain medication to address your migraines, but it also helps to know the signs of an upcoming attack, Tepper said.

    As well as monitoring sleep, exercise and diet, Merikangas suggests finding a way to monitor stress to be able to track the indicators of a migraine.

    There are five typical signs of an oncoming migraine headache, Tepper said. Those are sensitivity to light, fatigue, neck pain, and sensitivity to noise and dizziness, he said.

    5 ways to reduce your stress this year

    Cognitive behavioral therapy is often useful to help manage the stress that can trigger migraine attacks. What’s more, taking vitamins and supplements, such as magnesium and riboflavin, can be effective in reducing migraine frequency, Kylie Petrarca, a nurse and education program director at the Association of Migraine Disorders, said in a previous CNN article.

    It isn’t just about avoiding the pain, Merikangas said.

    “It’s really important to think of the full context of our health,” she said. “By being able to characterize not just headaches, but also all these other systems, we might be able then to get a handle on causes of negative health events.”

  • From Caffeine to Screens: Everyday Habits That Might Be Ruining Your Sleep

    A peaceful night’s sleep often remains an elusive dream for many, with daily habits being significant culprits. The subtle interplay of what we consume, our digital indulgence, and even our bedtime activities can significantly influence the quality of our slumber.

    What Habits Could Ruin Your Sleep?

    Take caffeine, for example. Renowned as a morning pick-me-up, caffeine does more than just jolt you awake. Research suggests that caffeine can linger in your system for 3 to 5 hours, potentially disrupting the sleep cycle. To circumvent this, consider wrapping up your caffeine consumption by early afternoon. If you’re hankering for a warm drink later on, herbal tea, notably devoid of caffeine, could be your go-to.

    Then there’s the omnipresent screen. The blue light emitted from our beloved devices is notorious for meddling with our melatonin production, a hormone pivotal for sleep. Frequent screen interaction, particularly in the twilight hours, could spell sleep trouble. Employing blue light filters on gadgets or designating the hour before bed as screen-free could pave the way for better rest.

    Late-night munching, though seemingly harmless, brings its set of sleep challenges. Certain foods, notably those rich in spice or acid, can potentially disrupt sleep. In case of late-night hunger pangs, foods like bananas or almonds, known to promote sleep, might be apt choices.

    But Wait, There’s More

    Alcohol, contrary to popular belief, isn’t the sleep ally it’s made out to be. While it might propel you into slumber initially, it notably compromises sleep quality, especially the NREM and REM phase, vital for memory and mood regulation. Moderating alcohol intake or consuming it well before bedtime could better your sleep odds.

    Engaging in rigorous physical activity late in the evening or succumbing to stress-laden thoughts can keep sleep at bay. The adrenaline surge post an intense workout can push sleep away, while stress can send the mind into an overdrive. Positioning workouts earlier in the day and carving out pre-bed relaxation routines can be beneficial.

    Lastly, the ambiance of your sleep quarters wields considerable influence. Studies emphasize the correlation between optimal room temperature and enhanced sleep quality. Moreover, noise can disturb sleep, impeding its depth and quality. Fine-tuning room temperature and possibly integrating tools like white noise machines can make a tangible difference.

    Better Habits is Better Sleep

    In sum, our day-to-day habits silently script our sleep narrative. Tweaking these can be a step towards improved sleep and, by extension, heightened well-being. For those keen on further sleep enhancement, exploring specialized sleep solutions or engaging with experts can provide tailored recommendations.


    [1]: Clark, I., & Landolt, H. P. (2017). Coffee, caffeine, and sleep: A systematic review of epidemiological studies and randomized controlled trials. Sleep Medicine Reviews, 31, 70-78.

    [2]: Gooley, J. J., Chamberlain, K., Smith, K. A., Khalsa, S. B. S., Rajaratnam, S. M. W., Van Reen, E., … & Lockley, S. W. (2011). Exposure to room light before bedtime suppresses melatonin onset and shortens melatonin duration in humans. The Journal of Clinical Endocrinology & Metabolism, 96(3), E463-E472.

    [3]: St-Onge, M. P., Mikic, A., & Pietrolungo, C. E. (2016). Effects of diet on sleep quality. Advances in Nutrition, 7(5), 938-949.

    [4]: Ebrahim, I. O., Shapiro, C. M., Williams, A. J., & Fenwick, P. B. (2013). Alcohol and sleep I: effects on normal sleep. Alcoholism: Clinical and Experimental Research, 37(4), 539-549.

    [5]: Stutz, J., Eiholzer, R., & Spengler, C. M. (2019). Effects of evening exercise on sleep in healthy participants: A systematic review and meta-analysis. Sports Medicine, 49(2), 269-287.

    [6]: Okamoto-Mizuno, K., & Mizuno, K. (2012). Effects of thermal environment on sleep and circadian rhythm. Journal of Physiological Anthropology, 31(1), 1-9.

    [7]: Basner, M., & McGuire, S. (2018). WHO environmental noise guidelines for the European region: A systematic review on environmental noise and effects on sleep. International Journal of Environmental Research and Public Health, 15(3), 519.

    February 6, 2024

  • Doctors’ Group Warns Sleep and Sound Machines May Be Too Loud for Kids

    Original Article | Good Morning America

    The American Academy of Pediatrics is warning parents and caregivers that excessive exposure to loud noises can be detrimental to children, and sound machines can cause more harm to children than previously thought.

    In a statement released Saturday, the AAP said: “What families may not realize is that children are exposed to potentially harmful noise from infancy and that the effects are cumulative over a lifetime.”

    ABC News medical correspondent Dr. Darien Sutton told “Good Morning America” that millions of children are at risk of some form of hearing loss.

    “One of the reasons why is because children have smaller ear canals. That exposes them to intensification of that higher frequency sound and [makes] them at risk for damage,” Sutton explained.

    According to one study published in BMJ Global Health in 2022, more than 1 billion young people are at risk of hearing loss around the world due to unsafe high listening volumes. The AAP cited another study that estimated 60% of adolescents listened to music and audio that was greater than the maximum recommended daily noise intake of 85 decibels averaged over eight hours, a standard that is also for adults and not children.

    “The average volume that kids listen to music at is 70 to 100 [decibels],” Sutton said. “That’s the upper limit of normal or the range for most of our headphone outputs.”

    “Now, noise above 70 [decibels] for prolonged periods of time can cause damage. Noise at 100, which is the maximum, can cause damage in minutes. And noise over 120 can cause immediate harm,” Sutton continued. “So it’s important to pay attention to those volume settings [and] keep them at least 60 to 70% total.”

    With sound machines, often used to lull infants and children to sleep, the AAP warns that they are often too loud for healthy listening.

    “The AAP recommends that parents and caregivers consider that if an environment sounds too loud for an adult, it probably is too loud for a child. ‘Too loud’ can mean having to raise your voice to speak with someone just an arm’s length away,” the pediatricians’ group said.

    “The Academy of Pediatrics recommends, for example, that nurseries have a volume maximum of around 50 decibels,” Sutton said. “That’s a volume that you and I can speak at without raising our voice. Most of these machines go above that. So if you’re going to use them, turn that volume down, place it away from the bed at least seven feet and make sure that you give limits.”

    Signs of hearing loss in children

    • Early speech and language delays
    • No reaction or a startled reaction to loud noises
    • Trouble hearing at schools

    Sutton recommended parents pay attention to their child’s communication.

    “It’s about paying attention to that communication. If you’re finding that your child is speaking loudly, having difficulties with pronunciation, if you’re finding that they’re not reacting to loud noises — these are all some of the reasons why you should get them checked, their hearing checked, because it can help with their learning comprehension and, of course, reduce their risk long-term,” Sutton said.

  • Too Little Sleep Might Raise a Woman’s Odds for Diabetes

    Original Article | Dennis Thompson, Published in HealthDay Magazine

    Key Takeaways

    • Women who get poor sleep might have an increased risk of diabetes
    • Getting just 90 minutes less sleep increased insulin resistance in women
    • Researchers will look at whether better sleep helps control diabetes

    TUESDAY, Nov. 14, 2023 (HealthDay News) — Women who don’t get enough sleep might have an increased risk of diabetes, an effect even more pronounced in postmenopausal females, a new study finds.

    Shortening sleep by just 90 minutes increased insulin resistance in women used to getting adequate sleep, researchers at Columbia University.

    The findings are the first to show that even a mild sleep deficit maintained for six weeks can raise the risk of diabetes, researchers said.

    “Throughout their lifespan, women face many changes in their sleep habits due to childbearing, child-rearing and menopause,” said lead researcher Marie-Pierre St-Onge, director of the Center of Excellence for Sleep and Circadian Research at Columbia University in New York City. “And more women than men have the perception they aren’t getting enough sleep.”

    For this study, St-Onge and her colleagues enrolled 38 healthy women, 11 of whom had gone through menopause.

    All of the women routinely slept at least seven hours each night. The recommended amount of sleep for optimal health is between seven and nine hours, researchers said, but about a third of Americans get less sleep than that.

    Each of the women were asked to participate in two different phases of the study, in random order.

    Women were asked to maintain their regular adequate sleep in one phase, but in the other phase they were asked to delay their bedtime by an hour and a half, shortening their total sleep to around six hours. Each phase lasted six weeks.

    Curtailing sleep by 90 minutes for six weeks increased fasting insulin levels by more than 12% overall, and by 15% among premenopausal women.

    Insulin resistance increased by nearly 15% overall, and by more than 20% among postmenopausal women.

    Average blood sugar levels remained stable for all participants throughout the study, but researchers said the changes in insulin resistance could cause them to start rising in the long-term.

    Although increased belly fat is a key driver of insulin resistance, the researchers found that the effects of sleep loss on insulin resistance were not linked to any increases in fat.  

    “The fact that we saw these results independent of any changes in body fat, which is a known risk factor for type 2 diabetes, speaks to the impact of mild sleep reduction on insulin-producing cells and metabolism,” St-Onge said.  

    Researchers will next investigate whether better sleep can improve blood sugar control and glucose metabolism.

    The study was published Nov. 13 in the journal Diabetes Care.

    More information

    The U.S. Centers for Disease Control and Prevention has more about sleep and diabetes.

    SOURCE: Columbia University, news release, Nov. 13, 2023

  • Sleep Disturbances Common in Patients Who Recovered from COVID

    Original Article | Jun 6, 2022 | Sleep Review Magazine

    Nearly all patients who recovered from COVID-19 report lingering fatigue, while half experience sleep disturbances, according to a recent analysis from Cleveland Clinic. Researchers found that race, obesity, and mood disorders are contributors. 

    Investigators analyzed data from 962 patients from the Cleveland Clinic ReCOVer Clinic between February 2021 and April 2022. The patients were recovered from COVID-19 and completed the sleep disturbance and fatigue questionnaires of the Patient-Reported Outcomes Measurement Information System. More than two-thirds of patients (67.2%) reported at least moderate fatigue, while 21.8% reported severe fatigue. Eight percent of patients reported severe sleep disturbances, and 41.3% reported at least moderate sleep disturbances.  

    “Sleep difficulties are highly prevalent and debilitating symptoms reported in patients with post-acute sequealae of COVID-19,” says Cinthya Pena Orbea, MD, a sleep specialist at Cleveland Clinic, in a release. “Our study suggests that the prevalence of moderate to severe sleep disturbances is high and that Black race confers increased odds to suffer from moderate to severe sleep disturbances highlighting the importance to further understand race-specific determinants of sleep disturbances in order to develop race-specific interventions.” 

    Patients with moderate-to-severe compared with normal-to-mild sleep disturbances had higher body mass indices, were more likely to be Black, and had worse general anxiety disorder.  

    After adjusting for demographics, Black patients were three times more likely to experience moderate-to-severe sleep disturbances. 

    The research abstract was published recently in an online supplement of the journal Sleep and will be presented June 6 and 7 during SLEEP 2022.

    Photo 188719463 © Robert Knesc

  • Restricted Sleep Increases Some Symptoms of Migraine, Study Finds

    Original Article | Sleep Review

    PharmacyTimes: Using a transcranial magnetic stimulation method, researchers have found that reduced sleep alters central nervous inhibition from GABAergic and dopaminergic mechanisms differently in individuals with migraines versus those without.

    Migraine is a primary headache disorder with a well-established association with insufficient sleep. According to the study, migraine affects approximately 15% of adults aged 15 to 64 globally and is the leading cause for years lived with disability below 50 years of age. Many patients with migraine report problems with sleep, headaches upon awakening, and using sleep as a way to avoid a headache. Researchers have also found worse sleep quality compared to individuals without migraines, as well as an increased likelihood for insomnia-like sleep patterns among individuals with migraines.

    Sleep restriction with about 50% sleep for 2 nights is a human experimental model of insufficient sleep, according to researchers. In healthy subjects, sleep deprivation may alter cortical inhibitory and facilitatory systems, and seems to increase pain sensitivity. Increased sensitivity to pain has previously been discovered in patients with migraine and may be associated with both increased homeostatic sleep pressure caused by increased need for sleep as well as reduced intracortical inhibition.

    Despite these findings, both the underlying pathophysiology of the disease and its relationship with sleep are unexplained. In order to investigate this association further, researchers applied transcranial magnetic stimulation to analyze possible mechanisms of insufficient sleep in patients with migraine.

    According to the analysis, sleep restriction had an opposite effect on cortical silent period duration in interictal migraines and controls. The cortical silent period refers to an interruption of voluntary muscle contraction by stimulating the contralateral motor cortex. With sleep restriction, this period was reduced from 147.9 minutes to 139.6 minutes. This impact was still significant when replacing sleep condition with measured sleep time in minutes.

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