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The month of June is Migraine and Headache Awareness Month. Our friends at the American Migraine Foundation shared a great story explaining how sleep disorders are linked to headaches and migraines.

Key Points:

• Sleep loss and oversleeping are common headache triggers.
• Regular, adequate sleep leads to fewer headaches.
• Common sleep disorders include: insomnia, sleep apnea, teeth grinding.
• Headaches that are linked to sleep include: wake-up headache and hypnic headache.

People living with migraine are between 2 and 8 times more likely to experience sleep disorders, compared with the general public. Those living with chronic migraine—which includes experiencing headache 15 or more days per month—report having almost twice the rates of insomnia as those with less frequent headaches. These higher-than-normal rates are due to migraine comorbidities and some migraine lifestyle factors that make good sleep harder to achieve. Fortunately, specific sleep patterns can be used to identify sleep disorders for treatment.

Common Sleep Disorders

Insomnia

The most common sleep problem for people living with migraine is insomnia. This includes difficulty falling or staying asleep, early morning awakenings and non-refreshing sleep. Insomnia impairs daytime functions, which results in fatigue, poor attention and concentration, and loss of motivation. In many cases, insomnia may stem from other chronic pain conditions, which makes it difficult to sleep comfortably and can disrupt normal sleeping patterns. For example, sleeping off a migraine attack in the day might delay your bedtime and throw your schedule off.

Providers diagnose insomnia with history or sleep diaries. Use a combined headache and sleep diary to diagnose insomnia and identify links between headache and sleep.

Snoring and Sleep Apnea

Regular snoring is a risk factor for chronic daily headache. Snoring may be the first sign of serious abnormal breathing, but not all snorers have obstructive sleep apnea, which is a condition that causes temporary pausing of breathing when asleep. Sleep apnea contributes to poor sleep routine; patients often awaken by headache or don’t feel rested after a full night’s sleep.

Symptoms of sleep apnea include apparent pauses in breathing, awakenings, nighttime urination, night sweats and daytime sleepiness. A significant proportion of sleep apnea-related headaches will improve or stop with the treatment of the apnea.

Teeth Grinding

Waking up with a dull, constant headache or sore jaw can be a symptom of excessive teeth grinding, which can contribute to temporomandibular disorders. While many people grind or clench their teeth from time to time, frequent teeth grinding—known as bruxism—can harm the teeth and be symptomatic of excessive stress and poor sleep.

Simple behavioral changes that target stress reduction, or the use of a mouthguard, can help prevent bruxism and the associated headache.

Types of Headaches Linked to Sleep

Wake-up Headache

The most common time for migraine to occur is in the early morning. People are vulnerable during the early morning because most over-the-counter and narcotic pain medications wear off in 4-8 hours, especially if they’re overusing those medications. Furthermore, many people will be asleep when the headache begins to emerge, missing the best time to take migraine medicines and rendering them less effective.

Hypnic Headache

Hypnic headache is a rare, primary headache disorder characterized by frequently occurring headaches that happen only during sleep. Sometimes known as “alarm clock” headaches because they occur at night and awaken the person from a sound sleep, these headaches can last between 15 minutes and 4 hours. Although these headaches usually occur without any other symptoms, some people report migraine-like symptoms like nausea, light or sound sensitivity that accompany their headache. If the diagnosis is in question, you may sometimes be referred to a sleep specialist to rule out more serious causes of headache.

Cluster Headache

Cluster headaches are another primary headache that may develop during sleep.  These excruciatingly severe attacks often develop within an hour of falling asleep.  The pain tends to be most severe in, around or behind one eye; last 20 minutes to 3 hours; and are associated with drooping of that eyelid, redness or tearing of the eye, or running or stuffiness of the nostril on the side of the pain.

The Link Between Sleep, Headache and Mood

The same brain regions and chemical messengers impact sleep, headache and mood, so inadequate or poor quality sleep increases the odds for headache and mood change. For example, people living with migraine who also experience insomnia often suffer from anxiety or depression, which are also common migraine comorbidities. An effective migraine treatment plan would factor in the patient’s medical history and psychological factors.

The Importance of Healthy Sleep

Behavioral sleep changes can promote restful, regular sleep and reduce headache. Simple changes like establishing consistent sleep and wake-up times, as well as getting between 7 and 8 hours of sleep a day, can make a world of difference. Experts also recommend avoiding substances that impair sleep, like caffeine, nicotine, and alcohol, and also suggest winding down before bed to prevent sleep problems. To hear about how members of our community stick to healthy sleep habits, read this article from our resource library.

From comorbidities to daily habits, many factors explain why a wide variety of sleep events trigger headache. Understanding your migraine and identifying simple lifestyle changes can make all the difference. As you embark on this journey, find the resources and support you need through our doctor-verified resource library and migraine support group.

May, marked officially as Military Appreciation Month, is a special month for both those in and out of the military.

Not only do we pause on Memorial Day to remember the sacrifice and service of those who gave all, but the month also holds several other military anniversaries and events, including Military Spouse Appreciation Day and Armed Forces day.

Our friends over at the American Academy of Sleep Medicine explain the risk of sleep apnea, insomnia, and nightmares for our veterans in an article by Kate Robards, with medical review by Virginia Skiba, MD.

Sleep problems affect everyone, but they are particularly common among military veterans. Recent studies of U.S. veterans highlight the prevalence of sleep disorders.

What sleep disorders are veterans likely to experience?

Veterans are exposed to stressful situations during military service. The stress of training, deployment, and returning to civilian life can impact sleep. The most common sleep disorders experienced by veterans include:

• Insomnia is the most common sleep complaint. It occurs when you have trouble falling asleep or staying asleep even though you had the opportunity to get a full night of sleep. Insomnia can affect your mood and make other medical conditions more difficult to manage.
• Nightmares may lead to sleep loss and, as a result, daytime sleepiness. Stress, anxiety, an irregular sleep routine or being overtired can increase your risk for nightmares. Having the same nightmare repeatedly over time can also be common after severe stress or a traumatic event.
• Obstructive sleep apnea, or OSA, is a common and serious sleep disorder that causes you to stop breathing during sleep. OSA can have a negative impact on your health. It may increase your risk of high blood pressure, heart disease, stroke, diabetes, and depression.

How are veterans impacted by sleep disorders?

A July 2021 study in the Journal of Clinical Sleep Medicine reported that undiagnosed and undertreated sleep disorders are common among veterans at risk for cardiovascular disease. In a sample of 420 veterans, more than half (52.1%) screened positive for sleep apnea.

In addition to a high prevalence of sleep apnea, many veterans experience insomnia as well.

A report published in the journal SLEEP found that in a study of more than 5,500 post-9/11 veterans, 57.2% had insomnia. This is much higher than the general population. Studies have found that about 30% of the general adult population experience insomnia.

The study also found that insomnia rates increased among veterans with certain conditions. More than 93% of veterans with PTSD also had insomnia. Also, 77.7% of veterans with a traumatic brain injury and 69.6% of veterans with chronic pain also had insomnia.

Older veterans may experience long-term sleep problems, too. One study found that many older veterans have reported sleep problems that began during or immediately following military service and have persisted for decades.

Sleep problems may be common among veterans, but they can be treated effectively.

If you are experiencing sleep problems, seek help from your primary care doctor at Veterans Affairs, use the Contact Us form, or call us at 866-337-2536.

April is Defeat Diabetes Month. Our friends over at Heatlhline.com have written the following article on how sleep apnea affects diabetes. We thought we’d share!

The impact of sleep apnea goes far beyond leaving you feeling tired in the morning. For people with diabetes, sleep apnea can influence your glucose levels at all times of day, change how your body responds to insulin, and play a part in diabetes complications later in life.

In the general population, an estimated 6 to 17 percent of adults experience some form of sleep apnea. But among those with diabetes, that number is dramatically higher with more than half of people with type 2 diabetes experiencing obstructive sleep apnea. Research shows it’s also quite high in those who live with type 1 diabetes.

Read on to learn more about the relationship between diabetes and sleep apnea, how it can impact your diabetes management and what you can do to address this breathing disorder that impacts sleep.

What is sleep apnea?

Sleep apnea happens when a person stops breathing while they are sleeping.

Unlike disrupted sleep, which can be caused by poor sleep hygiene or various physical or mental conditions, sleep apnea is a breathing disorder.

Signs of sleep apnea include the following:

• loud snoring
• gaps in breathing
• choking or gasping for air
• falling asleep during the day

Sleep apnea leaves the body deprived of oxygen which, in turn disrupts how the heart functions, blood pressure, and metabolism. These effects can be severe and make it crucial for people with diabetes to understand and treat sleep apnea when it occurs.

Of the three types of sleep apnea (central, obstructive, and complex), obstructive sleep apnea (OSA) is most common. With OSA the soft tissues at the back of the throat collapse, blocking the airway and interrupting the person’s breathing. OSA is associated with obesity but also happens in those who are not obese.

Why is sleep apnea more common in type 2 diabetes?

A symbiotic relationship has been observed between sleep apnea and type 2 diabetes. One seems to worsen the other, when left unaddressed.

Sleep apnea deprives the body of oxygen, which has a direct negative effect on glucose levels and insulin resistance. Its effect can be dramatic, promoting insulin resistance and changing glucose metabolism to the extent that OSA is associated with the development of type 2 diabetes.

Obesity is a recognized comorbidity of type 2 diabetes, and that comorbidity increases the likelihood or developing OSA. Fat deposits in the neck can impinge on the airway and abdominal fat can compress the chest wall—both constricting breathing while lying down or sleeping.

Does sleep apnea impact blood sugar?

Yes, it does.

When the body is deprived of oxygen the amount of carbon dioxide in the bloodstream increases. In this state insulin resistance increases leading to higher levels of glucose in the blood. Over time these persistently higher glucose levels lead to a higher A1C.

Beyond its effect on glucose levels, sleep apnea and other disruptions to sleep can negatively affect the progression of diabetes and the development of complications. The oxygen deprivation associated with poor quality sleep raises blood pressure and aggravates heart function. It’s associated with high blood pressure, heart disease, and stroke.

How to manage sleep apnea with diabetes?

Following the standard practices of effective diabetes management — keeping glucose levels in range, healthy food choices, exercising regularly, and taking medications as prescribed) — is a good starting point for managing sleep apnea. However, there is more that can be done.

• Begin with addressing any sinus or allergy issues that interfere with breathing clearly. This might include taking medication to keep the sinuses open and uncongested.
• Being overweight or obese is another condition to address in treating sleep apnea. By reducing weight there is less pressure on the chest cavity and less likelihood of fat in the airway passage. Addressing both of these decreases the likelihood of unobstructed breathing while sleeping.
• A continuous positive airway pressure (CPAP) machine can be prescribed, before our after an overnight sleep study is completed. The person wears a mask while sleeping. Attached to that mask is a hose and a device that delivers pressurized air. The pressurized air keeps the airway open, stopping disruptions to the person’s breathing.
• Surgery is also an option. These surgeries involve removing or shrinking the tissue at the back of the back of the mouth or top of the neck. By removing this soft tissue there is less likelihood that the airway will be obstructed while sleeping.

Using fitness trackers for monitoring sleep quality

A medical diagnosis of sleep apnea requires a formal sleep study where the person sleeps with sensors attached to their body and is monitored through the night.

But with the availability of fitness trackers and mobile apps, it’s become more common for people to track and record the quality of their sleep. This can be especially helpful when sleep apnea is suspected.

Importantly, a sleep or fitness tracker does not replace a medical professional’s diagnosis of sleep apnea. But it can help identify sleeping patterns to discuss with a medical professional.

Fitness trackers use a combination of sensors that measure body movement (restlessness), heart rate, and breathing rate to track sleep quality. These readings are then analyzed and reported in their app.

What the app reports varies by device, but can include things like:

• How long it took to fall asleep
• How long the person remained asleep
• How many times the person woke up through the night
• How long they stayed awake before going back to sleep
• How long the person stayed in various stages of sleep (light, deep, and REM)
• These individual readings are often combined into a composite score that reflects the overall quality of sleep (poor, fair, good, excellent).

The apps often also include information on how to improve overall sleep. This can include advice on improving sleep hygiene and notifications to reinforce a standard bedtime and daily routine for winding down.

Among the most popular fitness trackers, Fitbit, Apple Watch, Amazon Halo, and Oura Ring all offer some ability to track sleep. They all report on the amount of time the person is sleeping and the overall quality of that sleep.

Takeaway

Because of the negative effects sleep apnea can have on glucose levels it’s particularly important for people with diabetes to pay attention to the quality of their sleep. Left unaddressed, what seems like inconsequential snores in the night can lead to elevated A1Cs, high blood pressure, and heart problems.

Thankfully, we do have tools and treatments to identify and then address sleep apnea—ultimately avoiding the most serious complications.

Sources:

Original article: https://www.healthline.com/health/diabetes/sleep-apnea-and-diabetes

Senaratna C, et al. (2017). Prevalence of obstructive sleep apnea in the general population: A systematic review. https://pubmed.ncbi.nlm.nih.gov/27568340/

Muraki I, et al. (2018). Sleep apnea and type 2 diabetes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6123041/

Yano Y, et al. (2020). Sleep characteristics and Measurements of Glucose Metabolism in Blacks: The Jackson Heart Study. https://www.ahajournals.org/doi/10.1161/JAHA.119.013209

Farabi, S. (2016). Type 1 Diabetes and Sleep. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755454/

American Diabetes Association Standards of Care (2022). Glycemic Targets: Standards of Medical Care in Diabetes—2022. https://diabetesjournals.org/care/article/45/Supplement_1/S83/138927/6-Glycemic-Targets-Standards-of-Medical-Care-in

Sleep has an impact on every aspect of daily life. It affects your alertness, performance, physical health, and mental wellness. As you wrap up high school and start college, you’ll no doubt start to think about what career path is right for you.

When you choose to work in sleep medicine, you’re choosing to help millions of people. Watch this video from our friends at the American Academy of Sleep Medicine (AASM) to hear from leading professionals on why a career in sleep medicine is both rewarding and important.

Explore a Variety of Careers

The field of sleep medicine offers several interesting and exciting career options. Some careers include sleep physicians, surgeons, scientists, dentists, technologists, and psychologists. Each of these jobs requires different skills, education, and training. All of these careers allow you to have a positive impact on the health and well-being of others. Sleep is a growing field with more jobs available each year.

Why Choose Sleep?

Sleep medicine professionals provide vital medical care and promote healthy sleep habits. They also conduct research to improve the quality of sleep health care.

An estimated 70 million Americans experience a sleep disorder. Sleep disorders are linked to a variety of health problems. These include depression, diabetes, obesity, heart disease, and stroke. By choosing to work in one of the many jobs available in sleep medicine, you’re improving the health of millions of people.

A Career with SSM

We are growing! Take Your Next Step and Join the SSM Team! SSM Management provides a comprehensive solution to the state of Louisiana for the diagnosis and treatment of sleep disorders. Servicing every parish in the state, SSM welcomes individuals from all disciplines of the sleep care spectrum who are ready to learn, to grow, and to succeed! On-the-job sleep technologist training, competitive salary and benefits packages, and multiple upward-mobility career paths. For more information about the expanding opportunities in your area, call us at 1-866-337-2536 or fill out our contact form.

Every year, millions of people use the start of a new year as an opportunity for self-improvement, aspiring for personal change by setting New Year’s resolutions.

Health-related resolutions are some of the most common, with goals such as losing weight, exercising more often, and cessation of smoking leading the list of the most common resolutions.

Sleep is often overlooked in New Year’s resolutions, but it is one of the most fundamental steps to improving wellness. Sleeping better can not only enhance physical, mental, and emotional health but also generate the energy and self-control necessary to achieve other goals in the new year.

Properly planning a New Year’s sleep resolution can help you make a lasting change. Knowing how to craft and carry out your New Year’s sleep resolution can put you on the path to a healthier and more productive future.

Why Make a New Year’s Sleep Resolution?

A sleep resolution is a powerful tool for people looking to emphasize wellness and healthier living in the coming year. Sleep enables virtually all systems of the body to function effectively. It sharpens thinking and memory, strengthens physical health, and boosts mood and emotional regulation.

Sleep is also a lynchpin to achieving other goals. Getting enough sleep every night generates energy for exercise, helps with weight loss, enhances productivity at work, and fosters creative thinking.

Studies have found that getting quality sleep is associated with better self-control, which makes it easier to follow through on other resolutions. In addition, just developing consistent sleep habits may itself fuel self-control and the ability to continue striving toward goals even during times of difficulty.

While getting better sleep doesn’t have to be the only goal that you have for the new year, research demonstrates that it can have a positive impact on virtually all other New Year’s resolutions.

Tips for Making the Best New Year’s Sleep Resolutions

Just setting a New Year’s sleep resolution won’t do much good. What’s really important is creating a resolution that you can stick with, allowing you to benefit from better sleep.

There are many ways to successfully establish a new routine. However, experts suggest that one of the most effective ways to turn New Year’s resolutions into lasting habits is by using the SMART acronym:

• Specific: The goal should be clear rather than vague.
• Measurable: You should be able to easily track whether you’re meeting your goal.
• Achievable: The goals should be realistic, which often means small steps rather than trying to make wholesale changes in one fell swoop.
• Relevant: The resolution should matter to you, providing motivation to keep with it.
• Time-Bound: Plans for change should start with a set period of time, like 90 days, so you can see what works before making any changes.

For New Year’s sleep resolutions, another critical component is to zero in on things you can control, such as your sleep hygiene. By focusing on the process rather than outcomes, you can take advantage of the fact that humans are creatures of habit. Reinforcing healthy routines helps make behavior change feel automatic and, as a result, more sustainable.

If your resolution is based only on outcomes, such as sleeping better, you may be disappointed and give up if you don’t see quick results. Instead, a wiser approach emphasizes smaller steps that you can take to reshape sleep habits in a positive way. The following table gives examples of how to reframe your New Year’s sleep resolutions:

Instead of	Try	Why It Works
I will sleep better.	I will stop drinking caffeine after lunchtime because it can interfere with my sleep.	The first goal is too broad and hard to measure. The second offers a concrete step that you can track every day.
I will sleep eight hours per night.	I will be in bed with the lights out and my cell phone put away by 10:30 p.m. each night.	Even though the first goal is measurable, it’s too focused on an outcome alone that may not be fully under your control. The second resolution works to create a consistent sleep schedule that promotes healthy circadian rhythm and helps ensure you actually have enough time dedicated to getting the sleep you need.
I will fall asleep faster.	I will develop a three-step bedtime routine that I follow every night to help me relax before bed.	Opting for a practical plan to make it easier to fall asleep works to strengthen your sleep routines in a way that best suits your needs.
I will stop waking up so much during the night.	I will use an eye mask and earplugs to help prevent noise and light from disturbing my sleep.	No one can guarantee that they won’t wake up in the night, so a wise resolution focuses on what you can control and how to minimize the impact of external nuisances, like sound and light, on your sleep.
I will wake up feeling refreshed.	I will buy a new mattress and the best pillow to support my body and physical recovery.	Precise actions are more likely to generate meaningful outcomes, so a detailed resolution is a better bet to pay off.
I will stop snoring.	I will make an appointment with my doctor to discuss my snoring.	Sometimes the best resolution is to decide to get help from a professional. Loud snoring, especially with choking or gasping sounds, can be a sign of sleep apnea, which is a serious condition that is best treated under the guidance of a doctor.

The key to successful New Year’s sleep resolutions is turning your attention to tailored, concrete actions that represent daily changes to your habits and routines. By reinforcing healthy sleep hygiene, you can create lasting behavior change that promotes better sleep and all the wellness benefits that come with it.

Eric Suni is a staff writer for the Sleep Foundation. He has over a decade of experience as a science writer and was previously an information specialist for the National Cancer Institute. To read the original posting of this article on the Sleep Foundation website, please click here.