"The night is half of health" – an old saying that high performers often ignore. However, for those suffering from migraines, sleep is not just rest but a therapeutic lever. By adjusting their evening habits, individuals can reduce attacks, regain control, and truly start their mornings with enhanced performance.

Migraine is a neurological disorder characterized by recurrent, often unilateral headaches accompanied by nausea, and sensitivity to light or noise. It is associated with altered cortical excitability and cortical spreading depressiona traveling wave of excitation in the cortex that can trigger migraine processes. Sleep acts as a timekeeper in this context. The circadian rhythm24-hour sleep-wake cycle of the body and sleep architecturethe sequence of sleep stages such as Non-REM and REM influence pain processing, inflammatory mediators, and neuronal inhibition. Small shifts – going to bed late, restless nights, stimulating beverages – can lower the threshold for an attack. Conversely, consistent sleep stabilizes neuronal inhibitory mechanisms and makes the brain "more resistant" to migraines.

Sleep deprivation is not only unpleasant; it measurably alters brain physiology: insufficient sleep weakens GABAergic inhibition – the body's "noise suppression" in the brain – thereby increasing the susceptibility to attacks ^[1]. Animal data show that acute sleep deprivation increases the susceptibility to the triggering brain wave of migraines; this explains why "powering through" can provoke attacks ^[2]. Clinically, patients also report that many attacks occur immediately after waking – diary entries reveal that nights prior to an attack are shorter and of poorer quality; frequent early awakenings are typical ^[3]. Additionally, irregular sleep times and shift work seem to increase risk, as they destabilize the sleep-wake cycle – although the evidence remains heterogeneous ^[4][5].

Several new studies are focusing on sleep habits as a therapeutic lever. In a crossover-controlled study with migraine patients, restricted sleep led to measurable dysfunction of cortical inhibition – particularly around the time of an attack. This suggests that adequate sleep stabilizes neural balance and protects the recovery phase after attacks ^[1]. In experimental studies, acute sleep deprivation showed increased susceptibility to cortical spreading depression, the electrophysiological trigger of migraines. This provides a plausible mechanism for why "a short night" can lead to an attack the next day ^[2]. Lifestyle interventions also appear promising: a small randomized study tested a combined sleep and exercise program in affected individuals. Result: longer sleep duration, high feasibility, and reduced anxiety – important factors for mitigating attacks and stabilizing daily performance ^[6]. Additionally, relaxation has a dual effect: in an intervention study with pregnant women, relaxation, physiotherapy, and structured training reduced migraine frequency and improved sleep quality – safely and without medication ^[7]. An intensive meditation training over the course of a year also reduced migraine days and medication use; effects on sleep quality and stress persisted – indicating that mental practice can strengthen the "internal brake" over the long term ^[8]. Finally, large diary analyses show: nights before attacks are shorter and more restless; a sleep diary makes such patterns visible and manageable ^[3][9].

- Three hours before sleep: no caffeine, no alcohol. Both destabilize sleep and can increase the chance of an attack on the same day ^[10].
- 10–15 minutes of relaxation as an evening ritual: e.g., breathing meditation (4-6 breathing) or progressive muscle relaxation. Evidence shows fewer migraine days, better sleep, and lower stress – even during sensitive periods like pregnancy ^[7]; effects may persist long-term ^[8].
- Keep a sleep diary (digital or paper): falling asleep/waking time, duration, interruptions, caffeine/alcohol, exercise, stress, occurrence/intensity of migraines. This helps identify triggers and "risk constellations" such as early awakenings or short nights ^[3][9].
- Prioritize regularity: fixed bedtime and wake-up time (±30 minutes) – even on weekends. A stable rhythm reduces vulnerability, especially when shift work or irregular days are involved ^[4][5].
- Incorporate daily exercise: 30–45 minutes moderately (e.g., brisk walking, cycling), ideally before early evening. Studies show that a combined exercise-sleep program extended sleep duration and was easily implementable – a foundational aspect of migraine prophylaxis ^[6].

Sleep is not a luxury for migraine sufferers – it is therapy. Start today: an evening relaxation ritual, three caffeine-free hours before bedtime, fixed times, and a sleep diary. In two weeks, you will see patterns – and noticeably regain control and energy.