Headaches and migraines can occur at any time of the day or night. Unfortunately, nocturnal headaches often feel more intrusive than daytime headaches, because we’re unable to distract ourselves from the pain when we’re lying in bed.
Headaches can be triggered by lifestyle factors, health complaints, sleep disorders, or psychiatric conditions. In this article, we’ll identify the different types of headaches and their unique causes. As we’ll explore, it’s possible to alleviate the pain associated with headaches. Also, there are several ways you can prevent headaches from ruining your sleep.
Why Do I Get Headaches at Nighttime?
If you experience headaches when going to sleep, ask yourself whether you’re tired. Extreme tiredness is one of the leading causes of headaches. Additional risk factors include:
- Chronic Stress –Stress initiates physical and hormonal changes in the body which can trigger a migraine. If we accumulate stress throughout the day and don’t take time to relax in the evening – we’re more likely to get a headache at bedtime.
- Anxiety Disorders– The link between anxiety and migraines is well documented but poorly understood. Both of these conditions are associated with dizziness and vertigo, which is linked to inner ear functioning. Anxiety and migraine symptoms (such as dizziness) may be exacerbated by lying down in bed.
- Medication – Starting a new type of medication may trigger nocturnal headaches, particularly if you’ve been taking the medicine before bed.
- Hormones– Pregnancy, menopause, and the menstrual cycle can trigger headaches. Women who take hormonal birth control pills immediately before bedtime may be more likely to experience nighttime headaches. The hormone melatonin may also have a role to play in headaches and migraines.
- Bedroom Environment – Flickering lights, the glare from electronics, or the strong-smelling fabric conditioner on your bed linen could trigger a migraine.
- Poor Sleep Posture –Unhealthy sleeping positions may trigger headaches. Also, some people develop headaches while sleeping lying down very flat to the mattress.
- Old Age – If you’re over 60, and you’re experiencing headaches that wake you from sleep, you could be suffering from hypnic headaches or cluster headaches. We’ll show you how to differentiate hypnic headaches from other types of headaches later in this article.
- Dietary Influences – Late-night snacks and evening nightcaps can trigger nocturnal headaches – there’s also the morning hangover to contend with if you drink one-too-many nightcaps.
- Obstructive Sleep Apnea – If you suffer from sleep apnea, you’re more likely to experience nocturnal headaches. There are many reasons for this – as we’ll explore in more detail later.
What’s the Link Between Migraines and Insomnia?
If you go to bed with a throbbing migraine, you won’t fall asleep until much later than normal. What’s more, if you keep waking up in the middle of the night with a headache, you’ll struggle to get enough good-quality, restorative sleep.
Indeed, according to a recent study published by Wiley Online, 85% of migraine sufferers say they have poor-quality sleep and feel groggy in the morning. As such, it’s easy to see how nocturnal migraines could cause insomnia.
However, according to the American Migraine Foundation, the link between migraines and sleep disorders is not a straight-forward one. There is a two-way link between these conditions. Migraines might cause insomnia, but insomnia may also cause migraines.
This is the reason why improving your sleep hygiene will usually help to alleviate your nocturnal migraines. A little later, we’ll show you how to improve your sleep hygiene to prevent insomnia and migraines.
Are Headaches and Migraines Common?
Approximately 36 million Americans suffer from migraines or headaches, which equates to roughly 1 in 9 people. Unfortunately, it’s thought that just one-third of migraine sufferers discuss their condition with other people. This could be because they don’t believe they will be taken seriously, or because they think they should be able to “deal” with a headache.
Although migraines affect people of every race, age, and gender – some groups are more susceptible to this condition. According to a recent report, women in their reproductive years are most likely to suffer from headaches and migraines.
There is a genetic component to this condition; if both of your parents suffer from migraines, you have a 75% chance of developing them yourself. Although migraines can be managed, there is currently no cure for them.
It’s quite common to experience headaches sporadically throughout the circadian cycle (24-hour biological clock). It’s less common to experience headaches exclusively at nighttime.
Should I Be Worried About Nighttime Headaches?
Nighttime headaches are not necessarily a cause for concern. If you’ve started to experience head pain, eliminate the simplest explanations first. Are you tired, stressed, or coming down with the flu? Are you dehydrated, hungry, or going through some hormonal changes?
If you can’t find an obvious cause for your nocturnal headaches, it’s a good idea to visit your doctor for evaluation. If the following applies to you, you should not delay seeing a doctor:
- You’ve adjusted your lifestyle and tried OTC medicine, but your symptoms are not improving
- The frequency or severity of your headaches has suddenly worsened
- You have a complex medical history (particularly if you have a weakened immune system or have had cancer in the past)
- You are experiencing visual disturbances with your migraines that last for many hours at a time
- You experience confusion, vomiting, poor balance, or have severe pain in your eyes
- You started experiencing headaches after taking medication
- You have been diagnosed with a sleep disorder, or you suspect you have a sleep disorder (insomnia, sleep apnea, narcolepsy, etc.)
- You only ever experience headaches at night, and the headaches are waking you up from sleep
After an initial evaluation, your doctor may refer you to a headache specialist or a neurologist. These health professionals may perform a brain scan or carry out additional tests to determine the cause of your headaches.
According to the American Migraine Foundation, you should keep a headache journal while you’re waiting for an appointment or referral. This information will be beneficial to any doctor that treats you so try to record as much information as you can.
Nighttime headaches that occur solely at nighttime may indicate a sleeping disorder, so further investigation is usually required. Nighttime headaches that occur solely at nighttime are slightly more concerning for doctors than daytime headaches. In very rare cases, head pain at night can be one of the first symptoms of a brain tumor. Brain tumors are extremely rare, and most headaches do not have such a serious cause.
Do I Have a Headache or a Migraine?
These two terms are often used interchangeably, but they are slightly different conditions. It’s useful to distinguish between headaches and migraines because they often have different causes and may be treated in slightly different ways.
In terms of severity, a headache is usually mild-to-moderate in intensity, whereas a migraine is moderate-to-severe. Headaches are often felt in the temples and across both sides of the head. Conversely, migraine pain is usually isolated to the right or the left side of the head. Headaches give you the sensation of feeling bunged-up, lethargic, or under-pressure, whereas migraines are generally characterized by a jabbing or pulsating sensation. Finally, people with migraines often suffer additional symptoms such as vomiting, poor balance, or visual disturbances, whereas people with headaches do not. (There are exceptions to these rules, but this covers the main differences between the two conditions).
Most types of headaches and migraines can occur at any time during the circadian cycle (morning, noon, or night). However, there are three types of headaches that are experienced almost exclusively during the night.
On the other hand, there is no type of migraine that occurs exclusively at night. That’s not to say that your nighttime head pain is not caused by a migraine – as everyone experiences symptoms differently. However, if you’re experiencing pain only at night, this might suggest you’re contending with a headache rather than a migraine.
Below we’ll explore the main types of headaches and migraines, and the illnesses or lifestyle factors they’re associated with.
What Are the Types of Headaches?
There are six main types of headaches. Chronic paroxysmal hemicrania, hypnic headaches, and cluster headaches are very rare disorders but are worth mentioning here because they tend to occur exclusively at night. In the International Classification of Sleep Disorders, they are referred to as “sleep-related headaches.”
Pressure and Tension Headaches
Tension headaches are the most common type of headache; most people will experience these during their lifetime. A heavy ache is typically felt at the temples or behind the ears. Often, pain radiates back-and-forth between these two areas. The pressure is often felt bilaterally (on both sides of the head) and can make you feel sluggish. Tension headaches can be triggered by tiredness, dehydration, or stress.
Our sinuses are the hollow spaces between our nose, cheekbones, and eyes. Allergic reactions (such as hay fever) can cause the sinuses to swell and become congested. Also, after catching the flu, our sinuses might become infected with a virus, causing them to swell and become tender. Both conditions can lead to a sinus headache.
Indeed, people suffering from influenza or hay fever find it hard to sleep because of their symptoms. If you’ve developed a sinus headache, you’ll experience facial pain in addition to your headaches. Facial pain is usually felt around your forehead, cheeks, and eyes.
These types of headaches develop at that back of the head and are caused by neck or spinal injuries, or poor posture. You can differentiate these types of headaches from others because the pain will usually linger at the back of the head and won’t radiate elsewhere.
People who have been injured in road traffic accidents often complain of cervicogenic headaches for several weeks after the incident. These headaches are often made worse by standing or sleeping in an unhealthy position. Physical therapy, improving your sleep posture, and sleeping with a cervical pillow will usually alleviate this type of head pain.
Often referred to as “suicide headaches” cluster headaches are the most painful headaches of all. Cluster headaches are three times more common in men than women and are more likely to occur in people who suffer from obstructive sleep apnea or who smoke heavily. This is a rare condition, affecting approximately 1 in 1000 Americans. Cluster headaches are sometimes misdiagnosed as sinus headaches, so it’s difficult to determine their true prevalence.
If you’re experiencing excruciating headaches that wake you up from sleep, you could be suffering from this condition. Cluster headaches start around one after the sufferer has fallen asleep (during or towards the end of their first REM sleep cycle). Each cluster headache lasts between 15 and 90 minutes.
An intense burning sensation will start on one side of the head, just above the eyes. The eyes swell up, become red, or start to weep. Some people feel as if their scalp or face is on fire, and something is poking them in the eye.
It would be almost impossible to sit or lay still during a cluster headache. Many sufferers will pace up and down quickly, pull at their hair, or rub their eyes furiously to find relief. It’s important for sufferers to manage their behavior and to establish some safe ways to find relief, to avoid self-injury. Oxygen treatments are effective for most people but can take 5-10 minutes to kick in.
Chronic Paroxysmal Hemicrania
This condition is similar to cluster headaches, but there are a few fundamental differences. Chronic paroxysmal hemicrania is seven times more likely to occur in females than in males. Also, CPH attacks can be provoked by moving the neck suddenly, whereas cluster headaches are not generally triggered in this way.
CPH attacks are more frequent than cluster headaches, but their duration is shorter. CPH is a very rare disorder (rarer than cluster headaches), but its diagnosis is on the rise according to the American Migraine Association.
The pain starts in the orbital region (above the eye) and can last for 5 – 30 minutes. Someone suffering from CPH could have several attacks during the night. CPH pain is unilateral (it remains on one side of the head), so some people mistake it for a migraine. However, CPH can be differentiated from a migraine because there are no physical symptoms like vomiting or vertigo. The only physical symptom sometimes experienced is a sore or itchy eye.
Hypnic headaches are also relatively rare, but they are worth mentioning here because they only occur during sleep. This type of headache usually affects people over 60, though some people in their forties or fifties have been known to suffer from hypnic headaches. This particular headache wakes you up from sleep, usually between 1 am and 3 am. For this reason, it is sometimes referred to as the “alarm clock” headache.
Pain can be unilateral or bilateral and is occasionally accompanied by a running nose. A headache can last between 10 minutes and 6 hours. Although these headaches are irritating, the pain is usually bearable– which distinguishes them from cluster headaches or CPH. So, if you’ve been experiencing mild-to-moderate headaches during the night, and you’re over 40 years of age, you could be suffering from hypnic headaches.
What Are the Types of Migraines?
There are several different types of a migraine; most migraines can occur at any time of the day or night. If you experience any of the following migraines more than 14 times in one month, you’re likely to be diagnosed with chronic migraine disorder. People with chronic migraine disorder are five times more likely to be diagnosed with insomnia.
Migraine with Aura (Complicated Migraines)
As mentioned, migraines tend to be isolated to one side of the head and are moderate-to-severe on the pain spectrum. Approximately one-quarter of migraine sufferers experience migraines with aura. If you suffer from this condition, you may see black or white dots, flashes of light, or feel numb on one side of the body. Aura starts shortly after a migraine has begun and lasts for up to 30 minutes. Aura is a sign that intense migraine pain is approaching.
A variety of factors can trigger a migraine – including stress, diet, and certain smells. Also, it’s thought that hormonal factors play a role in migraines with aura. People who experience a migraine with aura have a slightly higher risk of stroke and heart attack.
Migraine Without Aura (Common Migraine)
Common migraines do not cause the visual disturbances that complicated migraines do. Nevertheless, common migraines can cause sensitivity to light and sound and can make you feel physically sick. Common migraines may last for several hours or days in some cases – making sleep very difficult.
As with complicated migraines, the pain will start on one side of the head and will often stay contained on one side. Sufferers will experience a pulsing or jabbing sensation in their head. Triggers for common migraines include stress, hormonal changes, exercise, and caffeine withdrawal – amongst other things.
Also known as an acephalgic migraine, a silent migraine can be very disconcerting. These migraines do not cause any localized head pain but can cause visual disturbances, poor balance, or nausea. Silent migraines are sometimes mistaken for anxiety and can be very scary for the person suffering. Stress is a known trigger, but there are likely to be other triggers, too.
A retinal migraine is similar to a migraine with aura, but the sufferer temporarily loses their vision in one of their eyes. This sight loss can last for a few minutes or hours. Retinal migraines are most common in younger women and may indicate a serious underlying health condition. As such, retinal migraines should always be investigated by a specialist.
As you can see, several different types of headaches and migraines can arise in the evening or nighttime. To gain a greater understanding of this pain disorder, let’s explore the causes of headaches and migraines in a little more detail.
Is Stress Causing your Nighttime Headaches?
Stress is linked to a variety of pain disorders – including migraines and headaches. But why should this be? Stress is good for us in small amounts, but it can cause many physiological problems if we let it get out of hand.
There are two ways that stress can cause headaches and migraines. Firstly, and most simply, stress causes tension in the body. When our muscles are tensed, pressure builds up in our neck, and our posture may suffer. If we don’t relieve this stress before bedtime, we could develop cervicogenic headaches or tension-type headaches.
Secondly, stress causes some neurochemical changes in the brain which can trigger migraines and headaches. According to Hopkins Medicine, stress may cause serotonin levels in the brain to reduce (or fluctuate). This is because, when we’re stressed, we produce an excess amount of cortisol, which can dampen the effects of serotonin in the brain.
This reduction (or fluctuation) in serotonin can cause blood vessels to narrow and constrict. Also, serotonin deficiency can prevent nerve cells from communicating effectively. It is this restriction to blood flow, and obstruction to nerve communication, which makes the sufferer more susceptible to pain. Serotonin is not the only neurochemical involved in this process – but it is an important one.
So, if you’re getting regular headaches at night, consider whether you’re going to bed feeling very stressed, or whether you’re exercising too close to bedtime (physical exercise is a type of ‘stress’ as it heightens cortisol levels in the brain, and exercise is known to trigger migraines in some people). Cortisol levels can be reduced if you try some stress-relieving activities before going to bed.
Can Depression Cause Migraines?
People who are diagnosed with depression often experience migraines or headaches as part of their condition. These headaches may be caused by chronically low levels of serotonin – a characteristic of depression. Even when patients are prescribed antidepressants to increase serotonin levels in their brain, they may suffer worse headaches in the initial few months while their serotonin levels are still fluctuating.
How Do Hormones Affect Migraines?
The hormone estrogen may have a role to play in the development of migraines – particularly migraines with aura.
As mentioned, fluctuating serotonin levels can restrict blood flow by narrowing the blood vessels in the brain. Also, fluctuating estrogen levels may cause the blood vessels to contract, causing a throbbing or pulsating sensation in various parts of the head. Fluctuating estrogen may also influence the trigeminal nerve, which can trigger pain sensations in the face and temples.
Estrogen levels are higher during the first half of a woman’s monthly cycle. During day 12-14 (ovulation), estrogen levels peak. Some women experience a severe migraine on day 12-14 during ovulation. However, according to a study published by Neurology, women prone to migraines suffer most during the final part of their monthly cycle (the late luteal phase) as estrogen levels decline rapidly during this portion of the menstrual cycle. This is sometimes referred to as an “estrogen withdrawal” headache.
Also, women going through menopause often experience headaches and migraines. This could be due to the stress associated with this transition, but it could also be due to low levels of estrogen. Evidence suggests that very low levels of estrogen can make nerves more sensitive – thereby increasing the chances of headaches and migraines.
Some women find their hormonal migraines get worse at bedtime because they cannot easily distract themselves from the pain. If you suspect your migraines are related to hormonal issues, speak to your doctor. They may advise trying hormonal birth control, or hormone replacement therapy to alleviate your symptoms.
Could Your Bedroom Be Causing Your Migraines?
If you’re experiencing headaches at night, think about the environment you sleep in. Many environmental factors can trigger a migraine, such as:
Using a mobile phone in bed or keeping your bedside lamp on at night may be contributing to your migraines. People that suffer from regular migraines often sleep better in total darkness. This may because migraine sufferers produce less melatonin than the rest of the population.
Melatonin is a hormone produced in the pineal gland which helps us to feel sleepy. Melatonin is produced more efficiently in the dark. According to a study published by Taylor and Francis Online, melatonin supplements could be a highly effective treatment for some migraine sufferers.
As such, sleeping in total darkness may help to prevent mild-to-moderate headaches and migraines, because you’ll encourage your body to produce enough melatonin. This will have a positive effect on brain health and sleep quality.
Perfumes are a known trigger for migraines. Scientists aren’t exactly sure why smells trigger migraines; perhaps they contribute to blood vessel or neural changes in the brain.
There are many ‘smells’ to be found in the bedroom. These could come from air fresheners, fabric conditioners, scented candles, or incense burners. Certain cleaning products are also known to trigger migraines in some people. If you’ve developed migraines and cannot find an obvious cause, consider if you’ve started using any scented products recently.
Poor sleeping posture can lead to cervicogenic or tension-type headaches. If you find yourself waking up with pain at the pack of your head, you may need to make some changes to your sleep posture.
A recent study published by Europe PMC found that 10% of participants had migraines caused by poor sleeping posture. For example, piling soft pillows up very high can strain the neck. Also, sleeping on your front for the whole of the night (without raising one arm to support the neck) can cause head pain.
Soft mattresses and feather pillows can seem comfy, to begin with, but they rarely provide enough support for the body. Many people find sleeping on a memory foam pillow helps to align their neck and support their spine.
Why Does Sleep Apnea Cause Headaches?
Sleep apnea is associated with several different types of headaches, including- cluster headaches, chronic paroxysmal hemicrania, cervicogenic headaches, and tension-type headaches.
Cluster headaches are more likely to occur in patients with sleep apnea. People with sleep apnea enter stages of disturbed breathing during the night, causing their oxygen levels to decrease temporarily. Cluster headaches occur alongside these breathing disruptions and may be an effect of these disruptions. As such, it’s no surprise that cluster headaches often respond well to CPAP therapy (an oxygen therapy used to treat sleep apnea).
Also, people with sleep apnea are often sleep-deprived so that they may develop tension-type headaches in response to tiredness and stress. Secondly, people with sleep apnea often sleep on their back and are overweight – so they are more likely to suffer from cervicogenic headaches.
People with sleep apnea are more likely to grind their teeth during the night. Teeth grinding (bruxism) often causes pain in the temporomandibular joint (jaw). TMJ pain affects the jaw, ears, and temples, and can feel very similar to a tension-type headache. In fact, TMJ is often misdiagnosed as a tension headache, which is one of the reasons why bruxism can go unnoticed by health professionals. If your headaches are concentrated around the jaw and temples, and you also have earaches, facial tenderness, and a “clicking” jaw – this could indicate bruxism.
Does Diet Influence Nighttime Migraines?
If you’re prone to migraines, certain late-snacks could trigger your condition. A common migraine trigger is monosodium glutamate (MSG). MSG is found in lots of packaged snacks and convenience meals. Other dietary triggers include:
- Foods that contain tyramine (beans, smoked fish, and cured or processed meats)
- Aspartame (an artificial sweetener found in some hot drinks you might drink near bedtime)
- Citrus fruits
- Foods containing histamine (kefir, kombucha, pickled vegetables, sauerkraut)
- Blue cheese
Although some foods can trigger nocturnal headaches, it’s important not to go to bed hungry as low blood-glucose levels can trigger migraines in some people.
One of the most common migraine triggers is alcohol – particularly beer and red wine. According to the American Migraine Association, it’s not unusual for adults to develop new triggers (such as alcohol) later in life. As such, you might overlook alcohol as a potential trigger because it hasn’t caused you any problems in the past.
The last dietary trigger is an obvious one, but many people seem to forget it – dehydration. Dehydration can contribute to tension-type headaches and migraines. In addition to drinking 2 liters of water per day, make sure you’re consuming the correct amount of sodium in your diet.
What Is the Link Between Caffeine and Nighttime Headaches?
Contrary to popular belief, caffeine is not a direct trigger of migraines. In fact, it is caffeine withdrawal that can spark off a pretty nasty migraine in some people. Caffeine-withdrawal migraines can sometimes get worse at night. Drinking a small amount of coffee may alleviate the symptoms of nighttime withdrawals, but this should be weighed up against the fact that caffeine can disturb sleep for many people.
If you decide to give up caffeine completely, withdrawal migraines will usually disappear within 2 – 4 weeks. On the other hand, if your intake of caffeine fluctuates, you may suffer these “mini withdrawals” on a semi-regular basis. For example, regular coffee drinkers that avoid caffeine for 1-2 days at a time may experience withdrawal migraines. As such, keeping caffeine intake consistent can help to prevent migraines associated with caffeine.
According to a review on NCBI, caffeine can even be used to treat some rare headache disorders such as hypnic headaches. This is partly because caffeine slows down the production of adenosine – a hormone that’s involved in nerve functioning and pain sensitivity in the brain.
How to Prevent Nighttime Headaches
It may not be possible to stop headaches from happening altogether. However, altering your lifestyle can often reduce the frequency and intensity of headaches and migraines. Keep the following tips in mind:
- Improve your Sleep Hygiene – As mentioned, insomnia and nocturnal migraines often occur alongside each other. If you establish a regular sleep routine, this may help to alleviate your migraines. Try to achieve total darkness in your bedroom so that your body produces the correct amount of melatonin.
- Manage Stress – Stress can cause (or aggravate) several types of headaches and migraines. Gentle physical exercise such as walking, or yoga is particularly useful for alleviating stress and tension. Gentle exercise can also help to balance hormones which may prevent hormone-related migraines.
- Treat Underlying Health Conditions – As mentioned, nocturnal migraines may occur alongside sleep apnea, anxiety, or neck injuries. If you suspect you have an underlying health condition, try to treat this as early as possible to prevent migraines from worsening.
- Keep a Migraine Diary – Keeping a migraine diary will help you identify your triggers, so you can eliminate these from your environment. Not only that, if you seek out treatment for your migraines, a diary will help the doctor understand your condition in more depth.
- Eat a Light Snack – According to a study on Science Direct, eating a light meal near bedtime helped reduce nocturnal migraines by 21%.
- Be Consistent with Caffeine – If you’re a coffee drinker, try to consume a similar amount each day to prevent withdrawal headaches.
- Improve your Posture – Bad posture can lead to tension headaches and cervicogenic pains. Practicing yoga or Pilates can help to improve posture and relieve orthopedic tension.
- Increase Magnesium – There is evidence to suggest that magnesium can help to prevent migraines and tension headaches in some people. The most efficient way to supplement with magnesium is to apply liquid magnesium directly on the skin.
- Increase Riboflavin – Vitamin B2 is found in foods such as beef liver, lamb, milk, mushrooms, and spinach. Studies have shown that increasing your intake of this vitamin may reduce the frequency and severity of your migraines.
- Try Therapy – If you’re struggling to make these positive changes to your lifestyle, you might find cognitive-behavioral therapy useful. CBT can help you to improve your diet, sleep hygiene, and help you to manage stress more effectively.
How to Go to Sleep with a Headache
If prevention therapy fails you, there are a couple of things you can do to alleviate the pain associated with a headache:
- Apply a Cold Compress – Apply a cold flannel to the site of pain for no longer than 20 minutes.
- Sip Some Water – Even if your headache was not caused by dehydration, being dehydrated can aggravate the pain.
- Use Black-Out Curtains – As mentioned, sleeping in total darkness will allow you to produce more melatonin, which should help to relieve a headache and help you to fall asleep faster. Alternatively, try wearing a blackout eye mask.
- Medication – Take your medication as directed. If you’ve got a mild-to-moderate headache, OTC pain medication should work effectively. If you experience chronic headaches or migraines, your doctor will usually prescribe specialist medication.
- Environment – If you’re in the midst of a migraine, you’re probably feeling hot and clammy. Try opening the window to let some fresh air circulate and lower the ambient temperature.
- Sleep Position – Sleeping on your side or sleeping on your back with your legs raised can sometimes help to alleviate a headache.
- Foot Massage – The evidence is largely anecdotal, but some people claim that massaging their feet helps to relieve a migraine.
- Don’t Fight Sleep – If your headache shows no signs of improvement and you’re struggling to fall asleep, don’t try to “fight” against it because this may lead to intense frustration. Try walking around the house or watching TV until the pain subsides. Avoid reading in bed as this may aggravate your migraine.
Headaches and migraines can often bring us down because we feel as if the pain is controlling our lives. One of the best defenses against migraines is to change your perspective. Instead of seeing this disorder as a life-limiting condition, you can find strength in your ability to manage the headaches. In most cases, nocturnal headaches can be alleviated with lifestyle changes or medical interventions. As such, remaining positive is the best way to stay in control of your headaches.