Dreams and Wanderings: The Connection Between Migraine and Sleep Disorders

Sleepwalking, sleeptalking, and acting out your dreams are sleep disorders that are more common in people who experience migraine. You can manage symptoms of both with symptom tracking and lifestyle tweaks.

As a person with migraine, I’ve always used sleep as a way to find relief during an attack. However, sleep has not always been peaceful.

Since I was a child, I’ve walked and talked in my sleep and woken up from vivid dreams and even nightmares. I was surprised to find that I wasn’t alone.

Many people with migraine also live with parasomnias, or abnormal behaviors during sleep. Read on to learn more about nightmares, sleepwalking, and migraine.

Join the free Migraine community!

Connect with thousands of members and find support through daily live chats, curated resources, and one-to-one messaging.

Sign up

What are sleepwalking and REM behavior disorder?

Two conditions cause people to move around while they’re sleeping: somnambulism and REM (rapid eye movement) behavior disorder. These are also known as parasomnias.

Somnambulism or sleepwalking

Somnambulism, also known as sleepwalking, is a condition that causes people to act as if they’re awake while they’re sleeping. It can also involve sleep-talking or vocalizing while you’re sleeping. Sleep-talking involves either just a few words or full conversations.

A sleepwalking person may sit up in bed or walk around the room or house. Sleepwalking usually occurs in the first half of the night during non-REM (“slow-wave”) sleep, and people often don’t remember these events.

Although I have never been formally diagnosed, I believe I have somnambulism. I often sit up and sometimes talk, but do not act out my dreams. I go back to sleep after and do not always remember what has happened in the morning.

REM behavior disorder

Sleepwalking is different than REM behavior disorder, which allows people to move and act out dreams during REM sleep.

This can sometimes lead to injury as a person acts out a violent or active dream. A person with REM behavior disorder often wakes up and becomes alert, and can talk about the dream they were just having.

Is there a connection between sleepwalking, REM behavior disorder, and migraine?

Several studies have looked at the connection between these conditions and migraine and headaches.

According to a 2020 review, migraine and sleep disorders seem to be linked by clinical presentation and by the presence of shared anatomical pathways, particularly calcitonin gene-related peptide (CGRP).

A 2021 study noted higher rates of somnambulism in patients with migraine with aura.

In an older 2013 study, researchers studied the association of migraine and REM behavior disorder. They found that 24.2% of patients with migraine acted out their dreams compared to 14.3% in the control group. People who acted out dreams had higher headache-related disability and lower sleep quality.

Do people with migraine have more vivid dreams and nightmares?

If you’ve ever had a nightmare, you don’t need an explanation of what it is. These vivid dreams evoke fear, terror, or anxiety and can cause you to wake in a state of emotional distress with your heart pounding.

I have had nightmares since I can remember, even as a child. These dreams seem so real, and when I wake up, my heart is pounding as if my dream is really happening to me.

A 2021 review noted that nightmares sometimes accompany migraine and may even be a sign of an impending attack. Migraine and vivid dreams do seem to occur together, but it’s unclear why.

The review noted that nightmares and migraine may be related to a number of factors, including:

• genetics
• environmental factors
• psychiatric conditions, like post-traumatic stress disorder (PTSD)
• neurobiological mechanisms, like increased arousal in certain areas of the brain

The review noted that more high quality research is needed, partly because nightmares are only reported sporadically.

What causes sleepwalking, nightmares, and vivid dreams in people with migraine?

Researchers are still trying to determine why people with migraine are more likely to sleepwalk, act out their dreams, and have more nightmares.

One theory involves serotonin, which is thought to influence migraine attacks by triggering chemicals that narrow blood vessels. It’s also thought to be important for initiating and maintaining sleep.

Medications that are sometimes taken as preventatives, such as venlafaxine, may also cause nightmares. Beta-blockers like metoprolol (Lopressor) have been shown to cause vivid dreams and sleep disturbances.

What can you do if you sleepwalk, have REM behavior disorder, or have vivid nightmares or dreams?

Walking in your sleep, acting out dreams, or having nightmares will definitely keep you from getting a restful night’s sleep.

Try to keep a record of when you find yourself sleepwalking, acting out your dreams, or having a nightmare, as well as potential triggers, like taking a particular medication, drinking alcohol, or drinking caffeine.

For instance, I walk in my sleep when I’m in an unfamiliar place or haven’t slept well for a number of nights. I’ve noticed a similar pattern with nightmares.

If you’re consistently experiencing sleep disturbances, your doctor can help you understand if it has to do with your migraine treatment or a possible medication. They can also help you learn what steps you can take to get a better night’s sleep.

Takeaway

Setting a sleep schedule, cutting back on caffeine early in the day, creating a restful environment, and waking up at the same time every day can help you create a routine that encourages restful sleep.

Finding out what may be causing your sleep disturbances and learning techniques to get better sleep can help you rest better. That way, you can cross poor sleep off your list of potential migraine triggers.