10 Essential Sleep Habits for Teens with Migraine

💤Page Navigation

1. Sleep Basics
2. The Connection Between Sleep and Migraine
3. Sleep Challenges for Teens
4. 10 Essential Sleep Habits for Teens with Migraine
5. When to Seek Professional Sleep Support for your Teen
6. To Sum It Up

Hi, parents and caregivers of teens with migraine! I’m Dr. Dawn Buse, PhD, FAHS, a clinical professor of neurology, licensed psychologist, migraine expert and mom. I specialize in helping people with chronic pain conditions (like migraine) live well by incorporating science-backed mind-body practices (like healthy sleep habits) into their daily routines.

For teens with migraine and those heading off to college, sleep isn’t just important – it’s a cornerstone for effective migraine management and being at their best. But with jam-packed schedules, schoolwork, sports, and social lives, getting enough quality sleep and sticking to a regular sleep schedule is a real challenge. Still, prioritizing good sleep is essential for their overall brain health, academic success, and migraine management. And no better time to start than the beginning of a new school year!

In this article, I’ll draw from my decades of clinical and research experience with migraine to guide you through:

1. The critical role sleep plays in migraine management
2. The unique considerations for teens in maintaining good sleep hygiene
3. Practical tips to help your student start – and stick to – healthy sleep habits

Let’s start with the fundamentals. 

💤Sleep Basics

Sleep is not just down time. It’s a busy and important time for the body, brain and spirit. Sleep gives the body and brain time to grow, recover, recharge and rejuvenate. During sleep, nerve connections in the brain (which aid in memory and cognitive function) develop and are strengthened, hormones including growth hormones (which are working especially hard during puberty) are regulated, and the body’s tissue and muscles are repaired. Other important things also happen during sleep, like memory consolidation and other essential functions that help with learning and school performance, mood regulation, and more.

A good night’s rest consists of distinct sleep stages that occur in a certain order and cycle throughout the night.

1. NREM* Stage 1 (Light Sleep): This transitional stage lasts a few minutes. The body shifts from wakefulness to sleep. Muscle activity decreases and eye movements slow. Thoughts quiet down. Breathing becomes slow and steady. The body feels warm and heavy, and you feel like you are “drifting off” to sleep.
2. NREM Stage 2 (Light Sleep): Now, the body and brain are really asleep. Sleep spindles, which are short bursts of brain activity, consolidate information and memories from that day. Many other important activities also occur.
3. NREM Stage 3 (Deep Sleep): Also known as slow-wave sleep, this stage includes the slowest brain waves, heart rate, and breathing patterns. It is vital for physical restoration, immune function, and overall health. It’s harder to wake someone up than in previous sleep stages.
4. REM** Sleep (Rapid Eye Movement): Due to increased brain activity, dreams are most common during REM sleep. This stage plays a significant role in emotional regulation, creativity, and immune system health. When someone gets enough REM sleep, they wake up feeling refreshed. More REM sleep happens later in the sleeping cycle, and your teen may be in REM sleep when their alarm goes off early in the morning.

*NREM = Non-Rapid Eye Movement

**REM = Rapid Eye Movement

The reality is that many teens aren’t getting the 8-10 hours of sleep each night, which is recommended by the American Academy of Sleep Medicine – and even if they are, it may not be unbroken, restful quality sleep. Specifically, teens with migraine have been found to be getting “nowhere near” the recommended amount of sleep. Centers for Disease Control and Prevention polls show that 60% of middle schoolers and 70% of high school students did not log enough hours of sleep on school nights. 

💤 The Connection Between Sleep and Migraine

As your teen navigates a new school year, the sleep-migraine cycle can pose a significant challenge in their migraine management. Lack of sleep, poor sleep quality, and changes in sleeping routine can contribute to the onset of a migraine attack. On top of that, the head pain or other symptoms associated with an attack have the potential to disrupt their sleep schedule altogether. As if being a teen isn’t stressful enough already! In addition, change in your teen’s routine, like getting TOO MUCH sleep, can also set the stage for a migraine attack. I’ll talk more about the importance of schedule and routine later.

People with migraine are also more likely to experience more sleep problems, including insomnia, sleep apnea, and restless leg syndrome, than those without migraine. Some people will notice certain patterns to the timing of the start of their migraine attacks. Migraine attacks can start in the middle of the night to very early morning, which may wake some people up. To better understand this connection, let’s take a closer look at the brain’s role in both sleep and migraine attack regulation.

• Sleep: The brain houses the body’s “master clock” (official name: the suprachiasmatic nucleus) that is responsible for regulating the sleep-wake cycle. It produces a variety of neurotransmitters that promote wakefulness and facilitate sleep. 

• Migraine: The hypothalamus keeps the body in a stable, balanced state and interacts with other parts of the brain that regulate pain. It is particularly active during a migraine attack prodrome (also known as the “pre-headache” phase of an attack) – the first phase of a migraine attack that can last up to 24 hours before the headache hits. If your teen experiences fatigue, mood changes, cravings, and other symptoms before the headache starts, these may be attributed to hypothalamus activity.

This intricate interplay between sleep regulation and migraine attacks emphasizes the importance of healthy sleep habits for teens with migraine. As parents/caregivers know, the transition from a laidback summer schedule to regimented school start times is tough enough – and even tougher for teens dealing with migraine. It can also be difficult to adapt to before-school sports practice or band rehearsal on some days – but not others – or waking up earlier on school days then sleeping later on days off. Let’s see why.

💤Sleep Challenges for Teens

Back-to-school highlights several challenges that may complicate your teen’s ability to prioritize a healthy sleep routine:

Sleep Phase Delay: In adolescence, there is a natural shift in the body’s “biological clock” (official name: circadian rhythm) that causes teens to naturally get tired, want to go to bed, and wake up later. This naturally delayed sleep-wake cycle is often not possible with school, work, sports, and other extracurricular activity schedules. 

Irregular Schedules: Extracurricular activities, part-time jobs, and late-night social gatherings or online activities can all contribute to erratic sleep patterns for teens. Consumption of caffeine or energy drinks to help sustain their always-on-the-go schedules at any time of day – and especially later in the day – can further hinder sleep hygiene.

Tech-Obsessed Screen Time: The near-constant use of smartphones, tablets, and laptops throughout the day presents another challenge to healthy sleep. Especially close to bedtime, and if waking up in the middle of the night, blue light emissions from screens can interfere with the production of melatonin, the hormone connected to sleep onset and sleep quality.

College Challenges: College life brings its own set of migraine challenges: noisy neighbors, a roommate who comes-and-goes on a different schedule, all-nighters, fluorescent lecture hall lights, or battling over the dorm room temperature. All of these can make it hard to get quality sleep and stay on a schedule, cranking up the chances of a migraine attack.

Academic Pressure: Many students sacrifice sleep to cram for exams, complete their homework due the next day, or work on a group project. Staying up late to study might seem like the only option, but sleep deprivation can seriously mess with your teen’s cognitive function, making it harder for them to retain information, concentrate, think clearly, and perform well on exams.

Stress and Anxiety: We’ve all been there – laying in bed, staring at the ceiling, unable to fall asleep, mind racing with stressful thoughts. But for teens with migraine, these feelings can hit harder. Those with migraine are more likely to experience anxiety symptoms than their peers without migraine. 

Stress and anxiety can disrupt sleep, making it harder both to fall asleep and stay asleep, and dramatic changes in stress levels in either direction can increase the risk of having a migraine attack. You may be surprised to know that both an increase in stress (example: last-minute cramming for an exam) and decrease in stress (example: a calm Saturday morning after a busy week of school) have been shown to increase the chance of migraine attacks.,, If stress or anxiety becomes overwhelming for your teen, consider speaking with their doctor, a counselor or a therapist.

💤 10 Essential Sleep Habits for Teens with Migraine

But don’t fret! I’ve compiled my top sleep hygiene practices that can help keep your teen’s sleep on track and their migraine in check:

1. Establish a Consistent Sleep Schedule

Consistency is key for living well with migraine. Encourage your teen to go to bed and wake up around the same time (within a 60-90 minute window) every day, even on weekends. This helps regulate their body’s circadian rhythms and set an internal “alarm clock,” which can help control the frequency of migraine attacks.

2. Create a Relaxing Bedtime Routine

A calming bedtime routine can signal to your teen’s body that it’s time to wind down. 20-30 minutes before bed, they should relax with a good book (on paper, not digital) or an audiobook, listen to soothing music, or practice mindfulness with deep breathing or meditation. Mindfulness meditation, yoga, and journaling are all techniques that can help reduce stress and promote relaxation. The goal is to keep a handle on your teen’s stress to avoid substantial peaks and drops. This is not always easy to do, and many things in teens’ lives may feel out of their control, but some of these strategies can help ease worried and anxious thoughts.

3. Practice Mindfulness on a Regular Basis

For better sleep and a more peaceful mind, your teen can integrate relaxation techniques into their daily routine. These can be practiced during a 45-minute Nerivio treatment session through the in-app GIER UP video library that is designed to complement their acute and/or preventive Nerivio treatments. At home, on the go, and at their own pace, your teen can immerse themselves in Guided Imagery, Education and Relaxation (that’s GIER!) programs created by top headache psychologists. Over time, these types of techniques can improve overall sleep quality, reduce insomnia symptoms, and enhance the restorative benefits of sleep. Here are a few techniques available in the GIER library that your teen can continue to practice at any time:

• Paced Breathing: Take slow, deep breaths that help activate the parasympathetic nervous system to reduce stress and promote a state of calm after a stressful period. This physiological response makes it easier to fall – and stay – asleep.

• Guided Visual Imagery: Envision tranquil serene scenes to draw the mind away from stressors and create a relaxing mental space for sleep.

• Mindfulness & Meditation: Focus on being present and embrace your thoughts without judgment. Train the mind to release the day’s worries to achieve a more relaxed state before bed.

4. Set Boundaries for Screen Time Before Bed

Work with your teen to agree upon a “curfew” for their screen time. This should be 1-2 hours before bed. Blue light from electronics can interfere with the body’s natural sleep-wake cycle by deceiving the body into thinking it’s still daytime. Rather than mindlessly scrolling social media or binge-watching TV, encourage non-screen activities that aid in relaxation (see #2 for some ideas!). If your teen finds themselves awake in the middle of the night, remind them to resist the temptation to look at their phone or other devices.

5. Curate a Cozy Sleep Space

Make your teen’s bedroom a sleep-friendly haven by keeping it dark, quiet, and cool. Consider blackout curtains, earplugs, or white noise. Reserve their bed only for sleeping and before-bed relaxation – not for studying, working, or other daytime activities. Mid-day rests should take place elsewhere whenever possible: on a hammock, a bean bag chair, or the couch.

6. Stock Up with Smart Snacks & Sips 

For better sleep quality, it’s best to avoid large meals close to bedtime. If hunger hits before bed, your teen should opt for a light snack instead. Herbal teas, like chamomile, are excellent alternatives since they contain antioxidants that promote sleepiness. Limiting caffeinated drinks and energy drinks all day – but especially in the afternoon and evening – is important. Even without caffeine as an ingredient, energy drinks may contain hidden energizers that can disrupt your teen’s natural sleep-wake cycle or lead to dehydration. 

7. Incorporate Daily Movement

Not only can regular exercise improve sleep quality, but also reduce migraine attack frequency, pain, and disability level. See how your teen likes low-impact, aerobic exercises. Yoga, walking, swimming, and even cycling – all are great options! They should be mindful to avoid vigorous exercise close to bedtime, as this can be energizing, making it harder to fall asleep. Aim for moderate physical activity earlier in the day.

8. Monitor and Adjust Sleep Habits

Be your own detective. Keep track of sleep patterns and how they relate to their migraine attack frequency, duration and intensity. Consider keeping a sleep diary or using a sleep tracking app or smart watch to monitor their sleep duration and quality. This can help your teen identify patterns and make adjustments to improve their sleep and manage their migraine.

9. Advocate for Accommodations

Accommodations, such as 504 Plans and Individualized Education Programs (IEP), are accessible by law to students with migraine. In colleges and universities, there is often a specific office or department that coordinates support, resources and accommodations to students with various needs. 

With the connection between sleep and migraine in mind, here’s some potential accommodations that can help facilitate healthy sleep habits:

• • Flexible schedule: Permit later class start times and schedule rest breaks
    • Research indicates later school start times are linked to a decrease in migraine frequency. Teens with migraine attending schools that begin before 8:30 AM averaged 7.7 headache days per month – nearly three more days than students with later start times.
  • Extended deadlines / modified workloads: Ease the pressure and stress of late-night homework to help ensure sufficient sleep
    • Read more: Homework and Study Strategies for Teens with Migraine

• Excused absences: Allow your teen to rejuvenate their physical and mental health, when necessary. 

• Quiet Hours and Quiet Spaces: Specifically for college students, designate specific times and/or places when noise levels must be lowered.
• Lighting: Replace overhead fluorescent lights with softer, soothing ambient light (green). Also, therapeutic glasses with yellow or rose tinted lenses can help block painful light.

Students can request these accommodations through their school’s disability services or counseling office. Providing medical documentation from a healthcare provider can help in obtaining the necessary support. Read more: Unlocking Academic Success: A Guide to Accommodations for Students with Migraine

10. What About Naps?

When it comes to maintaining good sleep hygiene, there are a few things for your teen to remember when it comes to naps:

• While short naps can be refreshing, avoid napping in the afternoon or evening. This may interfere with nighttime sleep. 
• Instead, aim for a 20-30 minute nap earlier in the day.
• During a migraine attack, the rules are different. Sleep can be helpful for getting through a migraine attack. In this case, encourage your teen to listen to their body. If they choose to do so and are able to, they can take a nap.
  • Once the attack has passed or the associated symptoms are more manageable, try to return to their regular sleep-wake cycle as quickly as possible.

It’s all personal. Some people with migraine may find that napping can help at the onset of an attack, while others may find that naps worsen their headaches. It’s important to pay attention to your teen’s body’s response and adjust accordingly. 

💤When to Seek Professional Sleep Support for your Teen with Migraine

Insomnia frequently co-occurs with migraine, so if your teen continues to struggle with sleep and/or managing their migraine despite better sleep habits, consider consulting their healthcare provider. For difficulties with sleep routines and insomnia, their doctor might suggest Cognitive Behavioral Therapy for Insomnia (CBT-I). CBT-I is a structured, evidence-based approach that uses cognitive and behavioral techniques – like sleep restriction, stimulus control, cognitive restructuring, and relaxation training – to address the underlying causes of chronic insomnia and improve sleep patterns. CBT-I for teens with migraine has been shown to reduce headache frequency, pain intensity, and activity limitations, as well as improve sleep quality, hygiene, and patterns.

💤To Sum It Up

For teens with migraine, maintaining healthy sleep habits is both crucial and challenging. Juggling school, social life, and the natural ups-and-downs of being a teen can make it tough to stick to a regular sleep schedule. However, by prioritizing sleep hygiene in your home and working toward improved sleep quality in partnership with your teen, it may be possible to improve migraine management and reduce the frequency and severity of their migraine attacks. Quality sleep is not just about managing migraine; it’s also key to boosting overall wellbeing, academic performance, and physical and emotional health throughout the school year and all year long. By taking steps to improve their sleep, your teen is investing in a healthier, more balanced life in and out of the classroom – one that allows them to take on each day with greater confidence and resilience.

Author’s Bio:

Dr. Dawn Buse, PhD, FAHS is a licensed psychologist, a Clinical Professor of Neurology at Albert Einstein College of Medicine, a Fellow of the American Headache Society (FAHS), and a member of the Board of Directors of the Headache Cooperative of the Pacific. She has worked with people with migraine and other chronic painful conditions for more than two decades through clinical care including biofeedback, cognitive behavioral therapy, relaxation training, research and patient advocacy. She has more than 200 scientific publications and has won 14 US and international research and professional awards for her work in the field of migraine.