- New research shows that migraine and cluster headache symptoms are often governed by the body’s internal clock or circadian system.
- Study results showed that symptoms for 71 percent of cluster headache patients and 50 percent of migraine patients followed a circadian pattern.
- This research could lead to new treatments, including steroids and melatonin, which affect the body’s circadian rhythms.
If it feels like you’re always getting headaches at the exact same time of day, you’re hardly alone.
New research shows a sound biological reason for this phenomenon — and it all has to do with the body’s internal clock, the circadian system.
Researchers published a meta-analysis, along with an accompanying editorial, today in the online issue of Neurology, the medical journal of the American Academy of Neurology.
Data on migraine and cluster headaches shows a strong correlation between these headaches and the time of day, with a circadian pattern present in 71 percent of cluster headache patients and 50 percent of migraine patients.
The study’s author says the findings help illuminate why headaches happen at consistent times and potentially open the door to new circadian-based treatment options.
Headaches can be like clockwork
“We had noticed that a lot of cluster headache patients have headaches at the same time each day,” study author Mark Joseph Burish, MD, Ph.D., of the University of Texas Health Science Center at Houston in Texas and a member of the American Academy of Neurology told Healthline.
“I had one patient that was getting a little bit irritated with how long it was taking to ask all the questions, and they said, ‘If you can just wait for 15 minutes, you’ll see what my headache looks like,’” Burish continued. “That’s how confident they were of the timing to the headaches, and that really struck me.”
The meta-analysis confirmed what Burish and others already suspected: headaches often follow the body’s circadian rhythms. However, cluster headaches and migraine followed different patterns. Cluster headaches were found to be more likely in the spring and fall, with attacks generally occurring between late night and early morning. Migraine, on the other hand, showed a consistent low ebb with few attacks late at night and a broad peak ranging from late morning to early evening.
Burish says that this understanding of how and when headaches occur could lead to new ways to mitigate the effects of these headaches.
Both cluster headaches and migraine were associated with circadian genes. Further, levels of hormones related to the circadian system, such as cortisol and melatonin, were altered in people with these headache disorders compared to those without them. Individuals with cluster headache had higher cortisol and lower melatonin while people with migraine had lower levels of melatonin.
“Maybe there are other genes or other medications that alter some of these core genes or alter their circadian rhythms,” he explained. “That’s a brand new type of treatment that we could use to help these patients.”
These potential new treatment forms could utilize compounds already well understood: steroids and melatonin, which both affect the body’s circadian rhythms.
“Both of these are actually already treatments for cluster headache and migraine,” Burish said. “If you take steroids at the right doses, that can prevent both cluster headaches and migraine, and same for melatonin. They’re not perfect treatments, but it’s still promising data to show that altering circadian rhythms really could help the patient.”
While it’s still too early to apply these findings to actionable treatment options, Burish says that the data can help people better understand why headaches can occur like clockwork throughout the day.
“There are stories of patients who think that they’re allergic to math class, or things like that, because the headaches are happening every time they’re in that class,” he said. “So this kind of explains that it’s not about trying to get out of the class every day at 10 a.m. This is just how the headache works.”
Setting your internal clock
Maintaining a healthy sleep schedule – and, in turn, healthy circadian rhythms – won’t magically make your headaches go away. That said, it’s still worth understanding how this process works and how a healthy schedule can benefit your body.
Azizi Seixas, associate director of the Center for Translational Sleep and Circadian Sciences at the University of Miami Miller School of Medicine, told Healthline that the body’s internal biological clock controls the process, which repeats itself approximately every 24 hours.
“Circadian rhythms play a crucial role in regulating many physiological processes, including sleep-wake cycles, hormone secretion, metabolism, immune function, and cognitive performance,” he explained.
“When circadian rhythms are disrupted, it can have negative impacts on these processes, leading to fatigue, mood disturbances, and health problems such as obesity, diabetes, and cardiovascular disease.”
For people who feel like their internal clock is out of sync, the best advice to follow is to set – and maintain – a consistent sleep schedule.
“Try to go to bed and wake up at the same time every day, even on weekends,” Seixas advised.
Another thing to keep in mind is how light can affect circadian rhythms. Bright light in the morning can help reset the circadian clock and promote alertness, while avoiding bright light in the evening can help the body feel more restful.
“Avoid stimulating activities before bedtime, like watching TV, using electronic devices, and exercising,” said Seixas. “Creating a relaxing sleep environment and limiting caffeine and alcohol intake, especially in the evening, [also helps]. By following these best practices, it’s possible to establish and maintain a healthy sleep and circadian schedule, which can lead to improved overall health and well-being.”