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Is you asleep sabotaging your migraine relief?
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Today we're unpacking 4 types of insomnia that could be quietly triggering your next
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Welcome to the Migraine Heroes podcast.
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A podcast for people living with chronic migraines, years of pain, misunderstanding and no answers.
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I'm Diane Ducarme and I've helped more than a thousand people reduce the burden of migraines
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and feel more in control.
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Each episode brings you grounded insight into what your body might be asking for and
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what can truly help.
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Before we dive in, a quick word.
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Last week I received an email from Julie, a customer of ours.
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And in her email, Julie shares that she has just received her new lab results showing
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that every marker has improved.
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Her thyroid are now within normal range.
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Her thyroid antibodies were cut in half.
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Her cholesterol, liver enzymes and insulin are now all in healthy ranges.
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And most importantly, of course, her migraines have significantly reduced in intensity and
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And her message reminded me of something I see again and again in this work.
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The moment migraines stop feeling random and start making sense, everything begins to shift.
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You know what you're working with and you know what to do next.
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That kind of clarity comes from slowing down and looking at the whole picture.
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Your medical history, your patterns, your other symptoms, your questions.
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And so this month, I've set aside time to personally hold more of these 90-minute migraine
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sessions that offer such clarity and offer them at no cost.
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If that feels important for you, you can book that session at no cost with the link in the
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podcast show notes or download the Migraine Heroes app, complete your Getting Started
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steps and you'll see how to reserve your session.
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Now take a deep breath and let's dive in.
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In this episode, you will learn how to recognize which sleep pattern might be setting up your
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migraines and what makes each one different.
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The exact hormonal and neurological links between poor sleep and migraines so you can
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start working with your biology.
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An East meets West framework that helps you rebuild healthy sleep by working with your
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body, not overriding it.
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Stay with me till the end because at the end of the episode, you will get one powerful
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calming step you can take tonight to start shifting your sleep patterns and reduce your
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So let's be real, poor sleep can feel like the first domino in a migraine spiral you
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You're exhausted, you're wired, you can't think straight.
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And just as you start to drift off, your brain kicks into high gear.
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Or maybe it's 3 a.m. and you're wide awake, watching the clock, dreading the migraine
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that will greet you in the morning or even worse, woken up by pain.
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You're not imagining this.
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Science confirms what you've been living.
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Insomnia is not a single experience.
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And when it comes to migraine, the type of insomnia you struggle with can tell us a lot
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about what your body and brain might be missing.
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So let's look at the four main types of insomnia from a Western perspective.
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The first one is sleep-onset insomnia, when your body is exhausted, but your brain missed
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So you get into bed, hoping for rest, and your brain decides it's the perfect time
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to replay conversation, plan tomorrow, solve problems, and question every life choice since
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You're tired, you're deeply tired, but you're wired in that cruel way where sleep
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feels just out of reach.
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The more you want it, the louder the thoughts get in.
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Scientifically, this is called sleep-onset insomnia, often linked to hyperarousal, meaning
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your nervous system stays in the on mode when it should be powering down.
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Second type of insomnia is sleep-maintenance insomnia.
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It's the 2-4am, why am I awake special.
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You fall asleep fine, victory.
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And then, your eyes snap open in the middle of the night, like an unwanted internal alarm
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No noise, no reason, you're just wide awake, staring into the dark, bargaining with yourself
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to please, please, please go back to sleep.
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Now this pattern, sleep-maintenance insomnia, meaning sleep is initiated normally, but can't
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be sustained through the night.
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The third type is early morning awakening, the too early, too alert wake up no one asks
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You wake up earlier than you need to, 5am, sometimes a bit earlier, and there's no drifting
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Your eyes are wide open, your brain is on, and your body feels tense instead of restored.
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Scientifically, this is called early morning awakening insomnia, often linked to shifts
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in circadian rhythms and stress hormone timing.
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And then the fourth one is the mixed insomnia, it's when sleep feels like a chaotic mystery
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Some nights you can't fall asleep, other nights you wake up halfway through. I use
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both because of course there is no clear pattern, no dependable rhythm, just the sense
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that sleep itself has become completely unreliable.
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And so this is known scientifically as mixed insomnia, meaning multiple sleep processes
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are dysregulated at the same time.
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Now each of those patterns is going to influence the migraine brain differently.
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The first one, that sleep-onset insomnia, aka difficulty to fall asleep, wired at night, has
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migraine patterns.
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So when you can't fall asleep, your nervous system is often stuck in a hyperarousal state
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we've talked about, so too much on signal. And in migraine brains, it tends to lower the
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attack threshold, you start the night already revved up, then you stack sleep loss on top
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of it, and that combo often maps to stress-linked migraines, can't-switch-off migraines, the
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next-day attacks that feel like your brain is already inflamed before breakfast.
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And science-wise, insomnia is common in migraine, and sleep fragmentation or deviation from
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your usual sleep tends to be a key driver of the sleep-migraine relationship.
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Now the second type, that sleep-maintenance insomnia, aka middle-of-the-night awakenings,
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is going to lead to night-early-morning attacks and migraine hangover days.
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So this is the 2-4am pop-awake pattern, you fall asleep, then your sleep gets fragmented.
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In migraine, fragmentation tends to matter because broken sleep disrupts the deep restorative
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phases your brain uses to reset sensitivity.
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People often report either a night-early-morning onset of migraine, or waking up with, I'm not
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in pain yet, but I'm off feeling. So fog, nausea, sensory sensitivity that can slide
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into a full attack.
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And science-wise, that sleep fragmentation is repeatedly highlighted as a major driver
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in sleep-migraine link, and migraine attacks themselves show circadian timing patterns
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with early-morning, late-night peaks in many studies.
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Then we have the third type, which is the early-morning-awakening insomnia, aka the
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terminal insomnia.
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So that's going to lead to wake-up migraine and morning peak patterns.
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So waking up too early and being unable to return to sleep tends to line up with circadian
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rhythm timing problems, and for migraine brains, that early switch can coincide with the body's
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natural morning ramp up. So that's alertness of hormones, light exposures, sensory input.
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And if your system is already sensitized, that morning surge tends to be enough to tip
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someone into a wake-up migraine, or a migraine that blooms fast in the first hours of the
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Science-wise, migraine onset shows circadian variation, so often early morning and late-night
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peaks, and broader circadian biology, melatonin cortisol timing, and that's all frequently discussed
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in the migraine sleep literature.
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Now the fourth one, the mixed insomnia, aka combined onset and maintenance issues, is
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going to give a higher burden, more frequent attacks, and higher chronification risk.
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So when it's both hard to fall asleep and hard to stay asleep, you're dealing with
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a more global sleep dysregulation pattern.
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In migraine, that tends to correlate with more disability and more frequent attacks,
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because your brain never gets a stable nightly reset.
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Over time, it's going to contribute to a cycle where poor sleep increases migraine frequency,
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and migraine worsens sleep, a feedback loop that can push some people towards chronic
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migraine patterns.
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Again, tends to, not always.
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So science-wise, insomnia is more prevalent in people with migraine. Poor sleep quality
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is common in migraine cohorts, and insomnia has been discussed as a potential contributor
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to migraine chronification.
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So to sum up, each sleep pattern that you see in the West maps to different neurological
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and hormonal imbalances, but all of them can feed the migraine beast, if not addressed.
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Now let's shift to the East.
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In traditional Chinese medicine, it has always treated sleep as a dialogue with time, not a random
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In traditional Chinese medicine, the night is mapped hour by hour through what is called
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the Chinese organ clock. That's a framework showing when different organ systems are meant
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to rest, prepare and regulate the body.
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And when sleep breaks in a specific time, troubling falling asleep, waking up at 2-3
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am, waking up too early, it is seen less as insomnia per se, but more as information. And
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your body isn't misbehaving, it's communicating where a balance is missing. The goal
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isn't to knock the system out with a pill, but to listen to the timing and restore harmony
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so sleep can return naturally.
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I remember the story of Jade from Singapore. We had been working together and she was
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over the moon, not with migraines anymore. And one or two weeks later, she calls me and
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she says, something really interesting happened. And I thought, and she says in French,
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Je veux rendre à César ce qui est à César. So I want to give to Caesar what's to Caesar.
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And I'm like, what could she possibly mean? And she says, I've been watching my watch
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and it has all of my sleep. And I noticed that my deep sleep doubled and you're the
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only thing that changed in my life. So clearly you did this. Can you explain to me how you
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managed to double my deep sleep?
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Anyway, it's the first time it was back in 2000, I think 19 or 20. And I said, oh, of course I can't
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make you have much less migraines unless you sleep well. Just amazed. I thought it was
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quite, you know, normal or expected, but clearly it shocked her. And this is really when I started to look
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into sleep and then start to monitor sleep as a symptom inside the app.
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Now back to TCM. So for example, difficulty falling asleep in the evening often points
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to stomach spleen or heart and shin, mind spirit agitation. So too much mental activity, emotional
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unrest, overstimulation that keeps the mind from settling. Waking between 1 and 3 a.m.
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So here you're going to notice we're not talking 2 to 4, we're actually on a different clock.
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So 1 to 3 a.m. is classically associated with the liver system, which is going to govern flow,
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emotional processing, and detoxification. So as some of you know, I lived in China and Shanghai
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for five years. And of course I had a lot of food takeaways. And part of that, I was exposed to a
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lot of MSG, which at some point my liver had had too much of. And so one thing I noticed,
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it was quite subtle, but if I was having MSG, you know, part of my dinner, I would wake up
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straight at 1 a.m., very predictably so. And so until I clean my liver from that MSG, pause
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the exposure, and then now it's fine. But it's really like you feel like it's a clock,
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like you have a meeting with your liver. And you know, once it's time, it's like you start by
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saying, hey, I'm really grumpy. What did you do wrong today or this month? Now early morning
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waking, particularly between 3 and 5 a.m., maps to the lung system. So more linked to grief,
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depletion, and the ability of letting go. And each timing pattern is going to give us a clue,
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not a diagnosis, but a direction that we can look at the broader picture with other symptoms.
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And so what's powerful about this framework is that it shifts the solution away from sedation
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and towards internal balance. Instead of forcing sleep, traditional transmedicine is going to work
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to calm what's overactive, nourish what's depleted, and help energy move where it's stuck
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through food, rhythm, breath, gentle herbs, emotional regulation, and lifestyle alignment
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with natural cycles. And when the liver softens, the heart settles, when the system feels safe,
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the mind can rest. And sleep, in this view, isn't something you chase. It's something that returns
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once the body feels coherent again. And this is why traditional transmedicine doesn't ask,
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how do we make you sleep? It asks, what keeps your system from resting? So what can you do today?
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Tonight, try this before going to bed. Turn off your screens, of course, dim your lights, and place
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your fingertips on the inside of your wrist, right at the crease. And that's heart 7, one of the
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acupuncture points. Gentle press and breathe into it for 1-2 minutes on each side. And that simple
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acupressure point helps calm the shin, quiet the mind, and prepare the body for rest. So sleep
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disturbances rarely show up alone in migraine. I really invite you to explore the podcast topics
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that resonate with you, and slowly assemble the pieces of your migraine puzzle. And remember,
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every small step you take moves you closer to freedom. You are powerful, you are resilient,
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and you are no longer alone. Keep rising, migraine hero.
