Migraines, Sleep Habits and Melatonin

Another new study has linked Migraine headaches and sleep disturbances.

When hyperactive nerve cells send impulses to blood vessels, Migraines can be the result. This is accompanied by the release of brain chemicals and inflammatory substances that cause the pulsations to be painful.

Research recently published in the journal Headache demonstrated a link between migraines and sleep disturbance. Researchers conducted a detailed sleep interview with 147 women with migraines. When asked whether they were refreshed or tired upon waking, none reported feeling refreshed, and more than 80% said they were tired when they woke.

In a second study on sleep habits and migraines, also published in Headache, researchers provided stronger evidence that good sleep habits reduce both the number and intensity of migraine headaches. In these findings, 43 women with transformed migraines received behavioral sleep instructions or placebo instructions in addition to usual medical care. The women recorded their migraine headaches in diaries. At the end of the study, the women who received behavioral sleep instructions reported a significant reduction in migraine headache frequency and intensity.

Taking melatonin 30 minutes before bedtime can help curb migraine headaches, according to a small study by Brazilian scientists.

Melatonin is a hormone produced in the brain's pineal gland; it helps regulate sleep-wake cycles. Imbalances in the level of melatonin in the body may be related to headaches like migraines and cluster headaches.

The findings, which come from a team of researchers led by Mario F.P. Peres, MD, PhD, of Hospital Israelita Albert Einstein in Sao Paolo, Brazil, show that melatonin may be used as a preventive therapy for frequent migraine sufferers.

During the study's last three months, participants took 3 milligrams of melatonin 30 minutes before bedtime.

Sources:
Peres, M. Neurology, August 2004; vol 63: p 757
American Headache Society: "Headache Hygiene Tips." The International Headache Society: "Epidemiology of Headache." WebMD Medical Reference: "Women and Headache: Migraine." The Women's Guide to Ending Pain by Howard S. Smith, MD, and Debra Fulghum Bruce, PhD. Calhoun AH. Ford S. Finkel AG. Kahn KA. Mann JD. Neurology. 2006; vol 46: p 1039. Calhoun AH. Ford S. Headache, 2007; vol 47: pp 1178-83. Vincent Fortanasce, MD, neurologist, psychiatrist; author, Anti-Alzheimer's Prescription. Ronald Fieve, MD, professor of clinical psychiatry, Columbia Presbyterian Medical Center; author, Bipolar II. The Fibromyalgia Handbook, Harris H. McIlwain, MD, and Debra Fulghum Bruce, PhD. Medicinenet, "Migraine Headache."

The Secret to Long Life

Former assistant surgeon general Dr. Douglas Kamerow tells us what is the most significant factor for longevity.

Hint: It's not what you eat or how much you exercise.

Click Here to Listen


Source:
All Things Considered, January 1, 2008

Exercise as Good as Surgery for Knee Pain

An exercise regime is as effective as surgery for people with a chronic pain in the front part of their knee, known as chronic patellofemoral syndrome (PFPS).

PFPS is often treated with arthroscopic surgery, in which equipment is inserted through small incisions in your knee to diagnose and fix the problem. However, there is little evidence that this treatment is the best option.

The study, conducted by researchers at The ORTON Research Institute in Helsinki, Finland, compared arthroscopy with exercise in 56 patients with PFPS.

One group of participants was treated with knee arthroscopy and an eight-week home exercise program, while a second group received only the exercise program.

After nine months, patients in both groups experienced similar reductions in pain and improvements in knee mobility. A follow-up conducted two years later still found no differences in outcomes between the two groups.

The only difference discovered was in cost: those who had received the surgery had to pay over $1,300 more than the exercise-only group.

The researchers concluded that arthroscopy is not a cost-effective treatment for PFPS.

Sources:

Science Daily December 13, 2007
BMC Medicine December 13, 2007, 5:38