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Friday, November 11, 2005

Theory # 11: CFS, Migraines, and Sleep

I just had my first migraine in... oh, it must be at least a decade. And it's been over 25 years since I had them regularly. So it's got me thinking.

Between the ages of 11 and 18, I had migraines on average of once every month or two. The trigger was invariable and easily identifiable: lack of sleep. If I didn't get enough sleep, I ended up with a migraine, period. I never had them when I wasn't short of sleep. The fact that they stopped abruptly when I went away to college seems to suggest that the stress at home was a factor, particularly since, like most college students, there were any number of late nights.

They didn't reappear when I had kids, either, and new parenthood is pretty much universally synonymous with sleep deprivation.

Fast forward a bit over 20 years, and I get CFS--chronic fatigue. One of the symptoms has been headaches whenever I've exerted myself too much. Not migraines, just run of the mill headaches.

But this migraine really seemed to fit in with the CFS. The fuzzy-headedness and shakiness just before the full-blown headache hit was very much like the CFS version. And in the days following the migraine, the CFS was worse than it was before the migraine. This last is what makes me suspect a connection.

For the past year at least I've been getting very little sleep. Six hours of sleep was a good night. Most nights I'd get four or five. So why the migraines didn't show up sooner is a mystery. Maybe I got enough rest by taking care of the CFS. In the week before the migraine, I'd been pushing the exercise, trying to recover (and to lose weight!), so perhaps my usual work-rest cycles weren't as effective.

It occurs to me that even though I'd had other periods in my life when I felt short of sleep, maybe I wasn't truly as sleep deprived as I thought. In college, I routinely missed any early-morning classes, making up for those late nights. And as a new parent, I remember being tired all the time, so I took naps.

My theory is that my body is wired to require a certain amount of sleep, and when that's not met, it manifests itself--in adolescence, and again last week as migraines; and for the past 4½ years as CFS. I wish I remembered what my sleep patterns were in the winter of '00/'01, to see whether sleep loss played a part in the onset of CFS.

Or maybe it's overexertion, not lack of sleep as such. The CFS onset was due, as far as I can tell, to pushing myself through a nasty stomach virus. Perhaps the overexertion in adolescence was emotional rather than physical.

That would make sense, and it would fit with a theory espoused by a fellow CFS sufferer on an email list some time ago--she averred that CFS was triggered, if not outright caused, by stress. I argued that fact, because I am, and was, one of the least stressed people I know--happy marriage, trouble-free kids, no stressful job, etc. But if it's physical as well as emotional overexertion, that would fit.

Or perhaps there's no connection between migraines and CFS, and rather than the migraine affecting the CFS, it's just that the exertion and lack of sleep that triggered the migraine also exacerbated the CFS, but it seems an interesting coincidence that sleep figures so prominently in both.

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