MINNEAPOLIS — If it feels like your headaches happen like clockwork, arriving at the same time of the day, then there might be something wrong with your body’s internal clock. A new study finds that disruptions to a person’s circadian rhythms have a link to cluster headaches and migraines.
“The data suggest that both of these headache disorders are highly circadian at multiple levels, especially cluster headache,” says study author Mark Joseph Burish, MD, PhD, a researcher at the University of Texas Health Science Center at Houston and a member of the American Academy of Neurology, in a media release. “This reinforces the importance of the hypothalamus—the area of the brain that houses the primary biological clock—and its role in cluster headache and migraine. It also raises the question of the genetics of triggers such as sleep changes that are known triggers for migraine and are cues for the body’s circadian rhythm.”
Researchers found 71 percent of people with cluster headaches experienced them at the same time every day. The headaches typically manifested between the late hours of the night and early morning. People’s cluster headaches also appeared more often during the spring and fall. When looking at people’s genes, cluster headaches displayed a connection with the expression of two circadian genes. What’s more, five of nine circadian genes raised the risk of cluster headaches.
Your hormones may also be triggering headaches
The study authors also took a look at how hormones affected headaches and migraines. Cortisol and melatonin are two hormones whose levels depend on circadian rhythms. The results showed people with cluster headaches often had elevated cortisol levels and lower melatonin levels in comparison to people who did not regularly experience these types of headaches.
Half of the people with frequent migraines (50%) showed a pattern of attacks that revolved around a particular time of day. Most people experienced migraines during the day, ranging from late morning until early evening. Few attacks occurred during the night. Circadian-related migraines also had a link to two circadian genes. Additionally, the team identified 110 out of 168 genes related to migraines that had to do with managing the body’s biological clock. An analysis of urine samples showed people with migraines had lower melatonin levels than people without migraine. There were also drops in melatonin levels during a migraine attack.
“These results raise the potential for using circadian-based treatments for headache disorders,” Burish explains. “This could include both treatments based on the circadian rhythm – such as taking medications at certain times of the day—and treatments that cause circadian changes, which certain medications can do.”
One study limitation was that researchers did not have information on other factors that could influence people’s internal clocks. For example, some medications and bipolar disorder can disrupt someone’s circadian rhythms. Additionally, working nighttime shifts and sleeping during the day can shift a person’s natural biological rhythm — which can cause sleep problems.
The study is published in the journal Neurology.