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	<title>migraines Archives - Amazing Health Advances</title>
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		<title>5 Common Questions about Migraines</title>
		<link>https://amazinghealthadvances.net/5-common-questions-about-migraines-8518/#utm_source=rss&#038;utm_medium=rss&#038;utm_campaign=5-common-questions-about-migraines-8518</link>
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		<dc:creator><![CDATA[The AHA! Team]]></dc:creator>
		<pubDate>Fri, 11 Apr 2025 05:22:30 +0000</pubDate>
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		<category><![CDATA[Brain Health]]></category>
		<category><![CDATA[Healthcare]]></category>
		<category><![CDATA[Mental Health]]></category>
		<category><![CDATA[contributing factors to migraines]]></category>
		<category><![CDATA[Duke Health]]></category>
		<category><![CDATA[head pain]]></category>
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		<category><![CDATA[treating migraines]]></category>
		<guid isPermaLink="false">https://amazinghealthadvances.net/?p=17488</guid>

					<description><![CDATA[<p>Morgan deBlecourt via Duke Health &#8211; Migraines are more than just bad headaches, and they’re more common than most people think. Here, Timothy Collins, MD, a headache specialist at Duke, answers five common questions about migraines. 1. What Is a Migraine? Migraines are a moderate to severe throbbing pain in the head (usually on one side, but sometimes both), that often includes nausea, dizziness, facial tingling or numbness, visual disturbances, or sensitivity to light, sound, or smell. They can happen as often as several days per week. Each person may have their own combination of symptoms, and they can change from one migraine to the next. 2. What Causes Migraines? While no one knows for sure why migraines happen, newer treatments target a specific protein that appears to contribute to migraines. Migraines are much more common in women, which suggests that hormones like estrogen may play a role. A genetic link may also increase your risk, as migraines appear to run in families. Researchers continue to search for the root cause of migraines. 3. Will Migraines Get Better Over Time? The good news is that most people with migraines have fewer headaches as they get older. But this is not guaranteed, which is why your doctor will likely recommend treatment now rather than wait. 4. Are Migraines Damaging My Brain? No. Migraine headaches do not cause any damage to your brain or head, even when they are severe. 5. What&#8217;s the Best Treatment for Migraines? Fortunately, there are many medications available for headache treatment. But while every medication is right for someone, that someone might not be you. Your doctor may have you try several different medications to find the right one. Although there is no definitive test for migraine, neurologists and headache specialists can help sort through your headache symptoms, severity, frequency, and other characteristics to determine whether migraine is the right diagnosis and to recommend a treatment plan. Dr. Collins is a neurologist and headache specialist with more than more than 25 years of experience treating migraines and other headache disorders. To read the original article click here.</p>
<p>The post <a href="https://amazinghealthadvances.net/5-common-questions-about-migraines-8518/">5 Common Questions about Migraines</a> appeared first on <a href="https://amazinghealthadvances.net">Amazing Health Advances</a>.</p>
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		<title>Kola Nut: The Little-Known Ingredient that Supports Energy Levels</title>
		<link>https://amazinghealthadvances.net/kola-nut-ingredient-that-supports-energy-levels-8348/#utm_source=rss&#038;utm_medium=rss&#038;utm_campaign=kola-nut-ingredient-that-supports-energy-levels-8348</link>
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		<dc:creator><![CDATA[The AHA! Team]]></dc:creator>
		<pubDate>Fri, 08 Nov 2024 06:30:00 +0000</pubDate>
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		<category><![CDATA[Diet]]></category>
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		<category><![CDATA[Kola Nut]]></category>
		<category><![CDATA[migraines]]></category>
		<category><![CDATA[nuts]]></category>
		<guid isPermaLink="false">https://amazinghealthadvances.net/?p=16547</guid>

					<description><![CDATA[<p>Rachael Link, MS, RD via Dr. Axe &#8211; Although few people have ever heard of the kola nut, it’s a common ingredient found in everything from soft drinks to herbal supplements. Although few people have ever heard of the kola nut, it’s a common ingredient found in everything from soft drinks to herbal supplements. Not only does this nutritious nut boast a unique flavor and aroma, but it’s also brimming with caffeine as well. In fact, each pod packs the equivalent caffeine content of about two cups of coffee nutrition, along with a host of antioxidants and other health-promoting compounds. Ready to learn more? Keep reading for everything you need to know about the kola nut, including its benefits, side effects and potential uses. What is the kola nut? The kola nut, sometimes also called the cola nut, is a type of edible nut that comes from the kola tree, which is native to West Africa. These trees can grow up to 60 feet tall and are notable for their vibrant yellow flowers and star-shaped fruits, each of which contains two to five kola nuts. These healthy nuts are high in caffeine and often used as an herbal supplement and natural food flavoring. The kola nut taste is initially very bitter, but it becomes sweeter when chewed. The nuts can be dried, giving them a much more mild flavor and nutmeg-like aroma. Keep in mind that the kola nut should not be confused with gotu kola or bitter kola, also known as Garcinia kola. Like the kola nut, these two plants are known for their medicinal properties and have been used to treat a variety of ailments. However, despite having similar names, they are unrelated and belong to completely different species of plants. Types/varieties Kola nuts are very common throughout West Africa and often consumed fresh or dried for a quick burst of caffeine. Red and white kola are the two main varieties, each of which is produced by the same plant species and sometimes even found within the same pod. These nuts also play a central role in many cultures and traditions. In a kola nut Igbo ceremony, for example, the nut is presented to welcome visitors and used to symbolize peace and goodwill. In other parts of the world, kola nut extract and kola nut powder are much more common than the fresh nut itself. These ingredients are found in many sodas, energy drinks, weight loss drugs and herbal supplements. In addition to bumping up the caffeine content of these products, the nuts also provide a unique taste and aroma. Health benefits Rich in caffeine, theobromine and disease-fighting antioxidants, the kola nut has been linked to a number of powerful benefits. Here are a few of the ways that this healthy nut could impact your health. 1. Enhances energy levels Kola nuts are high in caffeine, a compound found in coffee and tea that acts as a central nervous stimulant. Caffeine alters the activity of certain neurotransmitters in the brain, leading to increased energy levels, focus and alertness. What’s more, studies even have shown that moderate amounts of caffeine could also enhance endurance, brain function and mood while decreasing the perception of fatigue. 2. May promote weight loss Thanks primarily to its caffeine content, some research has suggested that the kola nut could potentially help ramp up weight loss. This is because caffeine has been shown to increase metabolism by bumping up the amount of calories burned throughout the day. It may also help decrease energy intake, which could also be beneficial for weight loss. A 2002 study published in the International Journal of Obesity and Related Metabolic Disorders examined the effects of an herbal supplement with kola nut on weight loss. In this six-month randomized, double-blind, placebo-controlled trial, 167 people were divided into taking a placebo or the herbal treatment for six months. After six months, the kola nut supplementation group had greater weight loss and lost more body fat, not to mention saw a decrease in LDL cholesterol and increase in HDL cholesterol compared to the placebo group. This led researchers to conclude that the kola nut supplement promoted weight and fat loss and improved lipid profiles. 3. Could help treat migraines Caffeine has long been used as a natural remedy to provide quick relief from headaches and migraines. It works by constricting blood vessels in the brain, which can decrease blood flow and reduce pain. According to a review in the Journal of Headache and Pain, combining caffeine with over-the-counter medications like aspirin or ibuprofen significantly improved symptoms of migraines and tension headaches compared to medications alone. Historically, kola nuts have been used to treat migraines and headaches, along with many other conditions ranging from morning sickness to indigestion. However, more scientific studies are needed to evaluate the effects of the kola nut and whether or not it can treat or prevent headaches. 4. Helps stabilize blood sugar Several recent studies have focused on the potential relationship between the kola nut and diabetes. According to a 2019 animal model published in the Journal of Ethnopharmacology, kola nut extract was found to have powerful anti-diabetic properties and was able to decrease blood sugar levels when administered to rats. Not only that, but treatment with kola nut extract was also able to improve the function of beta cells in the pancreas, which are responsible for the production of insulin. Kola nuts are also rich in caffeine, which may be beneficial for balancing blood sugar levels. One massive review in Archives of Internal Medicine even found that each cup of coffee consumed per day was associated with a 7 percent lower risk of developing type 2 diabetes. However, more research on humans is needed to confirm the anti-diabetic effects of kola nut. 5. May block growth of bacteria Some research has found that the kola nut could possess potent antibacterial properties, which could potentially help prevent the growth of harmful, disease-causing pathogens. For instance, one in vitro study conducted in Nigeria noted that red and white kola nut extracts were effective against several strains of bacteria, including Streptococcus anginosus and Proteus vulgans, both of which can cause dangerous infections in humans. Uses What foods contain kola nut, and how can you start incorporating it into your diet? Depending on where you live, you may have a hard time finding fresh kola nuts for sale at your local supermarket. Certain online retailers and specialty shops may carry them, but they are often more widely available in powder, capsule or tincture form instead. Try mixing powdered varieties into yogurt, smoothies or cereals for a kick of caffeine and antioxidants. Alternatively, you can use it to brew kola nut tea by combining one teaspoon with a cup of hot water and steeping for a few minutes to taste. Nutrition facts Kola nuts are high in caffeine, a compound that acts as a central nervous stimulant and has been linked to a long list of potential health benefits, ranging from increased energy levels to reductions in hunger and appetite. In addition to providing a hearty dose of caffeine in each serving, kola nuts are also high in theobromine, a chemical compound found in food sources like chocolate and tea leaves. Theobromine can dilate the blood vessels, stimulate the heart and act as a natural diuretic to promote urine production. Kola nuts also offer a range of antioxidants and polyphenols, including catechin, epicatechin, apigenin and naringenin. Risks and side effects According to the U.S. Food and Drug Administration, the kola nut is generally recognized as safe for human consumption. However, although this nutritious nut can be safely consumed by most, there are a few kola nut side effects to consider as well. Because kola nuts are high in caffeine, it’s very important to keep your intake in moderation. Not only is caffeine very addictive, but consuming high amounts can cause side effects like hyperactivity, nervousness, fidgeting and sleep problems. It’s generally recommended to limit caffeine intake to fewer than 400 milligrams per day for most healthy adults. However, those who are pregnant should limit their caffeine consumption to fewer than 200 milligrams per day to avoid caffeine overdose. Caffeine is also not recommended for infants, children or adolescents, as there is limited research on its safety or potential side effects. If you have any underlying health conditions or take any medications, it’s best to consult with your doctor before making any changes to your diet or starting any new supplements. Conclusion What is the kola nut? Native to West Africa, the kola nut is a popular ingredient derived from the fruit of the kola tree. Keep in mind that this specific type of nut should not be confused with the bitter kola nut, a plant that is also known for its medicinal properties but is unrelated to the kola nut. Although they are often enjoyed raw, dried or ground in many parts of the world, kola nuts are also a common ingredient in sodas, sports drinks, weight loss drugs and herbal supplements. Potential kola nut benefits include increased energy levels, enhanced weight loss, better blood sugar control, decreased bacterial growth, and relief from migraines and headaches. However, it is also high in caffeine and can cause adverse effects when consumed in high amounts, including hyperactivity, nervousness and fidgeting. To read the original article click here.</p>
<p>The post <a href="https://amazinghealthadvances.net/kola-nut-ingredient-that-supports-energy-levels-8348/">Kola Nut: The Little-Known Ingredient that Supports Energy Levels</a> appeared first on <a href="https://amazinghealthadvances.net">Amazing Health Advances</a>.</p>
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		<title>6 Ways to Naturally Eliminate Migraines</title>
		<link>https://amazinghealthadvances.net/6-ways-to-naturally-eliminate-migraines-6907/#utm_source=rss&#038;utm_medium=rss&#038;utm_campaign=6-ways-to-naturally-eliminate-migraines-6907</link>
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		<dc:creator><![CDATA[AHA Publisher]]></dc:creator>
		<pubDate>Wed, 28 Oct 2020 07:00:45 +0000</pubDate>
				<category><![CDATA[Archive]]></category>
		<category><![CDATA[Health Disruptors]]></category>
		<category><![CDATA[acupuncture]]></category>
		<category><![CDATA[blurred vision]]></category>
		<category><![CDATA[dizziness]]></category>
		<category><![CDATA[headache]]></category>
		<category><![CDATA[Magnesium]]></category>
		<category><![CDATA[Melatonin]]></category>
		<category><![CDATA[migraines]]></category>
		<category><![CDATA[nausea]]></category>
		<category><![CDATA[sensitivity to light and sound]]></category>
		<guid isPermaLink="false">http://amazinghealthadvances.net/?p=10295</guid>

					<description><![CDATA[<p>Dr. Matthew Roe via NaturalHealth365 &#8211; Migraine headaches are the second most common type of primary headache after tension headaches. And, just to be clear, a “primary” headache is a headache that is not caused by another disease or condition. Along with debilitating pain, migraines can generate blurred vision, dizziness, nausea, and sensitivity to light and sound.  Often without much warning, migraines can happen once a year, monthly, or several times a week. And, unfortunately, migraines can either occur with an aura – which is known as the classic migraine – or without an aura, which is called a common migraine. What can trigger a migraine? The possible migraine triggers not only vary from one individual to another, but encompass a whole range of common substances. This can include hormonal imbalances, synthetic fragrances, processed cereals (or other junk foods) and skipping meals.  A simple drop in blood sugar can cause all kinds of health issues including head pain. The list of possible triggers is so long – it often appears impossible to eliminate the so-called causes.  In the food category alone the list is extensive and includes ripened and aged cheese, poor-quality chocolate, citrus fruits, conventionally-raised (processed) meat with nitrites such as hot dogs, MSG, caffeinated beverages and alcohol. Food additive such as nitrites, sulfites, and aspartame can be the culprit behind a migraine.  In fact, studies show a large percentage of migraine sufferers point to specific foods as the trigger. Non-food triggers include changes in the atmosphere such as drops in barometric pressure, high temperatures and bright, fluorescent lights.  Many women get migraines monthly due to hormone fluctuations or the use of birth control pills. However, one of the most common migraine triggers seems to be chronic stress.  It is a known fact that anxiety, worry, depression and moods changes can all release specific brain chemicals – which can trigger a migraine. Sadly, Western medicine promotes the use of analgesic migraine medications – including both prescription pain relievers and over-the-counter drugs – which produce “rebound” headaches.  The point here is simple: no pill will ever solve the (underlying) problem associated with chronic head pain. A better way to achieve freedom from chronic headache pain Even with many drugs, lifestyle techniques, and surgical options available to treat and prevent the onset of a migraine – finding the right combination of therapies to manage migraines can be difficult. Fortunately, there is growing scientific evidence to suggest that natural means are just as effective as prescription medication and, many times, even more effective. #1 – Biofeedback: Most studies on biofeedback show that it can reduce the frequency and duration of headaches. The effects of biofeedback appear to be comparable to many drugs used for chronic headaches, and can be recommended as early treatment for recurrent migraines. #2 – Acupuncture: Albrecht Molsberger, MD, a medical acupuncture said it is at least as effective as blood pressure medication such as, beta-blockers – most often used for migraine prevention. The American Headache Society has recommended acupuncture for migraines. Acupuncture helps the natural energy flow and is thought to correct an energy disruption which leads to a migraine. #3 – Melatonin: Two-thirds of study participants who took melatonin before going to bed every night for 3 months said the number of migraines they experienced dropped by 50%. #4 – Magnesium: Studies have shown that migraine sufferers have low brain magnesium during migraine attacks and may also suffer from a magnesium deficiency. It is thought magnesium deficiency may play a particularly important role in menstrual migraine. #5 – Diet: It pays to avoid headache-inducing substances, including nitrites in processed meats, sugar, processed foods, chocolate, nuts aged cheese, aspartame and monosodium glutamate (MSG) used in foods as a flavor enhancer.  It’s also worth mentioning that dehydration is a major cause of headaches. Even though food may not be the underlying cause of a migraine, a poor diet does contribute to the problem by depleting vitamins and minerals – which are meant to help ward off an attack. #6 – Upper cervical chiropractic treatment: The most recent research is showing that the most plausible cause of migraine headaches resides in the autonomic nervous system. The swelling of the blood vessels in the brain and the drop in neurotransmitters are secondary and mainly occur in response to the changes in the autonomic nervous system. Emotional stress is a well known trigger for migraine.  Japanese researchers have found that people living in fast-paced business centers in Tokyo tend to have an imbalance in the autonomic nervous system – specifically, an inhibition of the parasympathetic system that is active during relaxation, and an excitation of the sympathetic nervous system, which governs our response to stress. The major finding of a recent study is that migraine is a disorder of chronic sympathetic dysfunction. Many times the top vertebra in the spine known as the atlas can be jarred from its normal position. The atlas is the only vertebra in the entire spine not connected by discs to the vertebra below it and the atlas is the only vertebra that can induce increased pressure on the spinal cord. Right above the atlas sits the brain stem and a misalignment in the upper cervical spine can affect the functionality of the brain stem, which in turn can cause migraine headaches. The goal of the upper cervical treatment is to correct the misalignment consequently addressing the real cause of the migraine instead of just the symptoms. There are many case studies, which show a positive response using upper cervical chiropractic adjustments to treat migraines. About the author: Dr. Matthew Roe is a practicing upper cervical chiropractor and has a Bachelor of Science Degree in Exercise Science. He has a Doctor of Chiropractic degree graduating Cum Laude from Life University College of Chiropractic. Having studied with the best Upper Cervical specific doctors in the world he understands true healing. His practice focus is to help people fine true health naturally.  For more information about Dr. Roe – visit: WinterGardenChiropractors.com Sources for this article include: Healthline.com, Medscape.com, Holistichelp.net, Health.com To read the original article click here. For more articles from NaturalHealth365 click here.</p>
<p>The post <a href="https://amazinghealthadvances.net/6-ways-to-naturally-eliminate-migraines-6907/">6 Ways to Naturally Eliminate Migraines</a> appeared first on <a href="https://amazinghealthadvances.net">Amazing Health Advances</a>.</p>
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		<title>The Brain of Migraine Sufferers Is Hyper-Excitable, New Study Suggests</title>
		<link>https://amazinghealthadvances.net/the-brain-of-migraine-sufferers-is-hyper-excitable-new-study-suggests-6358/#utm_source=rss&#038;utm_medium=rss&#038;utm_campaign=the-brain-of-migraine-sufferers-is-hyper-excitable-new-study-suggests-6358</link>
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		<pubDate>Tue, 25 Feb 2020 08:00:24 +0000</pubDate>
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		<category><![CDATA[brain wave patterns]]></category>
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		<guid isPermaLink="false">http://amazinghealthadvances.net/?p=8052</guid>

					<description><![CDATA[<p>University of Birmingham via Newswise &#8211; Individuals who suffer from migraine headaches appear to have a hyper-excitable visual cortex researchers at the Universities of Birmingham and Lancaster suggest. Newswise — Migraines are characterised as debilitating and persistent headaches, often accompanied by an increased sensitivity to visual or other sensory stimuli. The exact causes of these headaches are not well understood, although scientists believe they may be related to temporary changes in the chemicals, nerves, or blood vessels in the brain. In a new study, published in the journal Neuroimage: Clinical, researchers set out to test a theory that at least part of the answer lies in the visual cortex &#8211; the part of our brain that is responsible for vision. Dr Terence Chun Yuen Fong, lead author on the study, explained: &#8220;Most migraineurs also report experiencing abnormal visual sensations in their everyday life, for example, elementary hallucinations, visual discomforts and extra light sensitivity. We believe this hints at a link between migraine experiences and abnormalities in the visual cortex. Our results provide the first evidence for this theory, by discovering a specific brain response pattern among migraineurs.&#8221; The study was carried out by researchers based in the Centre for Human Brain Health and School of Psychology at the University of Birmingham, and the Department of Psychology, Lancaster University. The team set up an experiment with a group of 60 volunteers, half of whom were &#8216;migraineurs&#8217; &#8211; regularly suffering from migraines. Participants were presented with a striped grating pattern, and asked to rate the pattern according to whether it was uncomfortable to look at, or any associated visual phenomena from viewing it. In a further test, the participants underwent an electroencephalogram (EEG) test, in which the researchers were able to track and record brain wave patterns when the visual stimuli were presented. In both tests, the researchers found a larger response in the visual cortex among the group of migraine sufferers when participants were presented with the gratings. The study also took into account results from a subgroup of non-migraineurs &#8211; participants who reported additional visual disturbances, a common feature of migraines. Surprisingly, it was found that these participants also showed hyperexcitability in the response of their visual cortex. Dr Ali Mazaheri, the senior author on the paper, explains: &#8220;Our study provides evidence that there are likely specific anomalies present in the way the visual cortex of migraine sufferers processes information from the outside world. However, we suspect that is only part of the picture, since the same patterns of activity can also be seen in non-migraineurs who are sensitive to certain visual stimuli.&#8221; The next step in this research will be to monitor the group over time to see if their response to the visual stimuli changes as they get close to having a migraine and to try to map what other physiological changes might be occurring. This will pave the way to being able to forecast migraine headaches and help prevent their onset. To read the original article click here.</p>
<p>The post <a href="https://amazinghealthadvances.net/the-brain-of-migraine-sufferers-is-hyper-excitable-new-study-suggests-6358/">The Brain of Migraine Sufferers Is Hyper-Excitable, New Study Suggests</a> appeared first on <a href="https://amazinghealthadvances.net">Amazing Health Advances</a>.</p>
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		<title>Nightly Sleep Disturbance Linked to Daily Risk of Migraines</title>
		<link>https://amazinghealthadvances.net/nightly-sleep-disturbance-linked-to-daily-risk-of-migraines-6216/#utm_source=rss&#038;utm_medium=rss&#038;utm_campaign=nightly-sleep-disturbance-linked-to-daily-risk-of-migraines-6216</link>
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		<pubDate>Tue, 17 Dec 2019 08:00:26 +0000</pubDate>
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		<category><![CDATA[sleep deprivation]]></category>
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					<description><![CDATA[<p>Brigham and Women&#8217;s Hospital via EurekAlert &#8211; Sleep fragmentation predicted migraine risk a day later while sleep duration and low sleep quality were not associated with risk of migraines. Boston, MA &#8212; Nearly half of all patients who suffer migraines report sleep disturbance as a trigger for their headaches. But the relationship between sleep and migraine headaches is not well understood or well-studied. Investigators from Brigham and Women&#8217;s Hospital and Beth Israel Deaconess Medical Center have conducted the largest prospective study using objective measures of sleep to date to evaluate the relationship between sleep and migraine headaches. The team&#8217;s findings generally support patients&#8217; reports of sleep disturbance as a trigger for migraines. In both diary assessments and actigraphy measurements, the team observed that sleep fragmentation &#8212; time spent in bed, but not asleep &#8212; was linked to migraine onset not on the next day but rather the day after that. The team did not find that sleep duration or self-reported low sleep quality was associated with higher risk of migraine over the next day or day after. Results are published in Neurology. &#8220;When it comes to sleep and migraines, there&#8217;s a lot that we don&#8217;t know. I became interested in this topic because migraine patients are frequently referred to me in the sleep clinic for help with treating their insomnia,&#8221; said corresponding author Suzanne Bertisch, MD, MPH, a physician and clinical investigator in the Division of Sleep and Circadian Disorders at the Brigham. Bertisch began work on this project while at Beth Israel Deaconess Medical Center. &#8220;Anyone treating these patients wants to be able to counsel them on what to do to decrease their risk of a migraine, but the literature is unclear on what kind of sleep interventions may be helpful.&#8221; Bertisch and colleagues conducted a prospective cohort study of 98 adults with episodic migraines, who reported at least two headaches, but had fewer than 15 days each month with a headache. The participants completed electronic diaries twice a day, recording details about their sleep, headaches and health habits for six weeks. During that time, they also wore a wrist actigraph to bed to objectively capture their sleep patterns. The team adjusted data for other migraine triggers, including daily caffeine intake, alcohol intake, physical activity, stress and more. Over the course of six weeks, participants reported 870 headaches. Nightly sleep duration of 6.5 hours or less and poor sleep quality were not associated with migraines the day immediately following (Day 0) or the day after that (Day 1). However, sleep fragmentation measured by both diary and actigraphy were associated with higher odds of having a migraine on Day 1. &#8220;Sleep is multi-dimensional, and when we look at certain aspects such as sleep, we found that low sleep efficiency, which is the amount of time you&#8217;re awake in bed when you&#8217;re trying to sleep, was associated with migraines not on the day immediately following, but on the day after that,&#8221; said Bertisch. &#8220;However, we did no observe a relationship between short nightly sleep duration (under 6.5 hours) or reported sleep quality and risk of migraine.&#8221; To read the original article click here.</p>
<p>The post <a href="https://amazinghealthadvances.net/nightly-sleep-disturbance-linked-to-daily-risk-of-migraines-6216/">Nightly Sleep Disturbance Linked to Daily Risk of Migraines</a> appeared first on <a href="https://amazinghealthadvances.net">Amazing Health Advances</a>.</p>
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