Painkillers are not the only way to treat migraine headaches. For one writer, a new approach to sleep, cutting out caffeine, meditation and dietary supplements have eased the pain
My earliest memory is of a migraine. I was sitting outside in a blue-and-white striped deckchair. The sun was too hot and the light was too bright and the pain was like a white fire up the sides of my face, and in my eyes. I drank some orange squash. It was like I’d taken a thick, choking gulp of orange-scented washing-up liquid. I knew I was going to be sick. I didn’t know how to communicate any of this. My mother and I have dated this memory to a family holiday in Bournemouth on the south coast of England when I was 18 months old.
Migraines are part of my inheritance: my father gets them, and his mother remembered her mother going to bed with “sick headaches”. My usual routine when one begins is to take ibuprofen or Migraleve and then sit in a darkened room for 16, 18, 24 hours, staring into the darkness and waiting for the tentacles of pain to recede from my skull. In the last couple of years they have become more frequent. In the first four months of this year, I had about six to eight a month. Each one wipes out a day and leaves me jittery when it’s over.
What to do? I could beg my doctor for preventative beta-blockers, but the list of side-effects including depression, insomnia and loss of libido sounds even less attractive than the migraines. I’d go for homeopathy or reiki except I think they’re nonsense.
Instead, I spoke to a UK health service migraine consultant. Are there any remedies that have actually been researched and tested? It turns out there’s a very long list. And I agreed, with a certain amount of hesitation, to follow all the recommendations for a few months.
Number one, I was told, was to cut back on painkillers -- it’s counterintuitive, but they can cause “rebound” headaches, especially those, such as Migraleve, which contain codeine. Different people respond differently, but it’s a good rule of thumb not to take them for more than two days in a week. Second, cut right back on caffeine. Migraineurs -- that’s people who suffer from migraine -- often overuse caffeine in an attempt to regulate their sleep, but end up not getting good-quality rest.
This leads to a third, all-important recommendation: “good sleep hygiene”. That means getting to bed and getting up at the same time every day. Which is a lot harder than it sounds; over the last couple of months I’ve realised how much I rely on being able to tweak my sleep. Stay up late for a night out, get up early to make a morning train. For my experiment I chose a sleep period of midnight to 8am, but having a “bedtime” made me feel socially alienated. If you need to be asleep by midnight, you have to leave the party by 11pm. Suddenly, I felt about 90 years old and boring. But, increasingly, pain-free. I’d been dimly aware that I was more likely to get a migraine after a bad night’s sleep, but this was a revelation.
Other recommendations were less arduous. Get more exercise: a virtual no-brainer. I bumped up my one or two weekly gym visits to a solid three or four. I took up meditation -- recommended for tension headaches, because I suspected that my migraines increased when I was under stress.
Finally, the consultant recommended I try taking vitamin supplements of riboflavin and co-enzyme Q10. As a loyal Ben Goldacre reader I was dubious: surely the nutritional supplement industry is all a con? Co-enzyme Q10 sounds like something invented by hair-product manufacturers to sell conditioner. But it turns out there are some small but well-conducted double-blind studies demonstrating significant reductions in migraines in people taking one of these supplements. Still dubious, I started taking the pills.
And has it worked? Well. The month before I started, I had six migraines. This month, after two months of treatment, I’ve had one. And it lasted only seven hours. And didn’t hurt so much. The riboflavin and Q10 studies had mentioned something called “reduced intensity”, but I honestly couldn’t imagine what that meant until I experienced it: my migraines have always hurt the same amount. This duller migraine is new.
True, there’s no way to tell which of these treatments has made the difference, but I suspect that it’s the combination of all of them. I’ve tried most of these treatments before, but never all together. They’re not expensive -- the most costly elements are the vitamins, at GBP25 for a month’s supply, and entry to your local fitness centre -- but they can be inconvenient. The most exciting thing, though, is that I now feel some kind of control over my migraines. I can choose to come home early to make my bedtime, or stay out late and risk a migraine the next day -- but the sense that I actually have a choice is brand new. Copyright: Guardian News & Media 2010