Similarities and differences between migraines and epilepsy

This article discusses similarities and differences between migraines and epilepsy.

Migraine and epilepsy have several things in common: they often co-occur and share similar symptoms, each is generally undertreated, one is often misdiagnosed as the other,1 and various medications are effective in treating both disorders.2 Recent research may help elucidate the relationship between the two and shed light on more appropriate diagnosis and treatment options.

“Patients with migraine are more likely to have epilepsy, and patients with epilepsy are more likely to experience migraine,” Pavel Klein, MD, director of the Mid-Atlantic Epilepsy and Sleep Center, told Neurology Advisor. In fact, people with seizure disorders are twice as likely to experience migraines which can often lead to misdiagnosis.3

There are commonalities between the two disorders “in clinical symptomatology, particularly with regard to visual and other sensory disturbances, pain, and alterations of consciousness.”3 For instance, if a patient has a migraine that causes focal neurological symptoms — numbness in the arm or face, for example — it can appear to be a seizure. It is also known that stress can trigger seizures, and in a less common scenario, “in someone with very severe migraine, it is possible that the stress of the pain could trigger a seizure,” Klein explained.

The potential reasons for the close relationship between the two disorders are just as varied. “There could be common substrates that cause both headaches and seizures,” said Klein. For example, a condition called benign epilepsy of childhood is commonly associated with migraine and is often misdiagnosed as such,3 while another possibility is that migraine could lead to mild forms of brain damage that increase the risk of epilepsy. Studies have found that MRI of some patients with migraine show small areas of abnormal lesions or scarring.4,5 Researchers are not yet sure of the cause, but it is possible that the scarring is a result of a stroke that is otherwise asymptomatic, and the “scarring leads to reorganization of the local network that could lead to seizures,” said Klein.

What Role Do Genetics Play?

Research published in Epilepsia in 2013 was the first to investigate the role of genetics in the co-occurrence of migraine and epilepsy.5 After testing 730 participants with epilepsy, researchers divided them into two non-overlapping groups — one with migraine with aura and one with migraine without aura — and interviewed participants about their family history of seizure disorders. The results showed that a history of migraine with aura was “significantly increased in enrolled participants with two or more additional affected first-degree relatives,” supporting the researchers' hypothesis of a shared genetic susceptibility to migraine and epilepsy.

“The hope of scientists, caregivers, and families with epilepsy is that genetics will offer a novel and wider understanding of the causes and the pathophysiology of epilepsy,” study co-author Melodie R. Winawer, MD, MS, an associate professor of neurology at Columbia University, told Neurology Advisor.

Approximately two thirds of epilepsy cases have no known cause, and genetic factors may play a critical role in that subset of cases. A ground-breaking aspect of these findings is in regards to reconceptualizing disease boundaries.

“A disorder does not stand alone but can be seen as part of a network of intersecting disorders — in fact, there have been intersecting bidirectional relationships identified for epilepsy, migraine, anxiety, depression, suicidality, and psychosis,” she said. “As we start to understand that some of these disorders are occurring in a network or a cluster rather than standing by themselves, I think it is going to completely transform treatment strategies” and potentially affect preventive efforts.

Ultimately, the knowledge of a shared pathophysiology could lead to the development of new treatment options, as well as recognition of accompanying disorders beyond seizures that can severely impact a patient's quality of life.

After all, failing to treat co-occuring disorders is a disservice to patients, said Winawer. Treatment of any condition — including migraine and epilepsy — should consider potential comorbidities that could worsen or improve depending on the chosen treatment. “We really need to understand epilepsy in its context,” said Winawer. “There is a huge move in the last few years to do that and I think this work is part of that larger question.” 

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Adolescent brain sensitivity

A few studies indicate that an adolescent's brain may be especially sensitive to new memories, drug use, and social stress.

Adolescence, like infancy, has been said to include distinct sensitive periods during which brain plasticity is heightened; but in a review of the neuroscience literature published on September 23 in Trends in Cognitive Sciences, University College London (UCL) researchers saw little evidence for this claim. However, a small number of studies do support that memory formation, social stress, and drug use are processed differently in the adolescent brain compared to other periods of life.

"Conclusively proving that adolescent sensitive periods exist will require studies comparing children, adolescents, and adults and will need to take into account individual differences in adolescent development," says Delia Fuhrmann, a PhD student in UCL's Institute of Cognitive Neuroscience Developmental Group. "Adolescents are much more likely than children to choose their own environments and choose what they want to experience."

Humans retain some plasticity--changes in brain and behavior in response to environmental demands, experiences, and physiological changes--throughout life. However, during sensitive periods plasticity is heightened and the brain "expects" to be exposed to a particular stimulus. For example, the brains of infants are primed to process visual input and language.

The ability to form memories seems to be augmented during adolescence, one example for how it may be a sensitive period. Memory tests in different cultures show a "reminiscence bump"; at 35 or later, we are more likely to recall autobiographic memories from ages 10 to 30 years than memories prior or subsequent. The recall of music, books, films, and public events from adolescence is also superior compared with that from other periods.

Further, they point out that simple aspects of working memory or ongoing information processing may reach maturity in childhood, while more complex, self-organized working memory abilities continue to improve during early adolescence and recruit frontal brain regions that are still developing. "Working memory can be trained in adolescents, but we don't know how these training effects differ from other age groups," Fuhrmann says. "Such data would be useful for planning curricula because it would tell us what to teach when."

Many mental illnesses have their onset in adolescence and early adulthood, possibly triggered by stress exposure. The UCL team explored studies indicating that both social stress and social exclusion have a disproportionate impact during adolescence. They also argue that adolescence may be a vulnerable period for recovery from these negative experiences.

"Adolescents are slower to forget frightening or negative memories," says Fuhrmann. "This might mean that some treatments for anxiety disorders, which are based on controlled exposure to whatever a patient is afraid of, might be less effective in adolescents and alternative treatments might be needed."

Finally, studies showed that adolescence is also a time of heightened engagement in risky health behaviors, such experimenting with alcohol and other drugs. Young adolescents seem to be particularly susceptible to peer influence on risk perception and risk taking compared with other age groups. Research in rodents also supports that adolescent brains might have an increased sensitivity to marijuana.

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Children with autism have higher cortisol levels

According to a recent study, children with autism were found to have elevated cortisol levels.

Researchers at the Institute for Autism Research at Canisius College have found that functional level appears to play a critical role in the stress levels of children with autism spectrum disorder (ASD). Specifically, lower-functioning children with ASD (LFASD) exhibited significantly higher levels of cortisol, the primary stress hormone in humans, than both high-functioning children with ASD (HFASD) and typical children.

Prior research has suggested that individuals with ASD experience elevated stress and related problems such as anxiety, however, many of the studies relied on informant rating scales and behavioral observations which have significant limitations for children with ASD. Attempts to more directly measure stress in this population using physiological measures such as cortisol have yielded mixed results. According to Susan K. Putnam PhD, chair and professor of psychology, the study's lead author, some of the inconsistent results may have been due to the prior studies not taking into account the significant differences in functional levels of individuals with ASD. "The inclusion of functionally-different individuals with ASD in studies has led to a need for studies of more precisely-defined subgroups with ASD, including subgroups based on functional level," said Putnam. This was the first study to assess cortisol (stress) levels in groups that were clearly differentiated based on functional level, specifically cognitive level.

Given the limitations in existing studies, the research team attempted to examine stress levels in ASD by examining the pattern of salivary cortisol across the day (morning, midday, and evening) and potential differences between lower-functioning children with ASD (LFASD IQ below 70), high-functioning children with ASD (HFASD IQ 85 or higher), and typical children. "It was important to determine whether the ASD groups exhibited the typical diurnal pattern of high cortisol in the morning, followed by a decrease at midday, and a further decline in the evening to determine if this typical pattern was present, and then examine the effect of functional level on stress level," said IAR co-director, Marcus Thomeer PhD, one of the study authors. Saliva samples were collected three times per day over four days on weekends from 13 children with LFASD, 16 children with HFASD, and 14 typical children. Results indicated that all three groups showed the typical pattern in which cortisol levels were highest at waking, followed by midday, and were lowest at bedtime. These findings are consistent with several prior studies of individuals with ASD.

The most significant finding, however, was that cortisol levels differed between the groups across the day. "Children with LFASD had significantly higher cortisol, the stress indicator, across the day than both the HFASD and typical children and, interestingly, children with HFASD did not significantly differ from the typical children across the day," said Putnam.

These findings have significant implications as they suggest that differences in cortisol levels and stress may be linked to the functional level, specifically IQ, of children with ASD. According to Putnam, this is an area in need of further study as it is unknown whether the elevated cortisol in the children with LFASD (compared to HFASD) is indicative of more significant neurological impairment and/or greater sensitivity to environmental stressors (associated with ASD symptoms), or whether a bi-directional relationship exists. IAR co-director Christopher Lopata PsyD, one of the study authors, noted that "identifying stress-level differences between functionally-differentiated groups with ASD has critical implications for how we assess and treat stress and stress-related reactions and conditions in children with ASD."

Findings from the study were recently published online first in the Journal of Developmental and Physical Disabilities.

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Study: Link between depression and sleep disorders in men

A study found a link between depression and sleep disorders in men.

Sleep problems are often caused by various mental illnesses, such as depression or post-traumatic stress disorder, but a new research shows interchangeability between sleep disorders and depression. Apparently, having trouble sleeping can also be a trigger.

Researchers from the University of Adelaide and the Adelaide Institute for Sleep Health examined levels of sleepiness throughout the day in almost 2,000 Australian men aged between 35 and 83.

It turned out that those exhibiting severe daytime sleepiness had 10 percent more chances of becoming depressed than those who felt rested during waking hours. Even after various risk factors were taken into account, the link between the two held up.

At the beginning of the assessment, none of the men entering the study were diagnosed with severe obstructive sleep apnea, but after joining, 856 of them were examined in the light of symptoms related to the condition.

Those receiving this diagnose turned out to be 2.1 times more prone to become depressed than participants who didn’t have the sleep condition.

According to the results, men who struggled with both extreme daytime sleepiness and severe sleep apnea had even more increased chances of depression – 4.2 times more than men with no sleep disorders. Suffering from both conditions also meant 3.5 times more chances of depression when compared with men with only one of them.

Two follow-up tests were involved in the evaluation of depression levels, taken at a five years difference from one another. This period allowed researchers to observe whether it is possible that sleep disorders are linked to a recent diagnosis of depression.

During those five years, men suffering from severe sleep apnea diagnosed during the study turned out to have 2.9 times increased risk of becoming depressed.

However, the study’s design could not help researchers determine whether sleep problems can be considered boosters of depression risk in men. They believe it is possible that depression is a cause of sleep disorders, but the reverse was more difficult to assess.

The team also considered the possibility that a third factor included in the equation could cause both depression and sleep troubles.

Authors of the study are still unsure about the exact relation between a sound sleep and risk of depression, but the results offer enough information doctors can use in their practices. For example, after a patient receives a depression diagnosis, physicians should order a screening for obstructive sleep apnea, even if the patient doesn’t show signs of sleepiness.

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Military members and sleep problems

This article discusses the importance of sleep for members of the military, especially post-deployment.

Improving the quality and quantity of U.S. military members' sleep following deployment could help reduce other health problems, including depression and post-traumatic stress disorder, according to a new RAND Corporation study.

However, a lack of consistent and transparent sleep-related policies may impede efforts to promote sleep health among service members, researchers say.

"The U.S. military has shifted from combat operations in Iraq and Afghanistan toward helping service members and veterans reintegrate into noncombat roles," said Wendy Troxel, co-leader of the study and a behavioral scientist at RAND, a nonprofit research organization. "One issue that is often overlooked once military men and women return home is that of persistent sleep problems, because in many ways such problems are viewed as endemic to military culture."

Sleep disturbances are a common reaction to stress and are linked to a host of physical and mental health problems. Sleep problems often follow a chronic course, persisting long after service members return home from combat, with consequences for their reintegration and the readiness and resiliency of the force, researchers say.

The RAND report is the first comprehensive review of sleep-related policies and programs across the U.S. Department of Defense, examining the frequency of sleep disorders and factors that contribute to the problem. A survey of nearly 2,000 service members from all branches of the U.S. military found sleep problems had negative effects on mental health, daytime functioning and perceived operational readiness.

"Military policies on prevention of sleep problems are lacking, and medical policies focus on treating mental disorders that are often linked with sleep problems, instead of sleep itself," said Regina Shih, project co-leader and a senior social scientist at RAND. "We know that sleep problems may precede the onset of mental disorders."

While there may be stigma about seeking sleep treatment, it may be lower than the stigma associated with seeking help for mental health problems. Researchers say this suggests sleep could be a gateway to improving psychological health and readiness in service members.

Researchers say that historically, military cultural attitudes have tended to discount the importance of sleep. For example, service members noted that depriving oneself of sleep is often seen as a badge of honor and acknowledging the need for sleep can be seen as a sign of weakness.

The study recommends widespread education and awareness programs within the Defense Department as one means of shifting these cultural attitudes. In operational contexts, the military emphasizes mission first and the need for sleep may be sacrificed for operational demands. Policies are needed to educate service members and leaders about the importance of sleep, including awareness on the importance of sleep for resilience.

Leaders are not always sure how to develop and execute sleep plans that can balance circadian rhythms with the realities of operational environments, or how to allow for adequate recovery periods after extended sleep deprivation in order to optimize force readiness.

The RAND study presents 16 policy recommendations to help the military improve the prevention, identification and treatment of sleep problems in service members. Those policies fall under four broad categories: prevention of sleep problems; increasing identification and diagnosis of sleep problems; ways to clinically manage sleep disorders and promote sleep health; and ways to improve sleep in training and operational contexts.

The report can be found online at:http://www.rand.org/pubs/research_reports/RR739.html

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Migraines in children

This article discusses how migraines manifest themselves in children.

Migraines aren't just a problem for adults -- about 6 percent of children and more than one-quarter of teens aged 15 to 17 have migraines, according to the American Migraine Foundation (AMF).

"There are many things that can be done if your child suffers from migraine, or if you suspect that he or she does," foundation chair Dr. David Dodick, a professor of medicine at the Mayo Clinic College of Medicine in Scottsdale, Ariz., said in an AMF news release.

If you suspect your child has migraines, take him or her to a doctor to be assessed and receive treatment if necessary. Options include treatment to stop the pain and prevent a migraine from getting worse, along with measures to prevent or reduce the frequency, severity and duration of migraines.

If your child is prescribed a migraine medication, it's important for you to make sure he or she takes the medicine as directed. Inform your doctor if there are changes in your child's migraines, such as becoming more frequent or severe. A new treatment approach may be required, according to the headache experts.

A number of factors may contribute to your child's migraines, such as too little or too much sleep or stress. Parents need to help their children follow healthy lifestyles and cope with stress. Recent research in stress management suggests that a type of counseling called cognitive behavioral therapy can benefit children with chronic headache, according to the AMF.

Other potentially helpful stress-control techniques include relaxation therapy and biofeedback.

Keeping a migraine diary can help youngsters understand why they get migraines and how to prevent them. The diary tracks migraines, the severity, how long they last, what patients were doing before and during the migraine, and what foods they ate.

Mobile phone apps may be an ideal way for children and teens to tracks their migraines and to take their medications as prescribed, the experts suggested.

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Getting to bed early helps mental health

Going to sleep early can help a person's mental health.

There are many benefits of going to bed early- and now, a team of researchers have found how this teeny tiny habit could have a positive impact on not just your physical health, but mental health as well.

Researchers from Binghamton University have found a possible connection between sleeping disorders and anxiety. It has been found that depression, anxiety, stress and obsessive compulsive disorders may cause heavy psychological traffic that could have an individual clinging too much to the past.

This new study, which took into consideration one hundred young adults, asked them to fill out questionnaires and carry out certain computerized tasks while the researchers assessed the extent of their obsessive behavior and thinking and worrying with respect to it. The study subject included individuals having different sleeping habits- some of them were night owls, while others had regular sleeping hours.

They found that individuals who slept less or went to bed late had signs of negative thinking as compared to those who slept early. While repetitive negative thinking isn’t a disorder as such, it does increase the risk of several anxiety disorders including depression and stress.

While the reason behind this phenomenon is unclear, scientists are making assumptions to decode it all. They have noted that sleeping late at night tends to disrupt the biological clock of the body, which also plays a negative impact on the levels of certain chemicals in our body.

These kinds of irregular sleeping patterns tend to upset the chemical production in the brain as well as other organs, even if you manage to get your much needed 8 hours of sleep a day.

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The impact of migraines on the whole family

This article discusses the impact that migraine headaches have on the entire family.

Most Migraine sufferers will tell you that their migraines are worsened by stress. Stress can come from a number of sources, but the ones that seem to be on the top of the list are school, or work, and family. Though all three are tremendously significant, it is infinitely easier to change a classroom, school or even job than it is to change one’s family.

Whether it be marital discord, money concerns, or parent – teen conflict, families issues have a tremendous impact on the migraineur and ignoring this is likely to result in less than successful migraine therapy.

On the flip side, having a supportive, understanding family can be an enormous help to the migraine sufferer…to an extent. Unfortunately, we find that very often with our adolescent patients, the parents are too focused on the migraine; so called “helicopter parents” who are hovering over their teen with repeated inquiries about their pain. In my clinic I had one parent ask her 16 year old son how he was feeling 4 times in a 15 minute visit. This kind of attention only serves to increase the focus on a problem that we are trying to minimize.

Often, having the whole family involved in the therapeutic process is the answer. It may mean scheduling visits at a time that spouses or parents are available, and it may involve family counseling. People often find the prospect of family counseling threatening. It really should not be viewed as such. Seldom do people take classes on being a spouse or a parent before having to be one. Processes that seem right and become family habit sometimes are detrimental in ways not obvious to those involved.

Making the effort to work on sources of family stress and how the family responds to them; learning to be supportive without being overbearing can be the key to improving the life not only of the migraineur, but the whole family.

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Headaches in children

This article discusses headaches in children, which is becoming more prevalent as the school year begins.

As the school year approaches and begins, many parents may start to hear their children complain about headaches.

According to Nick DeBlasio, MD, a pediatrician in Cincinnati Children's Hospital Medical Center's Pediatric Primary Care Clinic, about 10% of school-aged children and 15-27% of teens experience them from time to time.

Headaches can be triggered by a number of different things. Here are the most common causes of occasional headaches in children:

Inadequate hydration. Not drinking enough fluids is one of the biggest causes of headaches. This is especially true when the weather gets warmer and kids become more active outside and lose fluid through sweating. If this is the case, the cure might be as simple as having your child drink more water.

Diet. Does your child eat regular meals? Skipping one meal, like breakfast, can trigger a headache. It's also important to make sure that your child is eating a well-balanced diet with lots of fruits and vegetables. Too much caffeine and certain foods can cause a headache as well.

Sleep. Kids in middle and high school typically need at least 10-12 hours of sleep a night. Not sleeping enough at night can cause a headache. And getting less than 10 hours isn't enough to feel well-rested.

Stress. We all experience stress from time to time, and children and teens are no exception. If your child is under a lot of pressure from school, or experiencing big changes at home like a divorce or a big move, a headache can result.

Vision problems. If your child is unable to see what's happening at the front of the classroom, he might be straining his eyes to see far away, which can result in a headache. A vision test can give you a better understanding of whether or not your child's headaches are being caused by vision problems.

Family history. Your child is more likely to have headaches if a parent gets them as well.

If your child has a headache, try giving her water and over-the-counter ibuprofen. Follow the instructions on the package for the appropriate dosage and do not give it to your child more than three times in a week. If it persists for a few days or worsens, call your child's pediatrician.

Fortunately the majority of headaches in children are not a cause for alarm. However, there are a few instances which require a little more investigation. If your child's headaches have become more frequent or severe, if he wakes up in the morning of the middle of the night from it, or if the headache causes vomiting, it's best to have your child evaluated by your pediatrician.

He or she will perform a physical exam and decide if any tests need to be done. Brain MRIs and CT scans are rarely needed. If your pediatrician suspects a migraine, she might refer your child to a neurologist who is familiar with medications to help prevent and treat them.

And if your child or teen is suffering from chronic headaches and migraines, recent research by Cincinnati Children's found that adding cognitive behavioral therapy to treatment of pediatric migraines improves relief.

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Common issues that hurt your sleep

This article discusses common issues that hurt people's sleep, and tells you what to do about them.

You might remember a time when you could drift off to sleep in an instant and remain in a state of blissful slumber well past lunchtime the next day. Now your sleep is more likely to be lighter and more fitful, and when you wake up in the morning you don't always feel refreshed.

A lack of good-quality sleep could be a natural consequence of changing sleep-wake patterns after menopause. It's also likely that the issue is physical--and fixable. Many conditions can disrupt your rest, and they can be treated. It's important to address these issues. Lack of sleep does more than make you drowsy. Chronic insomnia has been linked to a variety of health problems, including obesity, high blood pressure, heart disease, diabetes and depression.

Go through this list to see whether you might have one of these sleep-stealing conditions. Also check your medicine cabinet. Some medications, including corticosteroids, beta blockers, cold and flu remedies, and certain antidepressants also can interfere with sleep.

1. Sleep apnea

The conventional image of sleep apnea is of the overweight man who snores, but women of any size can also develop these repeated pauses in breathing while they sleep.

"A woman who has a narrow jaw or a change in muscle tone can get apnea," says Dr. Julia Schlam Edelman, clinical instructor in obstetrics and reproductive biology at Harvard Medical School and author of "Successful Sleep Strategies for Women and Menopause Matters: Your Guide to a Long and Healthy Life." Either of these anatomical issues can block oxygen from reaching your lungs (and subsequently the rest of your body) while you sleep. Snoring might not be your main symptom if you do have sleep apnea, but you will notice that you're especially sleepy during the day.

Solution: See a specialist for a sleep study. You may be able to relieve apnea with a few lifestyle adjustments, such as sleeping on your side or losing weight. Your doctor might also suggest an oral appliance or a CPAP machine that blows air into your airways to keep them open at night.

2. Diet

What you eat can affect your sleep. Spicy foods can contribute to painful heartburn. Big meals leave you uncomfortably full, and over time can contribute to obesity--a well-known risk factor for sleep apnea. Too much caffeine could keep you wide awake, even if you finish your coffee in the morning.

"It takes six hours to clear half of the caffeine from your body. If you have enough caffeine, it's still in your body at 4 in the morning," says Dr. Edelman. And though a glass of wine or two with dinner will make you feel relaxed or even sleepy, it won't help you sleep. "You can fall asleep, but once you're asleep you can't sleep deeply," she says.

Solution: Eat dinner at least a couple of hours before bedtime, and keep the meal light. Avoid spicy, fatty foods, as well as alcohol and caffeine. Also, don't drink too many fluids before bed. Having to constantly get up to go to the bathroom can disrupt your sleep, too.

3. Lack of exercise

Sleep and exercise complement each other. Working out regularly can help you sleep better, and conversely, you're more likely to exercise if you get a good night's rest.

Solution: Exercise every day if you can, ideally in the morning. Doing a high-energy aerobic routine too close to bedtime can have the opposite of the intended effect, making you too energized to sleep. A gentle yoga stretch before bed probably won't hurt, though. It might even help you relax.

4. Pain

Arthritis aches or any other kinds of pain don't make for restful slumber. Conversely, a lack of sleep can increase your pain. Researchers believe that a lack of sleep may activate inflammatory pathways that exacerbate arthritis pain. Poor sleep can also make you more sensitive to the feeling of pain.

Solution: In addition to the pain remedies your doctor recommends, try using a heating pad or taking a warm bath before bed to soothe achy joints or muscles. Lying against a body pillow can put you in a more comfortable position while you sleep.

5. Restless legs syndrome

Women are twice as likely as men to have restless legs syndrome (RLS)--a condition that causes a creepy, crawly feeling and uncontrollable movements in the legs at night. It's often linked to hormonal changes early in life and during pregnancy, but RLS can continue as you get older. RLS isn't just miserably uncomfortable--researchers at Harvard have linked this condition to an increased risk for heart disease and depression in women.

Solution: Try simple interventions first. Exercise every day, take a hot bath before bed, massage your legs, and cut back on things that can make you jittery--like caffeine and tobacco. If these measures don't work, your doctor may recommend one of several medicines that reduce RLS symptoms--including ropinirole (Requip), pramipexole (Mirapex), rotigotine (Neupro), or gabapentin enacarbil (Horizant).

6. Depression

"Depression is a common compromiser of sleep, and it's much more common in women than in men," Dr. Edelman says. Women who are depressed may sleep more than usual, but their sleep isn't restful. Some of the antidepressants meant to counteract depression, particularly SSRIs, can also interfere with sleep.

Solution: See your primary care doctor, psychologist, psychiatrist, or therapist for help, which may include medications, talk therapy, or both. If your antidepressant seems to be keeping you awake, ask your doctor to switch you to another drug.

7. Stress

It's impossible to sleep when the weight of the day is pressing on you. Finding a sense of calm before bed isn't easy, especially when you can't unplug from the demands of your day.

Solution: Establish wind-down time. Do a quiet, relaxing activity before bed that doesn't involve a screen. Talk to a friend or family member, sew, or read a real book--not one on a backlit tablet device.

"Just allow yourself to have quiet time," Dr. Edelman adds. And don't sleep with your smartphone on your bedside table.

8. Poor sleep habits

Sometimes insomnia stems from long-ingrained behaviors, like staying up too late or engaging in stimulating activities before bed.

Solution: Follow a few basic sleep hygiene strategies. Go to bed and wake up at the same times each day. Keep your bedroom cool, dark, and comfortable. Use your bed for sleep and sex only. If you can't fall asleep within 15 minutes, get up and leave the bedroom. Read or do another quiet activity for 15 to 20 minutes until you get sleepy.

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Study: How you Cope with stress can change your insomnia risk

A study shows that the way a person copes with stress may change their risk of insomnia.

A new study is the first to identify specific coping behaviors through which stress exposure leads to the development of insomnia.

Results show that coping with a stressful event through behavioral disengagement -- giving up on dealing with the stress -- or by using alcohol or drugs each significantly mediated the relationship between stress exposure and insomnia development. Surprisingly, the coping technique of self-distraction -- such as going to the movies or watching TV -- also was a significant mediator between stress and incident insomnia. Furthermore, the study found that cognitive intrusion -- recurrent thoughts about the stressor -- was a significant and key mediator, accounting for 69 percent of the total effect of stress exposure on insomnia.

"Our study is among the first to show that it's not the number of stressors, but your reaction to them that determines the likelihood of experiencing insomnia," said lead author Vivek Pillai, PhD, research fellow at the Sleep Disorders & Research Center at Henry Ford Hospital in Detroit, Michigan. "While a stressful event can lead to a bad night of sleep, it's what you do in response to stress that can be the difference between a few bad nights and chronic insomnia."

Study results are published in the July 1 issue of the journal Sleep.

The study involved a community-based sample of 2,892 good sleepers with no lifetime history of insomnia. At baseline the participants reported the number of stressful life events that they had experienced in the past year, such as a divorce, serious illness, major financial problem, or the death of a spouse. They also reported the perceived severity and duration of each stressful event. Questionnaires also measured levels of cognitive intrusion and identified coping strategies in which participants engaged in the seven days following the stressful event. A follow-up assessment after one year identified participants with insomnia disorder, which was defined as having symptoms of insomnia occurring at least three nights per week for a duration of one month or longer with associated daytime impairment or distress. "This study is an important reminder that stressful events and other major life changes often cause insomnia," said American Academy of Sleep Medicine President Dr. Timothy Morgenthaler. "If you are feeling overwhelmed by events in your life, talk to you doctor about strategies to reduce your stress level and improve your sleep."

According to the authors, the study identified potential targets for therapeutic interventions to improve coping responses to stress and reduce the risk of insomnia. In particular, they noted that mindfulness-based therapies have shown considerable promise in suppressing cognitive intrusion and improving sleep.

"Though we may not be able to control external events, we can reduce their burden by staying away from certain maladaptive behaviors," said Pillai.

The American Academy of Sleep Medicine reports that short-term insomnia disorder lasting less than three months occurs in 15 to 20 percent of adults and is more prevalent in women than in men.

The research was performed under the supervision of Thomas Roth, PhD, and Christopher Drake, PhD, in the Sleep & Research Center at Henry Ford Hospital in Detroit. The study was supported by funding from the National Institute of Mental Health (NIMH) of the National Institutes of Health (NIH).

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Lifelong changes in brain caused by early life stress

A study shows that stress during early life can cause lifelong effects on the brain.

For children, stress can go a long way. A little bit provides a platform for learning, adapting and coping. But a lot of it — chronic, toxic stress like poverty, neglect and physical abuse — can have lasting negative impacts.

A team of University of Wisconsin-Madison researchers recently showed these kinds of stressors, experienced in early life, might be changing the parts of developing children’s brains responsible for learning, memory and the processing of stress and emotion. These changes may be tied to negative impacts on behavior, health, employment and even the choice of romantic partners later in life.

The study, published in the journal Biological Psychiatry, could be important for public policy leaders, economists and epidemiologists, among others, says study lead author and recent UW Ph.D. graduate Jamie Hanson.

“We haven’t really understood why things that happen when you’re 2, 3, 4 years old stay with you and have a lasting impact,” says Seth Pollak, co-leader of the study and UW-Madison professor of psychology.

Yet, early life stress has been tied before to depression, anxiety, heart disease, cancer, and a lack of educational and employment success, says Pollak, who is also director of the UW Waisman Center’s Child Emotion Research Laboratory.

“Given how costly these early stressful experiences are for society … unless we understand what part of the brain is affected, we won’t be able to tailor something to do about it,” he says.

For the study, the team recruited 128 children around age 12 who had experienced either physical abuse, neglect early in life or came from low socioeconomic status households.

Researchers conducted extensive interviews with the children and their caregivers, documenting behavioral problems and their cumulative life stress. They also took images of the children’s brains, focusing on the hippocampus and amygdala, which are involved in emotion and stress processing. They were compared to similar children from middle-class households who had not been maltreated.

Hanson and the team outlined by hand each child’s hippocampus and amygdala and calculated their volumes. Both structures are very small, especially in children (the word amygdala is Greek for almond, reflecting its size and shape in adults), and Hanson and Pollak say the automated software measurements from other studies may be prone to error.

Indeed, their hand measurements found that children who experienced any of the three types of early life stress had smaller amygdalas than children who had not. Children from low socioeconomic status households and children who had been physically abused also had smaller hippocampal volumes. Putting the same images through automated software showed no effects.

Behavioral problems and increased cumulative life stress were also linked to smaller hippocampus and amygdala volumes.

Why early life stress may lead to smaller brain structures is unknown, says Hanson, now a postdoctoral researcher at Duke University’s Laboratory for NeuroGenetics, but a smaller hippocampus is a demonstrated risk factor for negative outcomes. The amygdala is much less understood and future work will focus on the significance of these volume changes.

“For me, it’s an important reminder that as a society we need to attend to the types of experiences children are having,” Pollak says. “We are shaping the people these individuals will become.”

But the findings, Hanson and Pollak say, are just markers for neurobiological change; a display of the robustness of the human brain, the flexibility of human biology. They aren’t a crystal ball to be used to see the future.

“Just because it’s in the brain doesn’t mean it’s destiny,” says Hanson.

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Child's asthma and autism predicted my prenatal maternal stress

A study looks into prenatal maternal stress and how it predicts asthma and autism young children.

A new study finds a link between prenatal maternal stress (PNMS) and the development of symptoms of asthma and autism in children.

A team of scientists from The Douglas Mental Health University Institute and from McGill University has been studying women who were pregnant during the January 1998 Quebec ice storm since June of that year and observing effects of their stress on their children's development (Project Ice Storm). The team examined the degree to which the mothers' objective degree of hardship from the storm and their subjective degree of distress explained differences among the women's children in asthma-like symptoms and in autism-like traits.

Results reported in the journal Psychiatry Researchshow that the greater the mothers' objective hardship from the ice storm (such as more days without electricity), and the greater the mothers' distress about the ice storm 5 months later, the more severe their children's autistic-like traits at 6½ years of age.

The team emphasizes that the children in Project Ice Storm are not autistic; the results describe normal variations among children.

These traits include difficulty making friends, being clumsy, speaking in odd ways, etc. The effect of the mothers' ice storm stress was especially strong when the ice storm happened in the first trimester of pregnancy. Interestingly, the children with the most severe symptoms had mothers who had had high levels of hardship from the ice storm but low levels of distress.

"We have found effects of the mothers' objective hardship from the ice storm (such as the number of days without electricity), or their degree of distress from the storm, on every aspect of child development that we have studied, said Suzanne King, PhD, the senior author of the paper. This is surprising, since the children in our study are mostly from upper class families and are generally doing extremely well in school and in life."

In May, the team reported in the journal Biomedical Research International that girls whose mothers had had high levels of distress after the ice storm were more likely to have experienced wheezing, to have been diagnosed with asthma by a doctor, and to have been prescribed asthma medication before the age of 12. There was no effect in boys, and there was no effect of the mothers' objective hardship.

These results demonstrate the power of a stressor in pregnancy to influence both the physical development and the mental health of the unborn child. Project Ice Storm continues to follow the children's development, including brain MRI scans at the age of 16 years starting in September.

"If the stress of the ice storm could have such large effects on these children, helping to explain why some are sicker than others or have more atypical development than others, added Suzanne King, how much greater would the effects be with an even more stressful event in pregnancy or in disadvantaged families with fewer resources? Our research is showing us how vulnerable the unborn child is to his mother's environment and her mood."

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Stress relief could induce migraines

A study showed that migraines can occur after a period of stress ends and a person is relaxed.

Migraine sufferers who feel more relaxed and less stressed from one day to the next are at high risk of having another migraine attack the following day, according to a new study published in the American Academy of Neurology’s journal Neurology.

Periods of relaxation after stress-induced migraine events are as equally headache-inducing for migraine sufferers, said the study conducted by researchers from the Montefiore Headache Center and Albert Einstein College of Medicine at Yeshiva University in New York. The study was aimed at devising “preventive treatment and behavioral interventions” for migraine sufferers.

“This study highlights the importance of stress management and healthy lifestyle habits for people who live with migraine,” said Dawn C. Buse, Ph.D., a co-author of the study, according to Science Daily. “It is important for people to be aware of rising stress levels and attempt to relax during periods of stress rather than allowing a major buildup to occur. This could include exercising or attending a yoga class or may be as simple as taking a walk or focusing on one’s breathing for a few minutes.”

A month before the study was published online in March, the same journal presented another study linking headaches and stress at the Academy’s 66th Annual Meeting in Philadelphia. Participants of the study included 5,159 people aged 21 to 71. They were interviewed four times a year about their stress levels and headache occurrences for two years. Findings revealed that for each headache type the participants had, the frequency of the occurrences increased with stress.

One way of significantly reducing stress, as well as the occurrence of headaches, is by alternating the use of heat and cold therapy. In fact, the Mayo Clinic website recommends cold compress to numb neck and head pain caused by headaches. It also recommends the use of hot pads and heating packs to relieve muscle soreness.

Heating and cooling packs, such as Thermal-Aid can soothe swelling and relieve pain. The packs were made from malleable cotton and specialized corn kernels that have been modified to hold temperatures well without collecting moisture or molds.

The Thermal-Aid pack was a product of two years of research and development by Pacific Shore Holdings Inc. (OTC: PSHR). It was university-tested to prove their effectiveness on many kinds of pain such as arthritis, multiple sclerosis, and most importantly, migraine.

A study done by Pacific Shore Holdings proved that it could improve pain management by 35.3 percent and leads to a 21.8 percent decrease in dependency to acetaminophen and a 21.3 percent decrease in dependency on non-steroidal anti-inflammatory drugs in patients aged 58 to 96 years old.

Data from the Migraine Research Foundation revealed that 36 million people in American suffer from migraines. Out of this number, 18 percent were women while 6 percent were men.

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Study: Reducing stress may bring on a migraine

Surprisingly, a recent study showed that reducing stress may increase a person's risk of bringing on a migraine.

In a surprising twist on how stress may affect migraine risk, new research suggests that patients who are able to lower their stress levels may end up inadvertently boosting their immediate risk for a migraine attack.

The study, led by Dr. Richard Lipton, director of the Montefiore Headache Center and vice chair of neurology at the Albert Einstein College of Medicine, in New York City, was published March 26 in the journal Neurology.

"This study demonstrates a striking association between reduction in perceived stress and the occurrence of migraine headaches," Lipton said in a college news release.

Though the authors noted that stress has long been seen as a trigger of headaches, the new study found that when migraine sufferers are able to relax following a bout of elevated stress, the stress decline itself may boost migraine risk.

During the first six-hour period in which high stress starts to dissipate, the risk for experiencing a migraine increases fivefold, the researchers found.

Lipton and his colleagues theorize that something about the rise and fall in levels of the stress hormone cortisol may have something to do with the elevated risk as stress is reduced.

Migraines affect roughly 38 million Americans, according to the news release.

Lipton's investigation tracked 17 migraine patients who over a three-month period kept diaries that noted their stress levels and stress-reduction experiences, as well as sleep patterns, dietary habits and emotional state of mind.

"It is important for people to be aware of rising stress levels and attempt to relax during periods of stress rather than allowing a major buildup to occur," study co-author Dawn Buse, director of behavioral medicine at Montefiore Headache Center, and an associate professor of clinical neurology at Einstein, said in the news release.

"This could include exercising or attending a yoga class or may be as simple as taking a walk or focusing on one's breath for a few minutes," she explained.

Although the study found an association between a drop in stress levels and migraine attacks, it did not prove a cause-and-effect relationship.

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Headaches in children

This article gives a lot of information on headaches in children.

Why do children get headaches?

Headaches in children are common and usually not serious.  Causes include migraines, stress and tension headaches, trauma, sinus disease and eye problems.  Certain foods with nitrate preservatives and MSG (monosodium glutamate) can trigger headaches.  Brain tumors in children as a cause for headaches are extremely rare, and are usually associated with additional neurologic symptoms such as dizziness and lack of coordination.

How are children with headaches evaluated?

Children should have a thorough physical examination with a pediatrician.  He/she may order additional tests or refer to a neurologist.  It is helpful to keep a headache diary so that possible triggers (certain foods or activities) can be discovered.

If no obvious medical cause for the headaches is found by the pediatrician, a referral to an ophthalmologist is required to perform a complete eye exam.  The entire visual system should be examined.  This includes refractive error (the need for glasses), eye alignment, and binocularity (the ability to use both eyes together).  During this examination the pupils should be dilated.

 How do eye problems cause headaches in children?

Hyperopia (farsightedness) requires extra effort to focus clearly while reading.  This can sometimes lead to fatigue and headache.  Glasses can reduce the effort required to see clearly at near and improve the headache.

The decreased ability to pull the eyes toward each other when viewing near objects (convergence), particularly while reading, may cause headaches.  This is called convergence insufficiency, and symptoms include the doubling of images or words, blurred vision, fatigue, and headaches which worsen with prolonged reading.  Glasses are sometimes prescribed.  At home eye exercises, sometimes with the help of computer software, can help treat convergence insufficiency.  Expensive in office eye exercises are rarely indicated.

 Acute infections and inflammatory diseases of the eyes can cause headaches.  These problems are often accompanied by redness of the eye and/or eyelid and light sensitivity (photophobia).  Acute glaucoma can cause headaches, but rarely affects children.  A complete exam by an ophthalmologist can rule out these conditions.

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Study shows that more stress means more headaches

A study shows that having more stress in your life means you get more headaches.

A new study provides evidence for what many people who experience headache have long suspected—having more stress in your life leads to more headaches. The study released today will be presented at the American Academy of Neurology's 66th Annual Meeting in Philadelphia, April 26 to May 3, 2014.

For the study, 5,159 people age 21 to 71 in the general population were surveyed about their stress levels and headaches four times a year for two years. Participants stated how many headaches they had per month and rated their stress level on a scale of zero to 100.

A total of 31 percent of the participants had tension-type headache, 14 percent had migraine, 11 percent had migraine combined with tension-type headache and for 17 percent the headache type was not classified. Those with tension-type headache rated their stress at an average of 52 out of 100. For migraine, it was 62 out of 100 and 59 for those with migraine and tension-type headache.

For each type of headache, an increase in stress was associated with an increase in the number of headaches per month. For those with tension headache, an increase of 10 points on the stress scale was associated with a 6.3-percent increase in the number of headache days per month. For migraine, the number of headache days per month went up by 4.3 percent, and 4 percent for those with migraine and tension headache. The results were adjusted to account for factors that could affect the number of headaches, such as drinking, smoking and frequent use of headache drugs.

"These results show that this is a problem for everyone who suffers from headaches and emphasize the importance of stress management approaches for people with migraine and those who treat them," said study author Sara H. Schramm, MD, of University Hospital of University Duisburg-Essen in Germany. "The results add weight to the concept that stress can be a factor contributing to the onset of headache disorders, that it accelerates the progression to chronic headache, exacerbates headache episodes, and that the headache experience itself can serve as a stressor."

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