Introduction:
The circadian rhythms of physiology are vital to health and fitness because dysregulation, caused by genetic mutations or environmental factors, raises the risk of disease and speeds up the progression of existing conditions. An intrinsic clock that controls circadian rhythms and plays crucial roles in metabolic homeostasis, organ physiology, and brain functions has been the subject of significant molecular and physiological research. Pain, such as headache and neuropathic pain, is a new and exciting area in circadian research for which new systemic observations have recently emerged. This article explains the relationship between a circadian rhythm with migraine in detail.
What Is Circadian Rhythm?
All living things, from microbes to plants and animals, have an internal 24-hour timer, known as a circadian clock. It synchronizes crucial processes, which helps conserve energy or encourage activity when needed. Body temperature (maximum before midnight), blood pressure (maximum in the afternoon), pulmonary capacity (highest in the afternoon), and sleep (tiredness is highest around midnight)are some examples.
Understanding these fundamental circadian processes has enabled chronotherapy, or the administration of drugs at particular times in accordance with the circadian cycle, to advance in a straightforward but significant way. For instance, blood pressure medications are administered before blood pressure peaks, and medications for asthma are administered prior to a decline in pulmonary function.
Daily peak times for gluconeogenesis, academic performance, and athletic ability occur because the internal circadian clock also influences metabolic homeostasis and higher-order functions. As a result, when the circadian system is disturbed, several diseases are at an increased risk.
How Are Circadian Rhythms and Migraines Related?
According to a recent systematic analysis, migraine is a serious and causing severe condition with many comorbidities and has a worldwide incidence of 14.4 %. The disease primarily affects females, with a 3:1 ratio of females to males. The most common type of migraine is migraine without an aura, characterized by a unilateral, moderate-to-severe pulsing headache frequently accompanied by nausea, vomiting, and photo- and phonophobia. Although the high prevalence of migraine and their burden encourages research into the pathomechanisms of associated diseases, there is still no conclusive explanation for how and when a migraine attack will happen.
The transient neurological deficits connected to migraine attacks that affect about one-third of migraineurs are referred to as migraine aura (for example, sensory, retinal, or motor symptoms). The diurnal variation in migraine attack onset has been noted by both medical professionals and patients, and several terms, such as cyclical migraine, weekend migraine, or nocturnal migraine, have been used to define the periodicity of migraine attacks, indicating that migraine attacks do not emerge randomly but rather exhibit distinct temporal patterns. Understanding the circadian variability in migraine attack onset may offer pertinent knowledge for migraine management and prevention.
How Is Circadian Rhythm Related to Other Headaches?
Cluster headaches are known for having strong circadian and circannual patterns. Typically, patients experience headaches at the same time every day and cycle through attacks at the same moment every year or every other year. The central clock is located in the hypothalamus, which is one direct correlation between the circadian system and the mechanisms of cluster headaches.
The hypothalamus contains several areas that may play a role in cluster headache, along with the central clock (suprachiasmatic nucleus) and an area anterior and medial to the fornix that has been associated with defensive rage and may describe the restlessness and self-aggression seen in the disease. Patients with cluster headaches seem to have a close connection between these three systems: the trigeminovascular pain system, the autonomic system, and the hypothalamus.
Based on preliminary research, deep brain stimulation of the hypothalamus is recommended as a treatment for cluster headaches, and patients who have had hypothalamic deep brain stimulators implanted have higher thresholds for cold pain. Compared to people without cluster headaches, pain in episodic cluster headache patients' thresholds, such as the nociceptive flexion reflex in the leg, vary throughout the day. Depending on the stimulation setting, sphenopalatine ganglion autonomic system modulation can either cause or reduce cluster headache pain.
What Are the Steps to Be Taken to Reduce Headaches?
Fixed Sleeping Schedule - The circadian rhythm for sleep and wakefulness can be healthy or unhealthy. The body can rely on a regular circadian rhythm if a person goes to bed and wakes up simultaneously every day and night. If it is disturbed, one may also experience fewer headaches. Oversleeping and undersleeping have both been linked to an increase in migraines.
Avoid Using Screens Before Bed - Using screens at night may throw off the circadian rhythm, which depends on light cues to determine whether a person is alert or tired. One might find it difficult to fall asleep as a result. Dim the lights, read a book, or practice meditation at least an hour prior to bed. Most smartphones also have a night mode that adjusts the device's screen lighting at dusk so that the body is ready for bed.
Get Some Sunlight - Sunlight exposure in the morning is good for the sleep cycle. It is a good idea to get some morning sunlight and let the body know that it is time to start the day by going for a walk, reading the newspaper, or drinking coffee outside.
Be Prepared for Seasonal Time Changes - Time differences and travel may hamper the circadian rhythm. Consider adjusting the sleep schedule gradually instead of abruptly increasing or decreasing the bedtime by an hour. Using the same approach if a person intends to travel to a different time zone will help to prevent jet lag. As previously mentioned, spending more time in the morning sunlight is a great way to help the body adjust to a time change or different time zone. For migraines, as opposed to cluster headaches, most treatments are more effective. Nobody should have to endure persistent cluster headaches and migraines with no apparent cure. There are numerous potential root causes.
Conclusion:
Circadian rhythms are crucial for physiological health. It is becoming more widely recognized that circadian regulation plays important roles in other organ systems, systemic processes, and gut microbiota, in addition to its well-known effects on sleep, mood, metabolism, and cardiovascular functions. The main difficulty is identifying the causal pathways by which molecular changes related to circadian rhythms (such as transcription-translation feedback loops) can lead to physiological and pathophysiological adaptation. With a thorough understanding of circadian mechanisms at hand, studies of circadian regulation of pain should produce significant new findings that can be used to create practical regimens to reduce or manage pain symptoms.
