Heachache? With stress it goes away (earthquake victims confirm this)

When you are very stressed you don't get a headache. It's when stress drops that pain comes. We had the proof precisely in Italy when Professor Giancamillo Manzoni of the University of Parma verified that in the earthquake victims of Emilia in the wake of the earthquake, headaches were among the lowest in Italy and then subsequently increased.

This apparent contradiction always known to experts, finally finds a scientific explanation in a study just published on Neurology by the American neurologist Kathleen Merikangas of the National Institute of Mental Health in Bethesda. The researcher adopted a particular evaluation method which also confirms previous studies according to which have a bad night predisposes to a migraine awakening.

Sleeping badly

In fact, it was known that sleeping badly increases the stress hormone, the so-called corticotropin which in turn releases the CGRP, acronym for Calcitonin Gene Related Peptide, i.e. peptide related to the calcitonin gene. In recent years this peptide has proven to be the “primum movens” of migraine attacks, so much so that the development of new monoclonal drugs able to block it, it changed the lives of those who had up to two or three attacks a day and who with just one administration every two or three months saw them disappear as if by magic. In her study, Merikangas introduced technological innovations that once could not be used: smart devices equipped with apps capable of monitoring sleep, energy, emotions and stress levels.

Risk indices

Having started with the aim of defeating the anxious expectation that grips every migraine sufferer due to the unpredictability of the next attack, it managed to obtain precise forecast indices related in particular to the quality of sleep: a bad night increases the risk of migraine by 22%.
the next day and, if it was the same subject who reported the impression of poor sleep quality, the risk is 18%. Lower because no one is ever an impartial judge of himself. If a decrease in energy the risk was 16% and, to support what has already been said, with an increase in stress levels, the risk rose by 17% only the following day, but not the day in which the subject was stressed.

The study was conducted on 477 subjects (there were 291 women) of all ages (from 7 to 84 years) half of whom were known cephalalgic patients who had to carry out 4 assessments per day of mood, energy, stress level and the appearance of headaches. Once a day they also had to give a subjective assessment of the quality of their sleep beyond the monitoring provided by the smart device which also tracked their daytime physical activity.

Circadian rhythms

24-hour tracking of apps has allowed researchers to verify that it is of great importance in triggering attacks the disorganization of circadian sleep/wake cycles which turned out to be more important than anxiety or depression which until now had been given much importance, while they do not appear to be related to the attacks. Anxiety and perceived emotionality would tip the scales, that is, in other words, true stress does not derive from what happens to us, but from how we “interpret” it.

The role of resilience

In fact, resilience comes into play in these mechanisms, from English resilience, a term that indicates the ability of a material to resist deformations and impacts without breaking. Thanks to resilience we are able to adapt to critical and stressful situations such as heavy conflicts in the work environment or the serious illness of a loved one. There are those who have greater resilience and therefore know how to adapt better to difficult situations, but there are less resilient people who struggle more and are more vulnerable. Episodic migraine sufferers who do not become chronic are confirmation of the fact that those with greater resilience are better able to absorb the insults of stress.

Mindfulness can also help

«In our headache center at the Besta Neurological Institute in Milan we have been helping patients develop for a long time greater awareness of illness and more resilience through a path of mindfulness with which they learn to better accept their disease condition by developing attention to the present moment and gradually reducing the tendency to feel sorry for themselves, the so-called rumination so typical of migraine patients”, says Licia Grazzi, neurologist in charge of the Headache Center of the Carlo Besta Neurological Institute in Milan which has long studied the correlations between stress and headaches.

«Since the pandemic we have also been using mindfulness programs online to guarantee our patients continuity of treatment, a solution which has also allowed those far from Milan to benefit from it. A few years ago in a study conducted with some US colleagues as well as a significant reduction in the frequency of migraine episodes we also reported the parallel modification of various biological parameters related to stress. In light of Merikangas' research, the use of the apps she uses could allow us to obtain even more significant results, allowing us to also keep the variable of stress from alteration of sleep cycles which the patient is unable to evaluate in a subjectively clear manner even if he has been instructed to think in terms of mindfulness”, he concludes.

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