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    Migraines in the middle of the night
    Michelle83716 posted:
    Hi All! My name is Michelle and I have had almost daily migraines for 11 years now. I was seeing a Neurologist but since she decided that my Primary can take care of my meds for the migraines I have been following up with my primary doctor only.

    For the last year, of and on, I have had this one type of migraine that happens around 2:00 or 3:00 am. I am not sure if it wakes me up or when I wake up it is just there. When this migraine happens it is very, very hard to get rid of and usually makes me nauseated and unable to function the next day. The pain level with this migraine (about an is so much worse than my other daily ones and almost makes me go to the ER. It also lasts about 24 hours where my almost daily migraines last only a few hours and the meds handle it quickly. In the last six months I have been having this headaches about twice a month and I can not find a connection as to why I get them. I am unable to determine if they are hormonal because I had a hysterectomy in 2004 but I still have my ovaries.

    What should I do about these? Should I discuss this with my Primary Doctor or try the Neurologist again? I am not on a abortive migraine med and have tried almost everything without success. I did just start an Ace Inhibitor (Lisinopril) but it is for my high blood pressure and doesn't seem to help my headaches (I have tried it in the past for the migraines). The only thing that helps is Norco once the headache starts. This headache I am getting in the middle of the night barely responds to the Norco! I am just unsure what to do about them.

    Thanks for reading my post and I hope everyone here has a pain free day!

    An_205270 responded:
    Have you tried using ice packs and then alternating with a hot pack or a heating pad? I have Hemiplegic migraines and I deal with them daily. There is only one medication that I can take for them and that is Midrin. I was told by my physician that they took Midrin off the market. I also take topamax 50mg, twice daily. All that does is makes my migraines worse.
    I hope that you find something that will work for you.
    Coki2010 responded:
    Sorry you are having trouble.

    Funny, they used to say you couldn't wake up with a migraine and I would laugh. Bah! WRONG! You totally need to speak with your Dr about it. And really it depends on your Primary if you need to see a Neuro. Does your Dr. keep up on headache meds and news? Does he listen and try to change your meds/dosage if it isn't working? Is he open to different options on the profolatic (Topamax or Nortriptalene eg. example) medicines or the abortive and rescue meds? If not then you probaby need to see a Neuro.

    If you were a friend of mind I would recommend that you get on some daily meds that help control the headaches. I would think that would be the first step. And then get some decent triptans that work for you. I am finding Maxalt rocks! And then if those don't work then you resort to your Norco (I am not familar with that).

    Hope that helps.
    humbleones replied to Coki2010's response:
    I am having a "migraine" for two months now. It is in quotes as I have suffered with migraines for many years, but this one is different. Doctors who have known me over 15 years do not seem to be "hearing" me. Is it a migraine or cluster? Mine, too, wakes me up in the middle of the night--three hours after I fall asleep and about every two or three hours thereafter. It comes and go at different intervals during the day. The pain is in my right eye and does seem to come on AFTER I fall asleep and when I am hot or exercise, or certain other activities. I am also on Topomax (did help prevent onset of headaches) and tried Relpax, but for THIS headache, the Relpax won't work. Imitrex nasal spray provides more relief, but since I have heart disease the cardiologist strictly limits its use. Since I am female, they insist it is just another migraine and not a graduation to a cluster headache. I am tired of seeing doctors and remaining in severe pain. Where does one go to get a diagnosis where it is based on symptoms and not gender?!?!?
    Michelle83716 responded:
    Thank you all for responding. Unfortunately, all the medications mentioned, Topamax, Midrin, Nortriptylene, Maxalt, Imitrex, Relpax I have tried without success and there are many, many more that I can't remember the name of now. I did use to use Stadol nasal spray (pain killer) and it would work for these horrible ones but I had to stop using it because it was giving me sinus infections. I am prone to sinus infections so any of the nasal sprays are not recommended. Coki2010-Norco is a narcotic pain med in the same class as Vicodin and Lorcet. Norco has been the only thing that stops or helps my pain with migraines but I try to limit the use because I do not want to become dependent on a drug. An_180354--I will try the ice pack, hot packs, thank you for the suggestion. Humbleones---I am sorry you are having this headache. Does it help to know that you described mine to a T? I wouldn't wish this on anyone but it is nice to know I am not alone.

    As for my primary, I don't believe he keeps up with all the new Migraine medications but I will ask him in July when I see him again. I have several pain conditions going on (Fibromyalgia, Migraines, Rheumatoid Arthritis) so I am always at a doctor's office, lol! You would think someone could help but I am just a frustration to them all because none of them can ever figuring out exactly what is going on with me. Ughh!!! Anyway, thanks again to everyone for their responses. I hope everyone has a pain free day! Michelle
    yukonok responded:
    I'm a 55 yr old female using botox to control daily migraines which I've had since childhood and almost daily over the last 10-15 years. I've taken all the preventives with no luck. I too am also someone who gets migraines at any hour of the day/night. I've routinely been awakened w/migraines anytime after going to sleep at night (typically between 1:00 - 5:00 am). The only time I had to go to the ER was after waking in the middle of the night w/migraine so severe I couldn't stop vomiting and couldn't walk unassisted. Surprisingly, the ER couldn't rid me of the migraine either, although they pumped me with 5 different medications in a 2 hour period. They got the nausea to clear and said to go home and take more of what I had at home (Zomig - a triptan perscription). One thing you need to check is with a you by chance have TMJ (causes teeth grinding which sleeping)? I do ....and wear a bite splint, but it doesn't help me w/the migraines. I bite so hard during sleep, that I've gone through 3 different custom made bite splints! But, some people w/TMJ and experience migraine are helped by wearing one at night. I now take a muscle relaxer about 45 minutes before going to bed. I have to tell you, that I'm also getting botox therapy for my migraines and that has helped more than all medications I've ever tried. In fact, the few medications that I take work now that I'm getting botox...when they did not work before. Hope some of this helps.
    mymygraine replied to Michelle83716's response:
    Hi Michelle - Have you been to a headache specialist - that is a neurologist who specializes in headaches? I don't think your primary or even your neurologist will be able to help you with the kind of headache you have, and you need to find a neurologist in your area that specializes only in headaches. There are a lot of places around the country that have large hospitals and clinics that will accept you for tx on an inpatient basis where they will get you a real diagnosis in about an 8 day to 2 week span where they can do more within an in-patient setting than is possible on an out patient basis. This is something to look into if you have insurance and it will cover it. There are good clinics in all the majore cities - just google National Institute of Headaches for some Doctors in your area to try.

    Based on my own experience, which is similar to yours, I was diagnosed with "hemicrania continua" which simply means a one sided continuous headache. I described it as 2 headache, but it was really 1 headache with intermittent flare-up or acute attacks. I was given indocin, which is an arthritis medication and is a super aspirin mixture. The proof of the diagnosis is in the medication. If the medication stops the headache then the diagnosis is correct. That is why you need a headache specialist neuro to help you get a proper diagnosis. It is not just a case of moving from one med to another to see what works, and then walking away if nothing helps. You may have to wait a bit to get in to see one of these docs, and if you have good records of your headaches, when they come during the month, when the acute attacks come, what you eat, how much sleep you lose, how much work you lose, etc., all these are helpful for correct diagnosis. There is a lot of help out there, you need to keep looking, but look for specialists, and drop the ones you have been using. I hope this will help you get out of the pain you are in. Best wishes for success and keep in touch.
    Coki2010 replied to Michelle83716's response:
    I would so try a Neuro. One that has been recommended. I have had 2 that, well, I think would be better off in a funny farm. And then I finally hit the jack pot with 2 that are in a teaching hospital that were wonderful, friendly, helpful, explained a lot and just made me feel like they listened.

    My headaches run in the family and have done so for 3 generations prior to myself. They seem to grow worse as I grow older. I wish I had a fancy name for my headaches. But I don't. They usually come with no warning signs other than a stabbing poker in my right eye. (Which I so don't appreciate) I think it might be better to have a pretty aura (I am assuming it is pretty. I don't know)

    But find a doctor that cares what happens to you and if they can't keep up with what is going on in the field that effects you then have them refer to you someone that can. Plain and Simple.
    Coki2010 replied to Coki2010's response:
    Oh yeah, And I just had my first treatment of Botox.

    So I am crossing my fingers.
    carpetcrawler5 responded:
    Migraines persist because each bad one causes another, because of the inflammation and nerve irritation they cause.

    Are you supporting your neck at night while you sleep? Also find out if you're grinding your teethe at night. You can get a specail device to stop this.

    Some blood pressure meds can cause headaches, except Propanolol which also helps headaches.
    WarriorMaiden responded:
    I've had migraines almost nightly for several years, and while they say that menapause often ends them, I'm 70 and still having them. Yet, all the time I was taking meds for Hep C (Interferon shots and riboviran) I had no headaches. Since I've been off the meds, the headaches are back. My appetite was so diminished and being sick forced me to change my diet; ate only egg and toast for breakfast, chicken soup (homemade) and salad for lunch, and fish or chicken and a salad for dinner.
    Once my appetite returned, and I started adding in all those foods I love (chocolate, bread, etc) the migraines returned.
    The result of that is now I'm modifying my diet again and trying to get back to the healthy foods - see if that is what made the difference or if it was the meds. Time will tell.
    carpetcrawler5 replied to WarriorMaiden's response:
    maybe the hep c meds helped because you were getting headaches from hep c. Also did you make a headaches diary to try and find out which foods you shouldn't eat?
    mymygraine responded:
    Hi Michelle -
    I have migraines that wake me in the middle of the night - some of them start before I go to bed, and I use ice to try and stop them before taking meds, but within 3 hours I am awake and in more pain than I was 3 hrs. prior. Some wake me around 4:00am - it varies.

    As for your doctors, you need to find a migraine specialist, not a neuro who has no specialty in migraines, and certainly not a primary care doc. Neither of those doctors will really be able to help you get control of your migraines, and the very fact that a neuro would stop seeing you because all your med needs could be handled by a PC doc is horrifying to me!

    Most migraineurs go through lots of trial and error finding a medication regimen that will work for them. Everyone is different and what works for 1 person won't work for another. Also your body may become used to the medication, and it will no longer work for stopping the migraine, but instead cause a "rebound" migraine, which for me, are more painful and harder to get rid of. I usually have no other rescue med around to get rid of the pain, and rather than go to the ER, I just use ice packs, hot packs, stay in a dark room, and wait it out. This can sometimes take up to 60 hrs. but sitting in the ER for 10 hrs. with that kind of pain waiting to get seen, is not my idea of a good time.

    Look on the NIH (National Institue of Headaches) website for neurologists that are certified to specialize in Migraines. Find the one closest to you (may be in the next state over), call, make and app't, and they probably will send you an application to fill out and return before you come. You may have to wait for the app't up to 4 months, but don't be discouraged. Use the time to keep a very specific diary of your migraines, when they start and stop, how much sleep you are getting, possible triggers for the migraine - such as weather change, sleeping pattern, or food), what meds you took, how much and did they work, the severity of the migraine on a scale of 1-10 (10 being the highest, 1 the lowest). Add any notes, or questions you may have as you go. This will help you when you get to see the migraine specialist. These docs are neurologist with specialties in migraines, and they will help get you a correct diagnosis because there are many kinds of migraines, and also put you on a regimen that will start helping you control the pain and severity, and also frequency of your migraines. The more information you have with you, the better your app't will be.

    Do not expect everything to be solved with 1 visit, but it will get you on the way towards leading a more normal life.

    Keep us posted, and good luck!
    itmatsb replied to WarriorMaiden's response:
    To WarriorMaiden,
    It may be difficult to pinpoint which foods could be triggering your migraines by a diary unless you are severely allergic to a particular food. Otherwise it takes at least 4 weeks being off of the food for you to know for sure. Not sure if Medicare would pay for it, but the best way to know is to have IgG food sensitivity blood tests to know for sure. A well trained headache specialist thought that even slight sensitivities to foods could cause migraines while my regular neurologist didn't catch it.

    Good luck.

    mymygraine replied to itmatsb's response:
    To Warrior Maiden - just to add itmatsb's reply. I was told the same thing you were, and my migraines only got worse. I am having stomach & intestinal problems now, and have been reduced to a chicken broth, white chicken, white bread, white rice, banana & apple diet for at least 4 months now, and you can imagine how boring that is! If I don't stay on it, I have the runs badly, and there seems to be no in-between diet that works. I don't have the added meds that you have been on, but I do know that chocolate, coffee, or even decaf tea will cause a migraine for me. I have also had to cross out milk & milk products, including yogurt, which was a staple of mine, and certainly all vegetables are out, unless it is just 1 leaf of lettuce. My gastroenterologist is trying to figure out what is wrong, but so far we at a standstill. I have just been taking out foods that seem to make me feel bad, cutting them out of my diet, and then trying them in very small amounts after a 3 mo. vacation. I can say for sure that caffeine is something I will never try again, but am hopeful about veg and fruit - even in small amounts. I know my body better than any doc or test by now, and can feel what is wrong long before a test will tell me, so I am paying attention, and writing all that stuff down.

    Perhaps that would work for you, without all the intermediaries. I am sure a lot of my problems come from 43 years on every med you can think of to control the migraines. My body has had it with me, so I just have to be more careful.

    I hope this helps. Keep in touch!

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