There is a close link between headaches and disrupted sleep among children and adolescents with the two problems feeding into each other.

Apart from difficulty getting to sleep, other sleeping problems associated with headaches include not getting back to sleep after waking up in the middle of the night or early in the morning, and not feeling refreshed after sleep.

That's according to Dr Elliot Shevel the chairperson of the South African branch of the International Headache Society (IHS) and medical director at The Headache Clinic.

Dr Shevel, is a Maxillo-facial and oral surgeon who specialises in the treatment and prevention of headaches. He is also the founder of the South African Headache Society.

What's the relation?

He says that the relationship between sleeplessness and headaches in children is a complex one. In some cases, the sleeping problems are a side effect of the headaches, and in others, they seem to be one of the triggers.

It may even be possible for some children that the two problems have a common root cause, such as ingredients in certain foods or stress that triggers muscular tension.

"What is certain is that sleeplessness aggravates headaches or migraines, while headaches can make sleeping problems even worse — they feed off each other in a cycle of misery," says Dr Shevel.

How you can help your child

Dr Shevel recommends that parents concerned about a child showing an apparent pattern of headaches and sleeplessness should try to address the problem without resorting to over-the-counter medicines. In his three decades of medical experience, prescribing a routine of healthy living is one of the most important steps you can take to help your child he believes.

A predictable daily routine and a healthy diet with regular and well-balanced meals can often work wonders for a headache-prone child. Diet, particularly ingredients such as caffeine, sugar, processed meats, cheeses and chocolate can be a major contributing factor to both headaches and sleeping problems.

"Good sleep is important for people of all ages, but critical for children and adolescents," notes Dr Shevel.

The child should go to sleep and be woken in the morning at consistent times, with between eight and 10 hours of sleeping time.

The child should do something relaxing (like reading) for an hour or so before going to bed as part of the nightly routine. Television, computer use and video games are stimulating, and should be avoided in the hour before bedtime. Toys, especially electronic ones, should not be kept in the child's bedroom.

When to see a doctor

Parents should take the child to the doctor when headaches are frequent (taking place weekly, for example) or if they are severe enough to stop the child from going to school and participating in other activities.

Dr Shevel recommends investigating the possible causes by asking your child the following questions and discussing them with the doctor:

• Do the headaches wake you up, or do you notice them when you awaken? When do they occur? Middle of the night or on final awakening?


• Where is the pain? One or both sides of head, forehead, eyes, face, jaws, top or back of head or neck?


• How do they feel? Pounding, throbbing? Dull steady pressure or squeezing likes a vice sharp, jabbing pain.


• What other symptoms occur at the same time as the headaches? Nausea, visual symptoms, and so on…


• What makes them worse? Sleeping in late, sleeping on your back, sleeping without or with pillows, stress or relief from stress, nasal congestion, certain foods?


• What makes them better? Pressing over your scalp, medications, eating?

Treating the pain

"It is essential that every child that suffers from headaches has a thorough medical examination, to exclude the possibility of a serious or life threatening condition, especially if the child has fever and neck pain, or if the pain is becoming worse over time," says Dr Shevel.

An effective treatment regime will focus on treating the underlying cause of the pain rather than its symptoms. In other words, rather than treating the pain with drugs, an effective treatment will find which parts of the body are actually causing the pain and why, and then focus on finding a solution that prevents them from causing headaches in the future.

A multidisciplinary investigation into the cause of the headache that covers all the muscles, nerves, teeth, joints and other parts of the body that might cause the pain as well as conditions found alongside headaches (depression, for example) is the approach most likely to ensure your child stops suffering from headaches.

A range of therapies and treatments is available once the type and cause of a headache is diagnosed, says Dr Shevel.

For more information you can visit www.headacheclinic.co.za or call +27 861 678 911.