Researchers have proven the effectiveness of cognitive behavioral therapy for migraines

Combining drug therapy with cognitive-behavioral therapy can effectively treat both chronic migraine and insomnia, which is combined with headaches, scientists at Sechenov University have found out. They conducted the study on the basis of the university's Clinic of Nervous Diseases of the Clinical Center for Health Sciences. One of the authors of the scientific work, a doctor-neurologist, associate professor of the Department of Nervous Diseases and Neurosurgery of Sechenov University candidate of medical sciences Veronica Golovacheva told "Izvestia" on November 28, what is included in such cognitive-behavioral therapy.

According to the results of the study, which were presented at the conference "Actual Problems of Somnology", a positive effect was achieved in 85% of patients.

"The treatment program for patients with chronic diseases demonstrates very good effectiveness and stability of the effect. It was possible to meaningfully increase both the emotional state and daily activity of patients," Golovacheva said.

As she noted, chronic migraine and chronic insomnia are often combined with each other. In this case, drugs do not always help. Thus, according to her, many modern drugs that are effective in episodic migraine, can worse cope with chronic migraine. The doctor-neurologist specified that for the treatment of these disorders in the world are beginning to use along with drugs such a method as cognitive-behavioral therapy. To assess the effectiveness of a program that includes both medication and cognitive-behavioral therapy, scientists conducted a study. It involved 96 people with whom they conducted 10 sessions of cognitive-behavioral therapy for an hour and a half.

Golovacheva said that several strategies are used in cognitive-behavioral therapy. Among them is limiting bedtime without sleep.

"Patients with insomnia often spend four hours in bed because they have to go to work, or 12 hours when it's the weekend. But if the difference between bedtime yesterday and today is more than two hours, it's a big stress on the body, and it will take days for it to recover," the doctor explained.

Therefore, the specialist who conducts the therapy, finds out how much time the patient spends in bed and how much he actually sleeps, and based on this makes a sleep schedule, according to which the person lies in bed exactly the time he usually sleeps. Each week the time is adjusted. Over time, this makes it easier to fall asleep.

Another technique is stimulus control. Patients are asked to avoid any activity in the bedroom or bed except sleep or sexual activity. In addition, a person should only go to bed if they feel sleepy, and if they can't fall asleep within 20 minutes, they should get out of bed and do something quiet. Wake up at the same time even on weekends, you can not sleep during the day and fall asleep on the couch watching a movie. This technique helps to establish a strong association between sleep and bed, explained the neurologist.

In addition, the evening before bed, patients are encouraged to do relaxation exercises to relieve muscle tension, such as Jacobson progressive muscle relaxation, deep abdominal breathing or scenario-based relaxation, including "beach," "forest on a sunny fall morning" and "favorite safe place." Mindfulness meditative techniques are also included in the program. For example, a patient may count "ten gratitudes on his or her fingers" before going to sleep.

"This way a person remembers some pleasant moments that happened during the day, rather than what they didn't have time for and what a nightmare it will be if they fail tomorrow," Golovacheva explained.

Among other mindfulness techniques including "conscious breathing", "body scanning".

The specialist also works with the patient's anxious thoughts about sleep, various psychotherapeutic techniques are used, for example, "Socratic dialogue", when a person is brought to the point where he doubts the correctness of his fears and behavior.

"Such a game is also useful: a person imagines that in front of him is someone whom he treats with love and care, and who is afraid that insomnia or pain will never go away, and picks up words of support. Usually patients find something to say to other people; it is more difficult to say it to themselves. But when they say these supportive words out loud, these attitudes are stored and memorized," the expert added.

At the same time, a patient suffering from insomnia needs to increase activity during the day and do therapeutic exercises. In addition, such people are advised to limit the time spent in static positions, they should take breaks for therapeutic exercises when working on the computer and monitor the position of the head when using gadgets, so that the wrong static position does not provoke migraine attacks.

In addition, such patients are restricted from taking pain medications so that they do not take them when there is no reason to do so.

The person is also asked to follow a certain diet and plan the time of meals, avoiding both hunger and snacking on fast food, the components of which can be provocateurs of migraine attacks, said Golovacheva.

According to her, clinical psychologists, psychotherapists and neurologists who have been trained can use cognitive behavioral therapy techniques to treat pain and insomnia.

Earlier, on November 16, neurologist and somnologist Nikolai Ilyin of the European Medical Center (EMC) told Izvestia that reading before sleep can improve its quality. A chapter of your favorite book in bed helps to reduce stress, like meditation or yoga.