Sleep

Lack of sleep or poor sleep quality is known to be a common trigger for tension type headaches! 

Read more here: (Sullivan et al, 2019) - Psychological Sleep Interventions for Migraine and Tension-Type Headache: A Systematic Review and Meta-Analysis

Tension type headaches are strongly associated with pericranial muscle tenderness. Evidence shows that sleep deprivation is related to heightened pain sensitivity. 

Sleep and psychological health are tightly connected with the neuroimmune system, poor sleep can increase inflammation which increases the pain experience, this is known as central sensitisation.

Read more here: (Klyne et al., 2026) - Understanding the relationship between sleep, psychological and musculoskeletal health from a neuroimmune perspective

Here are some tips and tricks you can try yourself! 

1. Sleep Hygiene 

• Use a nice soft blanket or weighted blanket
• Make sure your pillow allows neck to be in neutral
• You can butterfly the pillow (grab both ends of the pillow and support the sides of the neck) 
• Use blinks or eye masks to control light exposure

Read more about it here: (Kaku et al., 2012) - Randomized Controlled Trial on the Effects of a Combined Sleep Hygiene Education and Behavioral Approach Program on Sleep Quality in Workers with Insomnia

2. Sleeping Environment 

• Keep a constant sleep schedule
• Limit stimulants like caffeine or electronic devices near bedtime
• Use the bed for only sleep (no studying or gaming!)
• Have a wind down routine before bed
• Get morning sunlight within an hour of waking up to regulate your circadian rhythm

Read more about it here: (Caddick et al., 2018) - A review of the environmental parameters necessary for an optimal sleep environment

3. ASMR/meditation 

• ASMR (Autonomous Meridian Sensory Response) - is relaxing sounds that calms you down and help fall into a deep sleep
• There are many meditation applications or videos online that provide guided deep breathing
• Try listening to one before bed or when you can’t fall asleep!

Read more about it here: (Hardian et al., 2020) - Improvement of Sleep Quality by Autonomous Sensory Meridian Response (ASMR) Stimulation Among Medical Students

Read more here: (Oh et al., 2018) - Insufficient Sleep in Tension-Type Headache: A Population Study

Monitor the effectiveness of these strategies with the 'Headache Self-Management Diary'!