1001 Painful Nights: Navigating Allodynia, Migraine, and Lack of Sleep

Allodynia (sensitivity to touch) can make ordinary sensations feel horribly painful, particularly for those living with chronic migraine 01 . Today, Sarah Alexander-Georgeson shares her personal struggle with the vicious cycle of allodynia and migraine, the challenges it can pose to sleep, and her ongoing quest to find relief.

Ever brushed against a tender-feeling patch of otherwise unharmed skin and flinched in pain? Allodynia is a type of nerve-related (neuropathic) pain caused by something that usually shouldn’t hurt, such as a light touch or slight pressure.

There are three main types of allodynia: 

1. Tactile allodynia: Pain can be triggered by light touch or pressure on the skin, like a gentle touch or the weight of clothing
2. Dynamic allodynia: Pain is triggered by movement rather than pressure. For example, this kind of pain can occur when clothing rubs against the skin or when hair shifts position
3. Thermal allodynia: Pain that accompanies changes in temperature, like walking into a warm room from the cold outside

Allodynia and migraine: the link

When dealing with migraine, my allodynia symptoms mostly fall into the tactile camp. Even slight pressure on my scalp can cause pain, such as when I wear a hat or rest my head on a pillow.

A couple of years ago, I wrote an article about "ponytail migraine." It explored the agony I often feel when I wear my hair in a tight style or when the weight of my long hair pulls on my scalp. If I'm in discomfort for too long, the painful sensations may be accompanied by a full-blown migraine attack. 

Struggles with skin or scalp tenderness and touch sensitivity aren't uncommon among migraineurs. In fact, according to David Dodick, MD, FAHS, professor of neurology at the Mayo Clinic and Chair of the American Migraine Foundation, 40% to 70% of people with migraine experience allodynia during attacks.

Unfortunately for me, avoiding allodynia and migraine flare-ups isn't as simple as forgoing a tight bun. There are still plenty of things that can trigger nerve pain leading up to or during a migraine attack.

The nighttime struggle: allodynia and disturbed sleep

I mostly experience allodynia in my sleep. In the middle of the night, as a migraine builds, I feel a heavy, unrelenting pressure in my head and intense sensitivity to the touch. Although I am still half asleep and it doesn't fully wake me, I can still feel the pain. My pillow feels very hard as if I'm lying on a brick, and my worsening migraine makes me extremely uncomfortable.

When I do fully wake up, my whole head is throbbing. It's unbearable. My head and neck are in agony when I lie on the pillow, but I can't open my eyes because the light will hurt, too. 

All I want is to sleep. As someone with hemiplegic migraine, sleep is so important for migraine management. Not enough sleep or disrupted sleep can trigger migraine attacks, whereas getting a full night can make everything slightly more manageable. Annoyingly but unsurprisingly, lack of sleep can worsen allodynia pain and frequency as well.

My head feels heavy, like a bowling ball lying on a concrete slab. I must sit up. I lie there for what feels like hours, willing myself to sit upright. I can't cope with the pressure in my head; it's so tender to touch. 

How has my pillow - something so soft, fluffy, and inviting - suddenly turned into a torture device? I can't even tilt my head back because it's excruciating when the base of my head touches my back and shoulders.  

My migraine pain often feels worse with allodynia. The tenderness of my scalp and skin intensifies the pain in my head, and every part of me feels uncomfortable.

I can feel the individual hairs on my head as they move, and it hurts. My eyes sting. I'm acutely aware of my forehead and neck, which are radiating pain.

I can feel every movement of my eyes in their sockets. There is so much tension in my body. 

It's agony.

Finding relief from allodynia seems simple – but avoiding any contact with my head isn’t practical 

Allodynia is affecting my whole head, especially at the base of my skull and on the right side. I can't lie down; I must sit up and get up. 

Once I force myself off my brick-like pillow, my allodynia symptoms settle pretty quickly. I'm left with a migraine headache, but the relief is so satisfying that I almost want to cry.

It's almost alarming how quickly the pressure dissipates from my head when I'm not touching anything.

And yet, holding onto this (relative) feeling of relief is easier said than done. It's the middle of the night. I'm exhausted and still dealing with migraine pain. But I can't lean back on the sofa or tie my hair out of my eyes.

I can't even touch my head because the lightest pressure will cause the pain to come back.

I wake up with allodynia symptoms twice a week, and they are usually triggered by stress, dehydration, or wearing my hair up. 

Although dehydration seems like an easy fix, my ADHD often makes me forget that not drinking enough water can lead to migraines. It's only later, once the pain has set in, that I realize how little I've been drinking while caught up in hyperfocus or struggling to get things done. I think about how real ADHD tax is, and how the consequences aren’t always financial.

Weathering the allodynia-migraine storm

My head is often tender to touch, not only at night. This tenderness frequently triggers a migraine, and I must be careful if I lean on something, wear my hair up, or put a hat on.

I love hats, so living with chronic migraine and allodynia - especially as a hat-loving fashion fan - is not fun. I try to wear loose-fitting hats or choose a size bigger. However, they can still cause a migraine because their weight on my head can trigger an attack.

As impractical as it is, when an allodynia migraine strikes, it's best to avoid anything that might put pressure on your head or scalp (including brick-like pillows). I find relief by applying a cool patch or a cold flannel to the back of my neck, as long as the touch sensitivity hasn't spread to that area. The cooling sensation helps ease my migraine. 

Once the allodynia and migraine pain subside, I can finally take a nap and start paying off my sleep debt. It is the most wonderful feeling to lie down and realize the pillow feels as it should: fluffy and inviting rather than unyielding stone.

Because allodynia often disrupts my sleep, I definitely need some rest - so it's back to bed for me! 

Sources

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   What Allodynia Tells Us About Migraine: Q&A With David Dodick, MD, FAHS (2019). American Headache Society. https://americanheadachesociety.org/research/library/what-allodynia-tells-us-about-migraine-q-a-with-david-dodick-md-fahs. Last accessed July 16, 2025.

The information presented is solely for educational purposes, not as specific advice for the evaluation, management, or treatment of any condition  

The individual(s) who have written and created the content and whose images appear in this article have been paid by Teva Pharmaceuticals for their contributions. This content represents the opinions of the contributor and does not necessarily reflect those of Teva Pharmaceuticals. Similarly, Teva Pharmaceuticals does not review, control, influence, or endorse any content related to the contributor's websites or social media networks. This content is intended for informational and educational purposes and should not be considered medical advice or recommendations. Consult a qualified medical professional for diagnosis and before beginning or changing any treatment regimen.

NPS-ALL-NP-01576 JULY 2025