The Doc Replies

Our expert answers your medical questions

How does a migraine differ from headache?

Migraine is a common and lifelong neurological disorder characterised by recurrent headaches that tend to be moderate to severe, usually on one side of the head. The most common headache is a tension headache, which is aching pressure on both sides, often the forehead, temples and back of the neck.

A migraine usually lasts longer, sometimes for days, and may be preceded by an aura, which can be flashing lights, lines in front of the eyes, tingling, numbness or even an unusual sense of smell or taste or feeling less mentally alert. It can be severe and cause nausea and vomiting, occur behind one eye and make you sensitive to light or sound.

Various things can trigger it, such as a lack of sleep, skipping meals, too much caffeine and some women get menstrual migraine, usually before their period. Treatment can be sickness medication and maybe an anti-inflammatory or drugs called triptans. Preventative treatments include avoiding triggers, beta blockers, and some blood pressure or epilepsy medication.

What is sickle cell disease?

It’s an inherited red blood cell disorder that affects haemoglobin, the protein that carries oxygen. It affects more than 20 million people. Normally, red blood cells are shaped like a disc, flexible and move easily through the blood vessels. In sickle cell disease, they are a sickle or crescent shape, don’t bend or move easily, so can block blood flow. It can cause bad abdominal pain, strokes and increased risk of infections. It’s a lifelong illness but can be cured by a blood and bone marrow transplant.

Why do I feel sleepy during the day, despite sleeping well?

It might be due to an underlying medical condition, or sleep disturbance caused by stress or depression, sleep apnoea (someone who is very overweight might wake themselves up snoring), restless leg syndrome or post-Covid, or another virus. A not-uncommon reason is anaemia, particularly in women with heavy periods. We’d normally start by doing a blood count and a thyroid test if there’s nothing obvious.