Hi, welcome to our site. I am Dr Saumya Mittal, MD. Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your query Unfortunately, migraine has no cure. What best we can offer is a prophylactic therapy that will help prevention of the migraine attacks. However, I understand from the query that you are not avoiding the triggers (triggers are things/activities that stimulate the attack of a migraine- like coffee intake, fast food, flickering lights) - in your case, a lack of sleep. The problem is that the prophylactic medicines (stilnoct) work best when the triggers are avoided. When the triggers are on, the effectivity of the therapy reduces. In the given situation, the only option you have is taking the medicines for acute migraines. This is best taken when the headache starts. I will suggest zolmitriptan nasal spray. The action is fast and repeateable within 6-8 hours. Being a nasal spray, you can avoid other additional medicines like antacids that may be needed with oral ingestion of tablets of same medicines. I have given you the answer to the maximum considering the information provided. The results of the tests/drugs could further enhance my answer to you. Please do understand that some details could be extracted from a detailed history and examination. Please feel free to ask another query. I would be glad to help you. Looking forward to your return query with the details asked so that I can help you further. (If the answer has helped you, please indicate this) Best of luck. Dr Mittal. MBBS, MD (Internal Medicine), CC (Diabetes Mellitus), DNB (Neurology)