Morning Headaches: Why Do I Wake Up With A Headache?

If you find yourself frequently waking up with headaches in the morning, you are not alone. Approximately 1 out of every 13 people experiences morning headaches. These headaches typically affect women more than men and are most frequent in people between the ages of 45 and 64.

A number of sleep or health disorders, as well as personal habits, can trigger a headache when you wake up. Sleep apnea, migraine, and lack of sleep are common culprits. However, teeth grinding, alcohol use, and certain medications can also cause you to wake up with a headache. Sometimes your morning headache comes from a combination of disorders or habits.

What Causes Morning Headaches?

As you transition from sleep to wakefulness, parts of your brain start to “wake up” too. Your brain becomes more responsive to changes in your body position, touch, and sound. During this period of heightened sensitivity, you may be more susceptible to pain.

Additionally, the hypothalamus in the brain is involved in both sleep and pain processes. The hypothalamus regulates your natural circadian rhythms and sleep cycles and modulates sensation and pain. Disturbances in the hypothalamus during sleep affect your ability to tolerate pain. As a result, while you may not have felt pain as you slept, you may feel it in the morning.

Sleep disorders commonly trigger morning head pain, but there are numerous possible causes for waking up with a headache.

Sleep Apnea

People with obstructive sleep apnea (OSA) experience disrupted or stopped breathing during sleep. OSA affects between 2% and 9% of adults. Morning headaches are a common symptom of OSA. In one study of people with OSA, 29% reported suffering from morning headaches. While the exact cause of these sleep apnea-induced headaches is unclear, it is often attributed to loud snoring, another common symptom of OSA. You can treat your sleep apnea using a CPAP machine, which may reduce or eliminate your morning headaches.

Snoring

Not all people who snore have sleep apnea. However, snoring alone may be the cause of many morning headaches. In one study involving 268 frequent snorers, 23.5% regularly woke with headaches in the morning. Having a history of migraines, insomnia, or psychological distress raised the likelihood of a morning headache among this group.

Sleep Loss and Insomnia

Because sleep deprivation is a common cause of morning headaches, people with insomnia also have a high risk of experiencing morning headaches. People with this sleep disorder struggle to fall asleep or to stay asleep. As a result, they often do not get sufficient sleep and may feel unrested or sluggish during the day.

Circadian Rhythm Disorders

People with circadian rhythm disorders have morning headaches more frequently than those without a sleep disorder. Circadian rhythm disorders develop when your body is misaligned with the standard sleep-wake rhythms in a 24-hour cycle. Because of this misalignment, you may get insufficient sleep, which can trigger a headache when you wake up.

Oversleeping

Oversleeping or sleeping too much can also affect your morning headaches. Both low-quality sleep and longer sleep are associated with more intense headaches when you wake up. The extra shuteye can contribute to an oversleeping headache.

Migraine

Migraines, or moderate to severe recurring headaches, often occur in the morning. Migraines often begin as headaches and grow more severe in pain intensity. About 12% of Americans get migraines, and they are most common among women and people who have sleep disorders. In fact, people who experience migraines are much more likely to struggle with insufficient sleep, and recurrent sleep loss can trigger migraines. New onset of headaches in elderly should be investigated for possible underlying malignancy.

Bruxism or Teeth Grinding

Sleep bruxism, or teeth grinding or clenching during sleep, can make you wake up with a headache. This forceful and excessive movement also leads to tooth wear, muscle pain, and gum damage. Causes of sleep bruxism include having an irregularly shaped jaw, stress and anxiety, sleep disruption, alcohol use, and coffee.

A dentist can determine if you have sleep bruxism. Treatment often involves wearing a mouthguard at night. Your dentist may also prescribe drugs for pain management and recommend cognitive behavioral therapy to manage stress and anxiety.

Tension

Your sleep posture and position can lead to tension, potentially triggering poor sleep and headaches. Choosing a supportive pillow or changing your sleep position can help relieve this tension.

Hangover

Heavy drinking of at least six drinks in an evening has a high association with morning headaches. However, even at lower levels, alcohol affects sleep and can lead to morning headaches for several reasons. When you drink alcohol, you’re likely to fall asleep faster than usual, but your sleep is likely to be disrupted, and you often wake up earlier. Alcohol also increases urination and loss of fluids, leading to mild dehydration. Headaches are a common side effect of dehydration. Additionally, alcohol can be a trigger for migraines.

Certain Medications or Supplements

Headaches are also a side effect of some over-the-counter medications and prescription drugs. While you may want to take medication for the head pain, that can contribute to a cycle of chronic headaches. Alternatively, overnight withdrawal from the drug can trigger a headache in the morning.

Drugs that can contribute to headaches include:

• Opioids
• Triptans
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Aspirin
• Acetaminophen/paracetamol
• Anti-anxiety medications

Treatments

If you have frequent or daily morning headaches, talk to your healthcare provider about what might be causing them. Consider keeping a sleep diary to track your symptoms and sleep habits and share this with your doctor. They can help you identify the exact trigger or triggers of your morning headaches and develop a treatment plan.

In addition to treatment specific to your trigger, you can also improve your sleep hygiene:

• Keep a Consistent Sleep Schedule: Go to bed and wake up at the same time each day.
• Exercise Regularly: Try to exercise at least several hours before bedtime. Exercising too close to your bedtime may keep you awake longer.
• Limit Caffeine and Alcohol: An afternoon coffee or a glass of alcohol just before bedtime can keep you up late or disrupt your sleep.
• Adjust Your Sleep Environment: You need a space that’s dark, cool, and with little noise. Limit the use of your bed to only sex and sleep.
• Find a Relaxing Routine: Winding down at the end of the day signals your body that it’s time to sleep. Try a soothing bath, reading, or meditation.

With good sleep hygiene and treatment for the disorder causing your headaches, you may be able to reduce or eliminate your morning headaches. Talk with your healthcare provider to determine the right treatment plan for you.