Written by: Lana Adler
Updated November 20, 2020
Health conditions, sleep disorders, alcohol and medication misuse, muscle strain, and dietary factors such as caffeine are all possible culprits for an early morning headache. Sleep, headache, and mood are influenced by the same chemical messengers and regions of the brain. Therefore, morning headaches can also be accompanied by feelings of anxiousness and depression. If you find that your days begin with a headache more often than not, it may be time to look for answers.
Before you can learn how not to wake up with a headache, you need to understand some of the primary causes of early morning headaches. Those who experience headaches are more likely to receive a sleep disorder diagnosis compared to the general population.
What Causes Morning Headaches?
Headaches may be associated with a disruption in REM sleep or the workings of the hypothalamus gland. The hypothalamus, which lies in a critical region of the brain, regulates sleep homeostasis and pain control, in addition to other functions. Research shows that its involvement in the transition from wakefulness to sleep and sleep to wakefulness may play a part in the mechanism of headaches.
Beyond sleep disorders, many other physical and mental issues can play a part in your not-so-pleasant early morning wake-up call.
Migraine is a common, heritable type of chronic disorder that causes recurring headaches. These headaches are more likely to strike in the early morning, causing people to wake with severe, pulsing pain.
For those prone to migraine headaches, poor sleep quality is a notable trigger, and so is too much sleep. Compared to a typical morning headache, migraines are usually much more intense.
Research has shown that a lack of REM sleep causes an increase in proteins that trigger pain, resulting in chronic migraine. Other types of headache disorders, such as hypnic and cluster headaches, may occur during sleep rather than upon awakening.
Insomnia could be the reason for your morning headaches. People with insomnia may be unable to fall asleep, stay asleep, or wake up early in the morning and not be able to go back to sleep. Insomnia is a risk factor for tension headaches and migraine, and it's the most common sleep complaint among headache patients, according to the American Headache Society.
Sleep deprivation from insomnia interferes with sleep homeostasis and circadian rhythms. Chronic insomnia, unlike acute insomnia, lasts longer than a month. Over time, a lack of consistent sleep exacerbates sleep deprivation and headaches. Insomnia can be associated with other risk factors common to people who have headaches, such as:
- Lack of exercise and obesity
- Medication misuse
Your insomnia could be a symptom of another problem. If sleep deprivation is affecting your mental and physical well-being, seek help from a doctor. Medications and therapy are available.
Anxiety or Depression
According to a telephone questionnaire that surveyed nearly 19,000 people, there is a positive association with anxiety and depression symptoms amongst those who experience chronic morning headaches. Persistent worry and feelings of hopelessness also disrupt sleep, which in turn can cause headaches.
Anxiety and depression can be associated with other medical conditions that cause morning headaches. Anxiety disorders are up to five times more common in individuals who experience migraine headaches. People with migraine are also 2.5 times more likely to experience depression than the general population.
The bidirectional relationship between anxiety or depressive disorder and headaches is complex. Many people living with migraine develop anxiety or depression after the headaches start. For others, the migraine occurs after living with anxiety or depression for some time.
Anxiety and depression are also risk factors for suicide. If you think that you or someone you know is experiencing depression, anxiety, or thoughts of suicide, speak with a mental health professional or contact the SAMHSA helpline.
Sleep Apnea and Snoring
Sleep apnea causes repeated, temporary pauses in breathing during sleep. It can disrupt a person's sleep routine, resulting in morning headaches and fatigue from lack of proper rest. Sleep apnea is associated with loud snoring, but this is not always an indication of sleep apnea.
Sleep apnea and snoring can be addressed with appropriate treatment, so seek medical help if you think you have it. Keep a record of your sleep habits and any symptoms, such as daytime sleepiness, difficulty concentrating, and irritability. Your doctor may recommend that you lose weight, quit smoking, avoid consuming alcohol, and use a breathing device, such as a continuous positive airway pressure (CPAP) machine.
Morning headaches can be caused by sleep-related teeth grinding, also known as bruxism. This overactivity of the jaw muscles during sleep can result in morning headaches. Bruxism is characterized by tooth-grinding sounds, jaw muscle pain, and the abnormal wear of teeth. Stress, misaligned teeth, and disrupted sleep can trigger teeth grinding.
Consult a dentist if you think that you have a problem with teeth grinding. Your healthcare provider may recommend wearing a dental night guard while you sleep. If stress is the cause, find ways to relax, or seek counseling if you have a hard time managing stress.
Muscle Strain in your neck and scalp can cause tension-type headaches. Sleeping with the wrong pillow can worsen the issue. Choose a pillow that maintains neutral alignment for your head and neck.
Your sleeping position can affect the type of pillow that works best for you. Stomach sleepers may need a flatter pillow than those who sleep on their back.
Medication or Supplements
Prescription and over-the-counter medications and supplements are well-known sources of morning headaches. It's tempting to increase your intake of pain medicines if morning headaches get worse, but doing so could cause more frequent headaches and be dangerous to your health without direction from a physician. Pain medicines that can lead to headaches from medication overuse include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Prescription pain medicines, including those for chronic pain
Taking medicines close to bedtime can disrupt your sleep patterns, which can lead to a morning headache. Overuse and withdrawal from the caffeine that's in many pain medications, foods, and beverages, can also cause headaches.
Discontinuing the use of certain medicines or lowering the dose can sometimes alleviate headaches. However, always talk with your doctor first before stopping or changing your medications.
Other medications and supplements that tend to cause headaches include:
- Heart and blood pressure medicines
- Birth control and hormone therapy for menopause
- Erectile dysfunction medicines
Alcohol consumption is responsible for morning headaches for a variety of reasons. It suppresses REM sleep and causes you to wake frequently. Alcohol is also a known migraine trigger. Too much alcohol over a period of time can lead to a hangover, which can include the following symptoms:
- Headache and dizziness
- Depression, anxiety, and irritability
- Sensitivity to light and sound
- Rapid heartbeat
In addition to waking up with a hangover and not feeling rested, you may have a morning alcohol headache because of disrupted sleep. Dilation of blood vessels and dehydration due to the diuretic properties of ethanol can also cause a headache.
Rest is important when recovering from a hangover. However, if the dehydration and low blood sugar are not addressed, spending long hours sleeping off a hangover can compound the issue and exacerbate your headache. To safely recover from a hangover, eat and replenish fluids. You should speak to a physician if you struggle with alcohol consumption or dependence.
Lastly, certain medical conditions can also cause early morning headaches. Examples include brain tumors and poorly controlled hypertension. Consult your physician to discuss the source of morning headaches and any underlying conditions that may be causing them.
How to Help a Morning Headache
If you have chronic morning headaches and are unsure why, consult your doctor. Understanding the root cause of your morning headaches is the first step to successfully treating the problem.
Once the cause is identified, you may be able to manage your headaches by limiting the triggers and practicing good sleep hygiene — the healthy habits and behaviors that help you fall and remain asleep. Your healthcare provider can work with you to develop an appropriate plan for your unique situation. Some causes of your morning headaches may be preventable, while others may need to be treated as they occur.
Here are some general tips for dealing with an occasional morning headache:
- Get enough sleep and schedule a consistent bedtime: Aim for seven or eight hours of sleep, even on the weekends. Strive to go to bed and wake up at the same times each day.
- Sleep in an environment conducive to sleep: Cool, quiet, dark bedrooms are considered best for sleeping.
- Reduce screen time right before bed: Avoid watching television and using electronic devices in bed.
- Refrain from napping too long during the day: Frequent daytime naps can lead to interrupted sleep at night.
- Limit stress: Practice relaxation techniques such as meditation, yoga, listening to soothing music, and prayer.
- Exercise regularly: Adults should get about 30 minutes of vigorous activity each day, at least five to six hours before bedtime.
- Track symptoms in a journal: Write down the days and times when you experience symptoms to help identify headache triggers.
- Eat a balanced diet: Eat fresh fruits, vegetables, whole grains, and lean proteins that are high in B vitamins, such as fish, poultry, and eggs.
- Avoid excessive caffeine intake: Try to consume no more than three 8-ounce cups of coffee each day and be mindful of the amount of caffeine in other beverages you drink, such as tea and soda.
By treating any underlying condition, such as a sleep disorder, and practicing healthy sleep habits, you may be able to say good-bye to morning headaches or at least reduce their frequency. Talk to your doctor about medication management, appropriate therapy, or complementary approaches.
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