Waking up with a bad headache is never a pleasant way to start the day, and it often appears at this time.
According to research, around one in 13 people suffer from recurrent morning headaches, with women and people aged between 45 and 64 more likely to suffer from them.
Chronic morning headaches can be a symptom of an underlying condition, so it’s helpful to determine what exactly causes them.
However, since morning headaches can be aggravated by a long list of possible causes—from the obvious, like drinking too much alcohol the night before, to conditions like sleep apnea, bruxism, or migraine—identifying the cause may require a little research.
These are some of the most common causes of morning headaches, as well as serious symptoms to watch out for.
suffers from sleep apnea
Sleep apnea, a disorder that causes frequent obstructions in the upper airways during sleep, is one of the most common causes of morning headaches, according to Sait Ashina, associate professor of neurology and anesthesia at Harvard Medical School and director of the Comprehensive Headache Center at Beth Israel Deaconess Medical Center.
“As sleep specialists, we always ask, ‘Do you wake up in the morning with a headache?’” said Phyllis Zee, chief of sleep medicine in the department of neurology at Northwestern Medicine. If the answer is yes, “we dig a little deeper” into related symptoms, he added, since snoring, difficulty breathing or excessive daytime sleepiness may be additional signs of this condition.
It’s unclear why people with sleep apnea might wake up with a headache, but reducing oxygen intake during the night could play a role, Zee said.
In a 2023 study, participants who received treatment for obstructive sleep apnea experienced a 72 percent improvement in the severity of their morning headaches.
have a migraine
Migraine, a neurological disease characterized by recurring headaches, affects one in seven people worldwide. It’s also one of the most common causes of morning headaches, as attacks typically begin late at night or just as a person is waking up, explained Niushen Zhang, associate clinical professor and chief of the division of headaches and facial pain at Stanford Medicine.
Migraines can feel like a throbbing, stabbing pain, and may be accompanied by other symptoms, such as sensitivity to light and sound, nausea and vomiting, neck pain, and mental confusion. About 30% of people with migraine develop aura, where bright patterns, such as zigzags, are seen that affect vision.
Although migraine usually begins in adolescence or early adulthood, people may first develop symptoms in their 30s and 40s, Zhang said.
Additionally, overreliance on medications to treat migraine or other headaches can lead to medication overuse headaches, also known as rebound headaches, in the morning.
“What happens is that during the night the medication wears off and in the morning you wake up with a headache,” Ashina explained.
suffers from insomnia
Not getting enough quality sleep (whatever the cause) can cause headaches in the morning.
“People who suffer from insomnia also have a very high prevalence of morning headaches,” Ashina said.
One study found that about 14.4 percent of people with insomnia disorder experience chronic morning headaches, compared to 6.9 percent of those without sleep problems.
Insomnia is also a known risk factor for migraine, he added.
Need a new pillow
Sleeping in an uncomfortable position or on a pillow that doesn’t provide good support can cause neck pain or headaches first thing in the morning, Ashina explained. In these cases, the headache may feel like it originates in the neck and radiates to the front of the head.
Bruxism or any jaw problem
Some people may wake up with a headache in the morning because they have been grinding or clenching their teeth overnight, a condition called bruxism, or because they have temporomandibular disorders (TMD), a group of conditions that can cause pain, stiffness, and limited jaw movement.
Read also: What is sweat, why it occurs and when it can indicate a health problem
Whether from temporomandibular disorder or bruxism, tension in the jaw joint can cause muscle pain, Zee explained, and this “can be transmitted to the frontal area because all those muscles become tight when you flex your jaw.”
Suffer from depression or anxiety
Research suggests that people with mood disorders, such as depression and anxiety, have higher rates of morning headaches, as well as different types of headaches in general, including migraine.
Experts aren’t entirely sure whether mood disorders themselves cause morning headaches or whether they cause worse sleep, which in turn contributes to headaches, “but we do see those associations,” Ashina said.
A study of more than 18,000 people who responded to telephone questionnaires revealed that anxiety and depressive disorders were among the most important factors associated with chronic morning headaches.
Consume too much alcohol and/or caffeine
It probably won’t surprise anyone that excessive alcohol consumption is significantly linked to morning headaches, but drinking too much caffeine can also lead to an early morning headache.
“If you drink a lot of coffee, for example, you can get withdrawal headaches.” [al despertar] due to the low levels of caffeine in your body,” Ashina explained.
When to see the doctor
Experts stressed that recurrent morning headaches always warrant a medical check-up. Although they are less common, they can be a symptom of more serious neurological conditions, brain tumors or brain hemorrhages. Hypertension has also been associated with headaches in cases of sudden increases in blood pressure, which would be considered a medical emergency.
According to Ashina, red flags that may indicate more serious conditions include morning headaches with neurological symptoms such as weakness, numbness, or speech disorders, as well as extreme pain.
If your symptoms are not urgent, “primary care doctors are a great resource,” Zhang said, and can be a good starting point for treating conditions like migraine. Depending on the consultation, your doctor might refer you to a specialist, such as a sleep medicine doctor, neurologist or headache specialist, he added.
CONTENT FOR SUBSCRIBERS
When preparing for your appointment, Zee recommended keeping track of any related symptoms (such as whether you’ve been snoring, not getting enough sleep, experiencing jaw pain, or other migraine symptoms), as well as potential triggers, such as alcohol, caffeine, or any specific foods that seem to be associated with your headache.
Also pay attention to any patterns: For example, Zhang commented, “Are your morning headaches a new phenomenon or have they suddenly become more frequent? If you’ve had headaches throughout your life, but now they’re starting to be different, you should also tell your doctor,” he added.