Reasons You Wake Up With a Headache

If you suspect that your morning headaches are due to teeth grinding (or your dentist has flagged you as a grinder), talk to your doctor about next steps, which can include wearing a protective bite guard at night, Dr. Kriegler says.

Here’s Why You Could Be Waking Up With a Headache Every Morning

You haven’t even opened your eyes yet but your head is already pounding. Instead of waking up refreshed and rested, you’re awaking with a headache. Again. If this happens to you often, you’re not alone.

“Morning headaches are really common,” Nasima Shadbehr, DO, board-certified neurologist and head of the Cedars Sinai Medical Center headache clinic, tells SELF. If they happen occasionally, they’re probably no big deal. But having them regularly may point to a specific cause, and this is actually a good thing because that means there might be a simple way to prevent them. So if you’ve been asking yourself lately, “Why do I wake up every morning with a headache?” here are some potential causes—and solutions—to keep in mind.

What types of headaches are more common in the morning?

If you’re having chronic morning headaches, they’re most likely a migraine or tension headache. “A migraine often starts between four and nine a.m.,” Dr. Shadbehr says. That could be because of migraine triggers like dehydration or poor sleep, or because endorphins and some hormones dip to their lowest just as you’re waking. Migraine is more common than you might think: It affects around 15% of the population, according to a 2018 study published in the journal Headache. For people assigned female at birth, that figure jumps to 20%. 1

Tension headaches are another common culprit of morning headaches. How do you know if it’s a migraine or tension headache? The location and quality of the pain are two clues. A tension headache often feels like a tight band is gripping your whole head and the pain is usually dull, according to Johns Hopkins Medicine. A migraine, on the other hand, is often localized to one spot—say, right behind your eye. The pain is piercing, and you may have other symptoms, such as sensitivity to light or nausea.

It’s usually pretty easy to tell when you have a migraine versus a tension headache, but there could be other things going on too. Ahead are potential reasons you’re waking up with a headache.

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What causes headaches and migraine, in general?

It’s important to understand that a migraine is not the same as a run-of-the-mill headache. While a headache is caused by nerves that signal muscles and blood vessels to send pain signals to the brain, migraine attacks are not as well understood. In fact, migraine is actually a neurological condition. Experts think this is what’s going on with migraine: Nerve cells in the brain overreact to various triggers, which then causes blood vessels to go haywire, leading to chemical changes in the brain that can lead to severe head pain and other symptoms like nausea and changes to your vision, according to the Cleveland Clinic.

What are the most common causes of morning headaches?

Whether it’s a migraine, a tension headache, or something else, here are 11 reasons you may be waking up with a headache:

1. You could have insomnia.

“There is an integral relationship between sleep and headaches,” Dr. Shadbehr says. “Poor sleep quality can cause headaches, and improved sleep quality can help relieve them.” There is also a link between insomnia and headaches. If you regularly have trouble falling asleep or staying asleep, and you don’t feel well rested after a night’s sleep, there’s a possibility you’re dealing with this common sleep disorder—and that it could be contributing to why your head is killing you in the morning.

Treating insomnia (and in turn, morning headaches) starts with getting to the root of the problem. Insomnia can be both its own primary problem or a side effect of other conditions. Plenty of things can cause chronic insomnia, from certain mental disorders to stress and poor sleep habits. To get to the bottom of your insomnia (and possibly your headaches), speak with a healthcare professional.

2. Or you might have sleep apnea.

Sleep apnea is a potentially serious condition that causes people to repeatedly stop breathing during their sleep. This condition is linked to a number of health issues, including causing you to wake up with a headache. Here’s what happens: A lack of oxygen can lead to increased pressure in the head that spurs a headache, Vernon Williams, MD, sports neurologist and director of the Kerlan-Jobe Center for Sports Neurology and Pain Medicine at Cedars Sinai in Los Angeles, tells SELF.

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It can be tough to figure out whether you have sleep apnea on your own, but if your partner complains that you snore a lot, you often feel tired even though you’ve gotten enough sleep, and you’re having morning headaches, it’s time to talk to a sleep specialist, Dr. Williams says.

3. You’re experiencing a migraine attack.

Migraine headaches can occur at any time, but plenty of people develop them overnight or early in the morning. One older study published in Headache: The Journal of Head and Face Pain found that migraine attacks follow a cycle, meaning people who have migraine typically get episodes in the same window of time. 2 So it’s possible that the headache you keep waking up with is actually a migraine attack that hits while you’re sleeping.

Migraine is a genetically inherited neurological condition, which means it can be difficult to control migraine attacks, Amit Sachdev, MD, an assistant professor and director of the Division of Neuromuscular Medicine at Michigan State University, tells SELF. The good news? There are many to manage your symptoms.

A good place to start is identifying your migraine triggers—stress, poor sleep, and diet are some of the biggies, Dr. Sachdev says. Avoid them as much as you can. And if you’re pretty sure you have migraine, make an appointment with a neurologist, who can help you come up with a treatment plan.

4. Maybe you’re going through caffeine withdrawal.

This is most common in people who chug coffee from morning till night, but it can happen to anyone. Why? Caffeine may impact blood flow to the brain, Dr. Sachdev says, and if you don’t have as much as usual, it can cause neurological side effects that are similar to withdrawal from other drugs like alcohol (yes, caffeine is considered a drug). A big part of that is a raging headache. And since many people drink coffee in the morning, it can come on first thing.

To combat caffeine-withdrawal headaches, try to avoid caffeine in the afternoon, Jennifer Kriegler, MD, a physician in the Center for Headache and Pain at the Cleveland Clinic, tells SELF. And be sure to wean yourself off slowly. She recommends substituting a quarter cup of your regular coffee with decaf, and then gradually decreasing how much caffeine you have over time.

5. You could be grinding your teeth at night.

Grinding your teeth can cause tension in your temporomandibular joints (TMJ), which connect your lower jaw to your skull in front of your ear, and it can also cause changes in the positioning of your jaw, Dr. Sachdev says. All this leads to tension, which can escalate into a headache. On top of a headache, you might also feel tightness or pain in your jaw, pain that feels like an earache, or pain or sensitivity in your teeth.

If you suspect that your morning headaches are due to teeth grinding (or your dentist has flagged you as a grinder), talk to your doctor about next steps, which can include wearing a protective bite guard at night, Dr. Kriegler says.

6. You had an alcoholic beverage (or several) before bed.

Whether you had one glass of wine with dinner or were at a bar until 4 a.m., drinking can cause you to wake up with a headache. That’s because alcohol has an effect on several neurotransmitters in your brain associated with headaches, Jennifer Wider, MD, a women’s health expert, tells SELF. Alcohol is also a diuretic (meaning, it causes you to pee), and many people wake up dehydrated after drinking, which can exacerbate a hangover headache or cause one to form, she says.

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The solution is pretty simple: Avoid drinking too much. And if you notice certain adult beverages give you a headache more than others, even when you have just a glass, it’s probably best to take a pass on them in the future.

7. You’re using too many OTC pain relievers.

Taking over-the-counter (OTC) pain medications, such as Tylenol and Advil, too often or for too long can cause medication overuse headaches. Taking them regularly can actually turn an episodic headache into a chronic one, Dr. Shadbehr explains. It’s also important to note that waking up with a headache is a common sign of medication overuse headache because your body is essentially withdrawing from the medications overnight.

Researchers don’t know exactly why rebound headaches develop. One theory is that repeated use of these medications makes certain nerves “hyper-excitable” or oversensitive, which triggers chemical changes in the brain that lead to head pain. Another possibility is that long-term medication use changes the way your brain metabolizes or breaks down the medication, which makes it less effective over time. 3

To avoid medication overuse headaches, over-the-counter pain relievers should be used no more than 10 days a month or a couple of times a week, says Dr. Shadbehr. If you’ve been taking pain medication more often than that, talk to your doctor who can help you gradually wean off the meds.

8. It could be a medication side effect.

Sometimes the medications you take for other health conditions can actually trigger morning headaches. Birth control pills, hormone replacement therapy, and nitrate medications (used to treat heart conditions) are all common culprits.

If the pill seems to be the problem, you can switch to a method of birth control that may be less likely to cause a headache, such as pills that contain the lowest level of estrogen, a progestin-only pill, a pill that has fewer inactive days to avoid an estrogen drop, or an intrauterine device, which only delivers hormones to your uterus or contains no hormones at all (depending on which you choose). If headache and hormone replacement therapy go hand in hand for you, it may be best to switch to the method with the lowest estrogen dose, which is the least likely to cause headaches, according to the Mayo Clinic.

Headaches are unfortunately very common with nitrates and your best option may be to wait until your body adjusts to the medication. If your headaches persist, talk to your doctor about the best way to proceed with your treatment plan.

9. You’re dealing with anxiety or depression.

People with depression and anxiety are prone to headaches, especially tension-type headaches, according to the National Institute of Neurological Disorders and Stroke. There’s also a connection between anxiety and depression and migraine. People with migraine have a higher incidence of depression and anxiety; these conditions overlap and feed each other in complicated ways, Dr. Shadbehr says.

People with migraine also experience more fatigue than those who don’t, which can negatively impact your everyday life. “You may feel your symptoms aren’t being acknowledged or addressed. Or your eating habits may change as a result of the depression or the headaches,” says Dr. Shadbehr. ”These psychosocial conditions can make you situationally depressed.”

10. You ate something that doesn’t agree with you.

If you have food allergies or food sensitivities, they could trigger migraine, according to a 2019 study published in the Journal of Headache and Pain. The reason could be inflammation: When you eat certain foods, your body responds with inflammation, and that inflammatory environment is exactly what’s needed to spark a migraine attack. 4

Reasons You Wake Up With a Headache

We regularly update our articles to include the latest research, expand coverage, and add new information as it becomes available.

Updated December 13, 2022

Waking up with a headache is an unpleasant way to start your day, and research suggests that morning headaches are all too common. A large international study found that chronic morning headaches affect one in 13 people, and up to 60% of snorers.

Morning headaches are often linked to sleep disorders or other underlying conditions. Knowing the cause of your headache can help you take appropriate steps to sleep better and prevent pain.

What Are Morning Headaches?

Headaches range from dull, throbbing aches to sharp, stabbing pain or tightening sensations in the head. Morning headaches encompass a variety of headache types that can be present upon waking or shortly thereafter.

What Causes Morning Headaches?

Headaches and sleep problems share several brain pathways, particularly in the region of the hypothalamus. Sleep disorders have been shown to increase sensitivity to pain, and in turn, headaches can cause problems with sleep. In other cases, sleep problems and morning headaches may both arise due to a third factor, such as stress, anxiety, depression, type 2 diabetes, or alcohol consumption.

Sleep Disorders That Can Cause Morning Headaches

Sleep disorders are linked to a variety of different types of headaches including cluster headaches, hypnic headaches, migraines, and tension headaches. There are a few sleep disorders in particular that may contribute to morning headaches:

• Obstructive Sleep Apnea: blockage of the airway. People with sleep apnea often report frequent morning headaches due to fluctuating carbon dioxide and oxygen levels in the blood. These are referred to as sleep apnea headaches.
• Insomnia: People with insomnia struggle to fall or stay asleep. Insomnia is associated with a higher risk of headaches. Sleep disturbances are reported to trigger migraines, and tension headaches are more likely to become chronic in people who experience poor sleep quality.
• Bruxism: Also known as teeth grinding, bruxism may be triggered by stress or other factors. The grinding and clenching of the teeth and jaws during the night has been shown to increase the risk of waking up with a tension headache or migraine.
• Restless Legs Syndrome: There is a strong relationship between restless legs syndrome (RLS) and migraines, which are both thought to arise in part due to problems with shared brain pathways or iron metabolism. RLS is also related to tension headaches. Researchers believe that anxiety and depression may contribute to both conditions.

Other Causes of Morning Headaches

Aside from sleep disorders, some other causes of morning headaches are:

• Dehydration: Water is essential to many processes in the body. When you are not drinking enough water you can become dehydrated, which may be one reason you are waking up with headaches.

• Too Much or Too Little Sleep: Both oversleeping and poor-quality sleep can raise the chances of a tension headache the next day. Sleep deprivation lowers the pain threshold, and people with chronic headaches experience more severe pain when they go short on sleep.
• Snoring: Snoring contributes to the development of chronic headaches for people who already experience occasional headaches.
• Depression and Anxiety: Research suggests that anxiety and depression contribute to both poor sleep and headaches, as well as raise sensitivity to pain.
• Using the Wrong Pillow: Pillows are designed to reduce tension by keeping the spine in a neutral position. A pillow that fails to provide enough support for your head and neck may contribute to headaches overnight. If your morning headaches occur along with neck, shoulder, or upper back pain, you may need to use a higher or lower pillow.

Tips for Morning Headache Relief

If sleep problems can exacerbate headaches and make it more difficult to find relief, then adopting healthy lifestyle and sleep hygiene habits may help you sleep better and reduce the frequency of morning headaches:

• Maintain a Bedtime Routine: Establish a routine of calming pre-bedtime activities to help you wind down for sleep. Aim to go to bed and wake up at the same time each day, even on the weekends.
• Reduce Caffeine and Alcohol: Experts recommend staying away from alcohol and stimulating drinks if you are experiencing headaches. Certain medications can also prompt headaches, so talk to your doctor about switching medications or lowering your dose if this is a problem.
• Drink More Water: Ensure that you are drinking enough water throughout the day to prevent dehydration at night.
• Improve Your Bedroom Environment: Keep your bedroom dark, quiet, and cool for optimal sleep.

When to Talk to Your Doctor

You should talk to your doctor if you start experiencing headaches that you did not experience before, if the headaches wake you from your sleep, or if your headaches change in any way, especially if they are severe. You should also contact a healthcare professional if your morning headaches are accompanied by any other symptoms, such as loud snoring, vomiting, or feeling tired during the day. In preparation for your doctor’s visit, consider keeping a journal next to your bed to record the frequency and intensity of your morning headaches.

Your doctor can run tests to see if you might have a treatable sleep disorder or other medical condition. They can also work with you to change your medications and implement productive lifestyle habits to help reduce morning headaches.

References

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8. Accessed on October 13, 2021. https://medlineplus.gov/genetics/condition/obstructive-sleep-apnea/
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About The Author

Clinical Psychologist, Sleep Medicine Expert

Michael Breus, Ph.D is a Diplomate of the American Board of Sleep Medicine and a Fellow of The American Academy of Sleep Medicine and one of only 168 psychologists to pass the Sleep Medical Specialty Board without going to medical school. Dr. Breus is a sought after lecturer and his knowledge is shared daily in major national media worldwide including Today, Dr. Oz, Oprah, and for fourteen years as the sleep expert on WebMD. Dr. Breus is the bestselling author of The Power of When, The Sleep Doctor’s Diet Plan, and Good Night!

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