Why you may wake up with a headache, from poor sleep and sleep apnea to teeth grinding and alcohol, when it is a warning sign, and what helps.
Waking up with headaches is more common than you think. In a study of 18,980 people in Europe, about 1 in 13 had them again and again. Women had them more often than men. Poor sleep, sleep apnea, grinding your teeth and last night’s drink are common causes. Stress and a low mood are in the mix too. Most morning headaches ease once you find the cause. But a headache that is worse in the morning is a reason to see your doctor soon.
How Common Are Morning Headaches?
Morning headaches are not rare. And they often stay for years.
What a Large Study Found
Researchers phoned 18,980 people aged 15 and older. They called homes in the United Kingdom, Germany, Italy, Portugal and Spain. They asked about morning headaches, sleep, health and mood. Here is what they found.
- About 7.6% had morning headaches again and again. That is about 1 in 13 people.
- Women had them more often than men, 8.4% against 6.7%.
- They were most common between ages 45 and 64, at about 9%.
- For half of these people, the headaches had lasted 42 months or more.
The study asked how often they came, too. About 1.3% had them every day, 4.4% often and 1.9% now and then.
What Went Along With Them
Morning headaches were linked with:
- Worry and low mood
- Insomnia and other sleep problems
- A body clock that is out of step
- Breathing problems in sleep, like sleep apnea
- High blood pressure
- Problems with muscles and joints
- Taking pills for worry
- Heavy drinking
The strongest links were with worry, low mood and insomnia, which means trouble falling or staying asleep. The authors wrote that morning headaches which keep coming back are a good sign of low mood or insomnia. They also found they are not only a sign of sleep apnea, as some doctors had thought. People with high blood pressure had them more often too, 11% against 7.2%.
What This Means for You
A morning headache is a clue worth following. It can point to your sleep, your mood or your health. Not everyone who gets them has a sleep problem. So look at the whole picture. The good part? Most of these causes can be found and treated.
Types of Morning Headaches
How your headache feels can help you and your doctor find the cause.
Tension Headaches
This is the most common kind. It feels dull and tight, like a band squeezing your head. The pain is often all over, not in one spot. It comes when the muscles in your neck and scalp tighten. Stress, worry, a low mood and plain tiredness can set it off. Women get them a little more often than men. The pain can last from 30 minutes to 7 days. It does not often bring nausea or vomiting.
Migraine
A migraine most often feels like strong throbbing in one part of your head. The pain can be very strong, and it may come with nausea and dizziness. Migraines can start while you sleep. And poor sleep can make the pain feel stronger. Do you see flashing lights or a blind spot before one? Read about ocular migraine.
Sleep Apnea Headaches
These often feel like pressing pain on both sides of your head. They are there when you wake up, and they most often go within 4 hours.
Cluster Headaches
These bring severe pain on one side of the head. The pain can fade, then come back hard. They are common after waking, and they can last from 15 minutes to 4 hours.
Hypnic Headaches
These are rare. People call them alarm clock headaches, because they wake you from deep sleep. They can come every night, sometimes more than once a night.
Exploding Head Syndrome
Despite the name, this sleep problem often brings no pain. You hear a loud crash or bang as you drift off, or as you start to wake. Some people feel a quick stab in the head.
Keep a Headache Diary
Write down when each headache starts, how it feels, where it hurts, and what you did the night before. A diary helps you and your doctor spot your triggers.
Sleep Problems That Cause Morning Headaches
Sleep and headaches go hand in hand. A sleep doctor puts it this way. A headache the moment you wake up may be a sign of a sleep problem.
Not Enough Sleep
Poor sleep makes a tension headache more likely in the day. And it can turn into a loop. Insomnia brings tension headaches. The headaches make sleep harder. Then poor sleep brings more headaches. When you sleep badly, pain also feels stronger.
Too Much Sleep
Sleeping much longer than usual can bring a headache too. It can throw off your body clock and leave you groggy. This often happens when you spend many hours in bed but sleep poorly.
Sleep Apnea
In sleep apnea, your breathing stops and starts while you sleep. Your airway gets narrow or blocked. Loud snoring is the classic sign. But not everyone who snores has it. The snoring may stop for a while, then end with a loud snort or gasp. Most people with sleep apnea do not know they have it. A partner is the one who hears it.
Other signs are:
- Waking up without feeling rested
- Feeling sleepy in the day
- Being forgetful or grumpy
- Headaches, most of all in the morning
More than half of people with sleep apnea get headaches. And when the sleep apnea is treated, the headaches most often go away.
Getting Checked
A sleep study can confirm it. You can often do it at home, or in a sleep lab. Many people then use a CPAP machine. It pushes air through a mask to keep your airway open while you sleep.
Other Common Causes
Sleep is not the only thing behind a morning headache.
Grinding Your Teeth
Many people grind or clench their teeth in their sleep and never know it. Doctors call it bruxism. It puts tension on your face and head. That can leave you with a headache the next morning. Other signs are a sore jaw and sore muscles, mostly early in the day. A partner may hear the grinding at night. Daily stress is a common trigger.
Alcohol
Even one drink in the evening can bring a pounding head the next day. It depends on how sensitive you are. Alcohol also dries your body out, which adds to the pain. Heavy drinking was one of the things linked with morning headaches in the large study.
Caffeine
Too much caffeine can trigger a tension headache. So can a sudden drop, when you have less than usual.
How You Sleep
Sleeping with your neck bent at an odd angle can trigger a tension headache. So can a room that is too cold. Holding your head in one spot for hours does the same. Think of a long day at your screen.
Pain Pills
Taking pain pills more than 3 days a week can lead to rebound headaches. Those are headaches the pills themselves keep bringing back. Do you reach for them often? Talk to your doctor.
Stress and Mood
Stress, worry and a low mood can tighten the muscles in your neck and scalp. In the large study, worry and low mood had the strongest link with morning headaches. Do you feel low or on edge most days? Then tell your doctor about your mood and your headaches, not just one of them.
Is a Morning Headache a Red Flag?
Some headaches need care right now. Others need a visit soon. Know the difference. A headache with a cold, the flu or a mild fever is common. But bleeding in the brain, a stroke, very high blood pressure or an infection can cause one too. Those need care right away.
Get Emergency Care If
Go to the emergency room or call 911 if:
- It is the first severe headache of your life, and it gets in the way of your day.
- The headache comes on all at once and feels explosive or violent.
- It is the worst headache you have ever had.
- You also have slurred speech, vision changes, trouble moving an arm or a leg, loss of balance, confusion or memory loss.
- The headache keeps getting worse over 24 hours.
- You also have a fever, a stiff neck, nausea and vomiting.
- The headache comes after a blow to the head.
- The headaches just started, and you are older than 50.
- You have had cancer, and a new headache starts.
See Your Doctor Soon If
These are reasons to book a visit soon:
- Your headaches wake you up, or keep you from falling asleep.
- Your headaches are worse in the morning.
- A headache lasts more than a few days.
- Your usual headaches have changed in pattern or in strength.
- You get headaches often and you do not know why.
How Often Is Too Often?
Do you wake up with a headache 3 or more times a week? Then book a visit. Your doctor can look for causes like pills, food or strained muscles. They can also check you for sleep problems.
How to Stop Waking Up With Headaches
The best plan depends on the cause. These steps help many people.
Keep a Steady Sleep Schedule
Go to bed and wake up at about the same times each day. It may take a while to settle in. But it can ease your headaches. Make sure you get enough sleep, too, since poor sleep brings more of them.
Go Easy on Alcohol
Does your diary show a drink before every headache? Then drink less in the evening, or skip it.
Drink Enough Water
Drink water through the day. A tall glass first thing in the morning can help too. A balanced diet helps keep headaches away as well.
Watch the Caffeine
Too much caffeine can bring on a tension headache. So can cutting back all at once. So try to keep the amount you have each day about the same.
Protect Your Jaw
Do you grind your teeth? Ask your dentist about a mouth guard. Relax your face and jaw in the day. Ice or damp heat can ease a sore jaw. While it is sore, skip chewing gum and hard foods like nuts, candy and steak. Less daily stress may help too.
Sleep in a Good Position
Keep your neck in a natural line. Do not let the room get too cold. If you snore, try not to sleep on your back. And skip alcohol, and pills that make you sleepy, before bed.
Ease a Tension Headache
Massage helps. So do quiet time and ice or heat packs. Your diary can show you what sets these headaches off. Want a calm cup for the evening? Read about stress relief tea.
Use Pain Pills Wisely
Pain pills can help now and then. But more than 3 days a week can lead to rebound headaches. Talk to your doctor if you need them often.
What to Try This Week
Start with a few small steps.
- Write down each morning headache. The time, how it feels, and what you did the night before.
- Go to bed and wake up at the same times.
- Skip alcohol in the evening for a week, and see what changes.
- Drink a glass of water when you wake up.
- Ask your partner if you snore, gasp or grind your teeth at night.
- Call your doctor if headaches come 3 or more times a week.
Want a quick read on last night? Try our free Sleep Check. It takes about 30 seconds. You answer 6 questions and get your sleep efficiency. Take it on the mornings you wake up with a headache, and on the mornings you do not. Then compare.
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Common Questions
Is morning headache a red flag?
It can be. See your doctor soon if your headaches are worse in the morning, or if they wake you up. Get emergency care for a sudden, explosive or worst-ever headache. Also for one with confusion, weakness, vision changes, fever or a stiff neck. Often the cause is poor sleep, sleep apnea, teeth grinding or alcohol.
What does a cortisol headache feel like?
Cortisol headache is not a term our sources use. But stress is a common trigger of tension headaches. Those feel like a dull, tight band around your head. The pain is often all over, not in one spot. Does stress wake you up with a headache? Then a diary and calmer days can help.
What is the best sleeping position for headaches?
There is no single best one. A neck bent at an odd angle can trigger a tension headache. So keep your neck in a natural line. If you snore, or have sleep apnea, try not to sleep on your back. That can narrow your airway. A cold room can trigger headaches too.
Why does my headache get worse as the day goes on?
Tension headaches can grow with stress, tiredness, noise or bright light. If those pile up through your day, so can the pain. Holding your head in one spot for hours, like at a screen, can bring them on too. But a headache that keeps getting worse over 24 hours needs care right away.
Sources
- Here’s Why You’re Always Waking Up With Headaches, Cleveland Clinic
- Prevalence and risk factors of morning headaches in the general population, Archives of Internal Medicine, 2004
- Obstructive Sleep Apnea, Adults, MedlinePlus, National Library of Medicine
- Tension Headache, MedlinePlus, National Library of Medicine
- Headaches, Danger Signs, MedlinePlus, National Library of Medicine
- Bruxism, MedlinePlus, National Library of Medicine
