Headache Disorders and Sleep

No one wants a headache after a peaceful slumber. But unfortunately, a number of headache disorders occur during or right after sleep.

In fact, it's sort of like the chicken versus egg dilemma — which comes first, the headache or the sleep problem? It can be tricky to distinguish. For one, various sleep disturbances like loss of sleep, oversleeping, or a change in your sleep schedule are triggers for acute migraines and tension-type headaches. On the flip side, headaches that occur at night like cluster headaches can impair sleep. Finally, snoring and underlying sleep disorders can contribute to the transformation from episodic to chronic headaches.

Here are some headache disorders that specifically affect or are tied to sleep:

Woman sleeping off headache

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Sleep Apnea Headache

A sleep apnea headache is a recurrent morning headache that is caused by a medical condition known as obstructive sleep apnea (OSA) — a disorder characterized by abnormal breathing during sleep. While the exact cause of this headache is unknown, scientists hypothesize that a sleep apnea headache could be triggered by low oxygen and high carbon dioxide levels. These abnormal levels occur as a result of a person's repetitive episodes of apnea at night — in which individuals stop breathing or breathe shallowly.

Sleep apnea headaches may occur as new headaches or as manifestations of migraines, tension-type headaches or cluster headaches. They can be located on both sides or one. People with sleep apnea headaches report a range of pain intensity — some people describe the headaches as mild and others as severe. Most sleep apnea headaches have a pressing or rubber-band-around-the-head sensation and nearly half remit within 30 minutes of walking.

Cluster Headaches

Cluster headaches are severely painful and disabling headaches. They are commonly referred to as alarm clock headaches because of how they occur at specific times of the day (nighttime) and certain times of the year — a concept known as seasonal variation.

It's important to note that sleep apnea is common among patients with cluster headaches so it can be difficult at times to differentiate between the two.

Hypnic Headache

A hypnic headache is a rare, dull headache that is more common in the elderly and awakens a person from their sleep. Like cluster headaches, hypnic headaches are sometimes referred to as alarm clock headaches because of their cyclical nature, occurring most commonly between 1:00 and 3:00 am.

Exploding Head Syndrome

Exploding head syndrome does not cause pain, so it is not included as a headache diagnosis by the International Headache Society. That being said, people with this syndrome do sometimes visit headache specialists. An exploding head syndrome, people wake from their sleep after perceiving a very loud noise that is associated with fear and distress.

A Word From Verywell

If you notice headaches during sleep or when you wake up, it's important to see your healthcare provider. Maintaining a sleep log will help your practitioner understand your headache and sleeping patterns so a proper diagnosis can be made. It's especially important to be evaluated for a sleep apnea headache if you have persistent head pain when waking up.

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By Colleen Doherty, MD
 Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis.