11 Reasons Why You May Wake Up With a Headache

Waking up with a headache is not the way anyone wants to start the day. This kind of pain can occur for a number of reasons, from obvious causes like drinking too much alcohol or getting a poor night's sleep to causes that may be more surprising, such as medication use or anxiety.

This article reviews 11 common causes of morning headache and what to do about them so you can avoid a rude awakening.

Woman in bed holding her head in her hands
Peter Dazeley / Getty Images

Types of Morning Headaches

First, it's important to know that not all morning headaches are the same. You can wake up with any of these types:

  • Tension headache: Involves dull tightening or pressure on both sides of the head. It may start at the forehead and radiate to the back of the head.
  • Migraine: Incapacitating pain, usually on one side of the head, plus nausea, sensitivity to light and sound, and sometimes visual phenomena called an aura.
  • Cluster headache: Brief, severe, sudden-onset headaches may occur multiple times a day, affect one side, and cause red, inflamed eyes, flushing, and runny nose.
  • Medication-overuse headache: Taking too much headache medication can lead to daily rebound headaches. These don't respond to headache medications.

The characteristics of your headache can help your healthcare provider determine what you may be dealing with and guide them toward a possible cause, which may include any of the following concerns.

Dehydration

Dehydration is a common cause of headaches in general. It happens when you lose more water than you take in. Dehydration is often caused by excessive sweating, vomiting, diarrhea, or a fever.

Morning headaches are especially likely if you get dehydrated overnight. This may be due to sweating while you sleep, either because of a warm environment or the night sweats of menopause.

Other symptoms of dehydration include:

  • Increased thirst
  • Fatigue and lack of energy
  • Dizziness, especially when you first stand up
  • Dark urine or low urine output
  • Dry mouth
  • Irritability

Treating Dehydration

If your headache is from dehydration, it'll likely go away when you replenish your fluids and electrolytes.

In mild cases, you can relieve dehydration with water. If you've lost a substantial amount of fluid, you may need a rehydrating beverage like a sports drink. Severe dehydration requires immediate medical attention.

Preventing dehydration is better than treating it, so do what you can to replace the fluids you lose during the day. That can put a stop to morning dehydration headaches.

Alcohol

Drinking alcohol, especially in large amounts, can contribute to morning headaches.

Hangover headaches are technically called delayed alcohol-induced headaches. They come on the morning after you drink and tend to:

  • Throb
  • Get worse with physical activity
  • Hurt on both sides of the head
  • Be located on the forehead and/or temples

Researchers don't fully understand what causes hangovers and their associated headaches. Potential factors could include:

  • Dehydration
  • Overactivation of certain pathways in the brain
  • Increase in blood sugars in the brain
  • Disrupted sleep
  • Inflammation
  • Exposure to a chemical called acetaldehyde, which your body produces as it processes alcohol
  • Withdrawal as the effects wear off

Hangover symptoms may last anywhere from a few hours to three days. The duration depends on how much you drank, how dehydrated you got, and several other factors.

Hangovers aren't the only way alcohol leads to morning headaches. If you get migraines, cluster headaches, or tension headaches, alcohol may be a trigger for them. Since drinking often takes place in the evening or at night, it's common to wake up to them.

Treating a Hangover

Hangover treatments, which may help ease your morning headache faster, include:

  • Rehydration
  • Eating or drinking carbohydrates to raise blood sugar
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Caffeine
  • B vitamins
  • Zinc

You can avoid hangovers and the associated morning headaches by drinking alcohol in moderation or not at all. Drinking water when you have alcohol beverages is also a good idea.

If you do drink enough to cause a hangover, drink plenty of water before you go to bed so you don't get dehydrated.

Strained Muscle

Sleeping on the wrong pillow or in the wrong position can leave your neck muscles aching in the morning. That muscle strain may lead to morning headaches.

When your muscles contract, it limits blood flow. That leads to chemical reactions that create a build-up of waste products including lactic acid, carbon dioxide, and water. They irritate your nerves, leading to pain.

Morning neck-strain headaches tend to be tension headaches or migraines. They often feature:

  • Mild to moderate pain
  • Mild nausea
  • Less often, increased sensitivity to light or sound (usually not both)

Blood flow can't resume until the muscle relaxes. At that point, the waste is flushed out and the irritation can ease.

Treating Strained Muscles

You can ease strained muscles with:

  • Rest
  • Ice
  • Massage
  • Anti-inflammatory drugs such as Advil (ibuprofen) or Aleve (naproxen)

Once you've identified strained muscles as the cause of your morning headaches, you can try a different pillow or change your sleep position.

Grinding Your Teeth

Regularly grinding your teeth at night is a disorder called sleep bruxism. This can be both a symptom of poor sleep and a cause of it. It's also tied to high stress levels.

Tooth grinding can aggravate your jaw joint and contribute to temporomandibular joint disorders (TMJ). Pain in the jaw, as well as the surrounding muscles and connective tissues, can lead to a dull, constant headache.

Research published in 2020 showed a direct relationship between nighttime grinding and morning headaches.

Treating Bruxism

To prevent you from grinding teeth, you may be given:

  • A custom-fitted mouthguard to prevent clenching
  • Antidepressants to regulate chemical messengers called neurotransmitters
  • Relaxation techniques for easing the tension in your jaw and mouth area

You may not be aware that you grind your teeth while you sleep. If you have a sleep partner and morning headaches consistent with bruxism, ask them if they've noticed you grinding.

Insomnia

Insomnia is a common sleep disorder that can:

  • Make it hard for you to fall asleep
  • Wake you up frequently overnight
  • Make you to wake up too early

Poor sleep can be a headache trigger because the same brain regions and neurotransmitters deal with both sleep and pain processing.

Related morning headaches are often tension headaches.

Treating Insomnia

Insomnia treatments include:

To help your doctor diagnose insomnia, keep a sleep journal that details how long it takes you to fall asleep, how long you sleep, and how often you wake up overnight.

Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) involves pauses in breathing that disrupt your sleep. Sleep disruption can be a headache trigger by itself.

It's also possible that low oxygen leads to high carbon dioxide levels in the brain, which increases blood flow and pressure inside your skull, leading to morning headaches.

These headaches typically:

  • Occur more than 15 times a month
  • Affect both sides of the head
  • Have a squeezing quality
  • Don't involve migraine symptoms (nausea, dizziness, vision changes, noise and light sensitivity)
  • Resolve within four hours of waking

The pain of morning OSA headaches is often described as aching rather than sharp. These headaches don't occur at other times of day.

Treating Obstructive Sleep Apnea

​Obstructive sleep apnea is treated with:

Sleep apnea and other sleep disorders are often diagnosed with polysomnography (a sleep study).

Improving Your Sleep Hygiene

If you often don't sleep well and have regular morning headaches, you may benefit from better sleep hygiene—habits and an environment that encourage good sleep.

This includes:

  • Going to bed and waking up at the same time each day
  • Keeping your bedroom dark, quiet, relaxing, and a comfortable temperature
  • Avoiding caffeine, alcohol, and large meals close to bedtime
  • Getting more exercise during the day (but not near bedtime)
  • Keeping electronic devices out of the bedroom

Anxiety and Depression

The brain regions and neurotransmitters tied to sleep and pain also impact your mood. Common physiology is at least part of why anxiety and depression are both common in people with migraines and sleep disorders.

In fact, a 2020 study confirmed a link between headaches and increased anxiety and depression scores. The links were strongest between:

  • Medication-overuse headache (see below) and both anxiety and depression
  • Migraine and both anxiety and depression
  • Tension headache and anxiety

Treating Anxiety and Depression

Anxiety and depression are both real conditions that need to be diagnosed and treated by a healthcare practitioner. Treatments may include:

If you have both depression and anxiety, you may want to start with treatments that can help both of them, such as talk therapy and antidepressants. Some antidepressants have sedative effects, helping you sleep better too.

High Blood Pressure

Hypertension (high blood pressure) often doesn't cause symptoms, but that's not always the case.

Research is divided as to whether mild or moderate chronic hypertension is associated with headaches and migraines. The link is better established between headaches and severely high blood pressure or a hypertensive crisis.

A hypertensive crisis is a sudden, sharp rise in blood pressure. It causes headaches that are often accompanied by a nosebleed and tend to be worse in the morning.

The reasons behind hypertensive headaches may vary for different headache types.

In non-migraines, researchers suspect it has to do with a disruption of the blood-brain barrier. That's a network of cells that prevent harmful substances from reaching your brain.

In migraines, evidence suggests it's because of common underlying mechanisms including:

  • A type of heart disease called endothelial dysfunction
  • Problems with the automatic regulation of your heart and blood circulation
  • Involvement of hormones that regulate blood pressure and blood volume

Recurring headaches of any severity are worth mentioning to a healthcare provider. This is especially important if you're pregnant and have frequent headaches. They could be a sign of a dangerous hypertension-related complication called preeclampsia, which can also cause blurry vision, swollen hands and face, and right-side abdominal pain.

Treating Hypertension

You have several options for treating hypertension. These include:

Hypertension increases your risk of heart disease. It's important to have it diagnosed and treated by a healthcare professional.

You should get a blood pressure cuff and check your blood pressure regularly if you have a history of hypertension, hypertensive crisis, or headaches and nosebleeds that occur together.

Call 911

If you have a headache and a nosebleed at the same time, check your blood pressure if possible. If it's high, rest for five minutes and check it again. If your second reading is above 180/120, call 911 immediately.

Medication Side Effects

Several types of medications cause side effect headaches in some people who take them. They include:

  • Hormonal medications used for birth control and menopause
  • Erectile dysfunction drugs such as Viagra (sildenafil) and Cialis (tadalafil)
  • Some heart and hypertension medications such as Plavix (clopidogrel), Zestril (lisinopril), nitroglycerin, Procardia (nifedipine), dopamine

Myriad other medications and some supplements can cause headaches as well. If you've started a new medication or had a recent dosage increase and start having regular headaches, talk to your healthcare provider.

Treating Headaches Caused By Medications

Headaches and other medication side effects may eventually taper off if you stay on the medication. They should also clear up if you stop taking the drug in question.

However, don't stop taking a prescription medication without the advice of a healthcare professional. Doing so can cause side effects, as well as complications related to your condition going untreated. Your provider can work with you to find a different treatment or a dosage of your current treatment that works better for you.

Also ask your healthcare provider or pharmacist what pain medications you can safely use to ease your headaches given other drugs you are taking.

Headache Medication Overuse

Ironically, the drugs you take to treat chronic headaches may eventually start causing them. The headache medications work at first, but over time, they become less effective.

Typically, you need to take the drugs more than 10 days a month for more than three months for this to happen.

When they wear off, your headache comes back—usually worse than it was before you took the medication. If you don't realize this is happening, it's natural to take another dose. That just compounds the problem.

Drugs that can cause medication overuse headaches (MOH) include:

If your headaches are getting worse despite taking pain medicine, let your healthcare provider know.

Medication-overuse headaches are sometimes called medication-induced headaches, rebound headaches, drug-induced headaches, or medication-misuse headaches. However, not everyone who gets them has overused or misused the medication.

Treating Medication Overuse Headaches

To get rid of an MOH, it's usually recommended that you stop taking the problem drug. Your healthcare provider can help you find different treatment, if needed.

Ask your healthcare provider or pharmacist how to treat your headache while the drug is still in your body.

Timing of Headache Medications

Migraines are most common early in the morning. There are several reasons for that:

  • Many pain medications last for between four and eight hours. If you take them before bed, they'll likely wear off while you're still asleep and leave you vulnerable.
  • If you're having MOH, it's even more common for drugs to wear off overnight.
  • Migraine treatments are most effective when taken soon after the migraine begins. If one begins while you're asleep, you may miss the ideal window for taking your next dose.

Treating Medication-Timing Headaches

Ask your healthcare provider about longer-acting or extended-release drugs.

You may also need to adjust the timing of your medications, but that should only be done under the direction of a medical professional.

Summary

Common morning headache types include tension, migraine, cluster, and medication-overuse headaches. They can be caused by a diverse array of triggers. These include sleep disorders, other medical conditions, and things like alcohol and medication use.

Treatments for morning headaches depend on the underlying cause. Treating a medical condition that triggers morning head pain may alleviate it. Getting good sleep may help, as well.

A Word From Verywell

Pain can have a major impact on your life. Getting control of chronic headaches can be a challenge and you may face frustrations along the way.

You may want to keep a headache journal with information about how well you sleep, any other morning symptoms you notice on headache days, what your headache triggers appear to be, and what treatments do and don't help

Working closely with your healthcare provider can give you the best chance of success.

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