Could It Be a Hangover Headache?

A lovely, cozy holiday party with friends, cocktails, laughter, and music can be a memorable experience, as long as a hangover headache does not develop the next day.

A headache that occurs the next morning, approximately five to twelve hours after alcohol consumption, is common and is called a delayed-alcohol induced headache (or a hangover headache).

A hangover headache usually occurs on both sides of the head and is located on the forehead and/or the temples. It is pulsating, like a drum beating on your brain, and is generally worsened by physical activity, which is why most people want to lie on a couch when enduring one.

Besides a hangover headache, alcohol consumption can trigger someone's underlying primary headache disorder. So if you already suffer from migraines, cluster headaches, or tension-type headaches, drinking alcohol may precipitate your usual headache attack.

This may explain why people who experience one of the above primary headache disorders tend to drink less alcohol or avoid alcohol altogether.

A hangover, which may last up to 72 hours, is an individualized experience, varying in severity and symptoms from person to person and episode to episode. In addition to a headache, other common symptoms of a hangover include:

• Poor sense of overall well-being
• Diarrhea
• Loss of appetite
• Fatigue
• Nausea
• Dizziness
• Fast heart rate
• Sweating
• Reduced attention and concentration
• Low or anxious mood

Scientists are not certain as to what causes hangovers, and there are several theories. Some potential causes include dehydration, the direct effect of alcohol on the brain, the withdrawal of alcohol, alcohol additives, alterations in the body's hormones, and an increased level of acetaldehyde, which is a product of alcohol metabolism.

Regarding additives, individuals who drink dark liquors, which contain by-products called congeners, tend to have more frequent and more severe hangovers, although some research suggests that congener content does not influence next-day performance (sustained attention and reaction time), sleep, or perceived impairment.

Many experts suspect dehydration plays a role. Dehydration occurs because alcohol inhibits the effect of a hormone called antidiuretic hormone (ADH). Normally ADH stimulates the kidneys to absorb water to avoid a dehydrated state. But by inhibiting ADH, water is not reabsorbed into our bodies. Instead, water is urinated out, at a rate that is greater than the amount of fluid being ingested. While hydration can help ease a hangover, it does not completely alleviate the symptoms.

There is really no good way to treat a hangover other than to avoid or limit alcohol in the first place.

That said, for a hangover headache, apart from drinking fluids, eating, and resting, taking an over-the-counter nonsteroidal anti-inflammatory (NSAID) like ibuprofen can usually ease the pain. Although, be sure take an NSAID with food, as it may upset your stomach. Also, some people cannot take NSAIDs due to underlying medical problems, so be sure it is safe for you.

Keep in mind that it is important to minimize the use of Tylenol (acetaminophen) when drinking alcohol, as the combination can lead to serious liver problems.

Lastly, there are factors felt to increase the severity of a hangover, so minimizing them may reduce the severity of your headache. These factors include:

• Poor physical health
• Smoking
• Sleep deprivation
• Congeners
• Lack of food consumption and fluid intake
• Increased physical activity while intoxicated
• Your DNA (some people may be born with a predisposition to developing worse hangovers than others)

If you want to avoid a hangover headache, the best thing you can do is think before you drink. Is consuming alcohol worth the hangover and the headache the next day? It may be that avoiding alcohol is the best decision for you, or simply alcohol moderation.

It is understandable that for some people alcohol may play an important role in their culture or family life. In these instances, knowing your limits may be your best strategy. 

Additionally, if you and/or others are concerned about your alcohol intake, please consult your healthcare provider, as alcohol intake can have serious health and social consequences.

While this article does not focus on alcohol use disorder, if you would like more information, please talk with your doctor and consider visiting the website www.niaaa.nih.gov from the National Institute on Alcohol Abuse and Alcoholism.