9 Reasons Why You're Waking Up With a Headache

A morning headache can make for a rude awakening. It can be hard to figure out what's causing them, too.

You may be surprised at what conditions and habits can make you wake up with head pain. This article will go over nine common causes and what to do about them so you can start your day off right.

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

Types of Morning Headaches

Not all morning headaches are the same. You can wake up with one 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, 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: Overuse of headache medications can lead to daily rebound headaches. They don't respond to headache medications.

Many different things can trigger these types of headaches in the morning.

Causes of Morning Headaches

A lot of morning headaches are caused by other medical conditions. Others may be caused by things you consume.

Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) involves pauses in breathing (apneas) 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 and leads 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

Morning OSA headaches are often described as an ache rather than sharp pain. They don't occur at other times of day.

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 (chemical messengers) deal with both sleep and pain processing.

So insomnia makes you more likely to have regular morning headaches. They're especially like to be tension headaches.

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 and 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.

Recap

Morning headaches come in many types and have many triggers. Sleep disorders are a common cause, especially obstructive sleep apnea, insomnia, and teeth grinding.

Anxiety and Depression

The brain regions and neurotransmitters tied to sleep and pain also impact your mood. 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 and both anxiety and depression
  • Migraine and both anxiety and depression
  • Tension headache and anxiety

Headaches related to mood disorders may be more common in the morning due to the common physiology they share with sleep problems.

Hypertension

Hypertension (high blood pressure) often doesn't cause symptoms, but sometimes it does.

Research is divided as to whether mild or moderate chronic (ongoing) 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 be different 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 is 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

Checking Your Blood Pressure

You should get a blood pressure cuff and check your blood pressure regularly if you have a history of:

  • Hypertension
  • Hypertensive crisis
  • Headaches and nosebleeds that occur together

Cuffs are easy to find online and in drug stores. You don't need a prescription. Many types are available with prices starting around $10.

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.

Pregnancy, Hypertension, and Headaches

If you're pregnant and have frequent headaches, let your healthcare provider know. They could be a sign of a dangerous hypertension-related complication called preeclampsia.

Also watch for other preeclampsia symptoms, including:

  • Blurry vision
  • Swollen hands and face
  • Right side abdominal pain

Chronic hypertension is a risk factor for preeclampsia. Home blood pressure monitoring is a good way to catch this problem early.

Recap

Medical conditions that can cause morning headaches include anxiety, depression, and hypertension. Hypertension headaches often involve nosebleeds. In pregnancy, headaches accompanied by high blood pressure could be signs of preeclampsia.

Strained Muscle

Sleeping on the wrong pillow or in the wrong position can leave your neck muscles aching in the morning. And 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. They irritate your nerves, leading to pain.

These waste products include:

  • Lactic acid
  • Carbon dioxide
  • Water

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

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)

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 motor 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
  • Mini-withdrawal as the effects wear off

Hangover symptoms may last anywhere from a few hours to three days. The length 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 most drinking takes place in the evening or at night, it's common to wake up to them.

Medications

Some medications can cause headaches as a side effect. Others can cause what's called a medication-overuse headache (MOH).

Side-Effect Headaches

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.

Medication-Overuse Headaches

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 ten 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 meds. If you don't realize this is happening, it's natural to take another dose. That just compounds the problem.

Drugs that can cause MOH include:

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

MOH By Other Names

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.

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 of opportunity for medication.

Recap

Muscle strain, alcohol, and medications all can trigger various types of headaches. Medications may cause them as a side effect or by losing their effectiveness and resulting in medication-overuse headaches.

Treating Morning Headaches

The right treatments for your morning headaches depends mainly on what's causing them. If they're secondary headaches, treating the underlying cause may help alleviate them.

Treatments for common causes of morning headaches include:

  • Obstructive sleep apnea: ​Continuous positive airway pressure (CPAP), other wearable or implantable devices, neurostimulation therapy, or surgery.
  • Insomnia: Sedative drugs, specialized cognitive behavioral therapy, and possibly supplements like melatonin.
  • Grinding teeth: A mouthguard to prevent clenching, antidepressants to regulate neurotransmitters, learning to relax your jaw and mouth area (which may be aided by biofeedback.)
  • Anxiety: Psychotherapy, anti-anxiety drugs, antidepressants, beta-blockers, stress management.
  • Depression: Psychotherapy, antidepressants, brain-stimulation therapies.
  • Strained muscles: Rest, ice, anti-inflammatory drugs, a better pillow, change in sleep position.
  • Hypertension: Dietary changes, physical activity, weight loss, stress management, smoking cessation, and blood pressure medications.
  • Hangovers: For prevention, drink less alcohol; Treatments include hydration, carbohydrates to raise blood sugar, NSAIDs, caffeine, B vitamins, and zinc.
  • Medication side effect: May go away with continued medication use; may require you to lower your dosage or find an alternative treatment.
  • Medication overuse: Stopping the problem drug and finding alternative treatments is recommended.
  • Timing of headache medications: Ask your doctor about longer-acting or extended-release drugs.

While you try treatments for the underlying cause of your headaches, see what options your healthcare provider recommends for managing your pain.

Headaches and Sleep

The connection between poor sleep and headaches is one to take seriously. If you often don't sleep well and have regular headaches, you may benefit from better sleep hygiene.

You may improve your sleep by:

  • 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, or large meals close to bedtime
  • Getting more exercise during the day (but not near bedtime)
  • Keeping electronic devices out of the bedroom

Talk to your healthcare provider about the reasons you aren't sleeping well. It may be due to an undiagnosed sleep disorder or another medical issue.

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 medications.

Treatments for morning headaches depend on the underlying cause. Treating a medical condition that triggers them may alleviate your headaches. 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
  • 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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