Why do you wake up with a headache?

If you start each morning with a headache, there’s a reason for it. Consider the following findings, courtesy of the American Migraine Foundation:

• 50 percent of migraines occur during the sleeping hours of 4:00 to 9:00 am.
• 80 percent of people with regular migraines often wake up still feeling tired.
• More than half of patients in headache clinics also report chronic sleep issues.
• People with sleep disorders experience headaches at 2 to 8 times the rate of others.

Clearly, sleep and head pain are closely related. If you are waking up regularly with a headache, you may have what’s called an “awakening headache.” The timing of awakening headaches – upon waking or shortly afterwards – is what distinguishes them from other types of headaches.

Why do sleep problems cause headaches?

It all stems from your brain. The same regions of your brain control your sleep, headache, and mood.

If you’re not getting enough sleep, you can expect to experience changes in mood or headache. Likewise, chronic sleep loss lowers your threshold for pain, so headaches can feel worse, and make sleep harder to achieve.

Not helping matters is that in the morning, your cortisol levels (your stress hormone) are higher, while your endorphins and enkephalins levels (your natural painkillers) are lower.

Common sleep problems associated with awakening headache

The following sleep issues are associated with morning headaches.

Insomnia

Insomnia, which describes difficulty falling or staying asleep. or related sleep deprivation  – related depression and stress feedback loop. Over half of migraine sufferers report sleep-onset or sleep-maintenance insomnia. The problem with insomnia is that it often leads to chronic sleep deprivation. For example, migraine sufferers with insomnia tend to sleep 6 or less hours per night. Even just a night of sleep deprivation can worsen mood, memory, and focus the following day. Over time, it can develop into depression or anxiety about not being able to fall asleep.

Snoring and sleep apnea

Besides insomnia, snoring or obstructive sleep apnea (OSA) are the most common sleep issues reported by headache sufferers. Snoring is heavy breathing during sleep, while OSA Researchers still have not confirmed a causal link between sleep apnea and migraines. However, sleep apnea does result in sleep disturbances like insomnia that can cause morning headaches, and some research has indicated that treating sleep apnea reduces the amount and severity of headaches.

Sleep movement disorders

Morning headaches are also experienced by people with sleep movement disorders, including:

• Sleep bruxism, a sleep disorder where people unknowingly grind or clench their teeth while they sleep. It’s related to stress and often causes headaches.
• Restless legs syndrome, a condition where people experience an intensely uncomfortable “pins and needles” sensation in their lower limbs while they’re in a supine position, accompanied by an equally intense urge to move them in order to find relief.

Hypnic headache

Hypnic “alarm clock” headache syndrome describes a condition where you wake during the night (1:00 to 3:00 am) due to a headache. The timing in the early middle of the night differentiates these from awakening headaches. Thus far researchers believe this to be a relatively rare and benign condition, although it is uncomfortable and the resulting sleep deprivation can cause the other types of headaches discussed in this article.

Other causes

Thanks to the sleep issues described above, migraine sufferers are also much more likely to experience excessive daytime sleepiness.

Additionally, waking up with headaches has been tied to:

• Circadian rhythm disorders
• Narcolepsy
• Sleepwalking
• Allergens in the bedroom environment
• Tension headaches from sleeping with the wrong pillow or in an exceptionally cold room
• Any sudden changes in sleep schedule, such as oversleeping or sleep loss

How to reduce sleep-related headaches

If you suffer from morning headaches, here’s the good news: improving your sleep often improves your migraine symptoms. Here are seven ways to enjoy better sleep, with fewer headaches.

1. Make your bedroom conducive to sleep.

The best temperature for sleep is a cool, low- to mid-60 degrees Fahrenheit. Anything colder than that, and you could induce a tension headache. Keep your bedroom dark, quiet, and clear of clutter. This will prevent noisy or visual distractions that can induce stress and anxiety.

2. Choose comfortable bedding and mattress.

If you suffer from tension headaches, the solution can be as simple as getting a better pillow so you don’t strain your neck while you sleep. Side sleepers should be sure to get one with a proper height to keep their neck and spine aligned while asleep.

Assess your sleep position, body weight, and other health factors to determine whether it might be time for a new mattress. For instance, memory foam does wonders for pressure point relief, but it can make hot sleepers even hotter, disrupting sleep and leading to sleep-deprivation headaches.

If your headaches are caused by allergies and sinus congestion, find ways to remove allergens from your bedroom. Get a HEPA filter and invest in hypoallergenic sheets and bedding. There are even fully hypoallergenic, antimicrobial mattress options, such as all-latex beds.

3. Get better sleep, consistently.

Too much or too little sleep are common headache triggers. Reduce headaches caused by sleep deprivation by getting sufficient, quality sleep on a regular basis. Set aside enough time for you to get 7 to 8 hours of sleep per night.

4. Address your snoring.

Treating snoring or sleep apnea can eliminate headaches. Invest in anti-snoring chinstraps, mouthpieces, or pillows. If you think you have something more serious, like sleep apnea, talk to your doctor. They may order additional overnight sleep testing before fitting you for a continuous positive airway pressure (CPAP) machine.

5. Avoid headache-triggering substances.

Caffeine, alcohol, and nicotine all interfere with sleep. Alcohol also causes dehydration, another risk factor for headaches, and daily caffeine consumption has been linked with chronic headaches.

Drinking coffee or alcohol late at night can make you need to urinate during the night, leading to sleep disruptions that result in headaches. Instead, drink plenty of water during the day, but limit your fluid intake in the hour before bed and use the restroom before going to sleep.

Also watch out that you don’t become dependent on any of these substances, as withdrawal itself can induce a headache. The same goes for pain relievers. Since you’re go without the substance for several hours while you sleep, by the time you wake up your levels are low and can trigger a withdrawal or rebound headache.

The one caveat to all this: If you suffer from hypnic headaches, caffeine can be an effective treatment.

6. Keep a sleep and headache diary.

This will aid your doctor in diagnosing the cause of your headache and related sleep issues, as well as inform their treatment plan. Note when you have headaches, the intensity and location of the pain, and any other symptoms. Note when you go to bed, when you wake up, your total sleep time, and any sleep issues (such as reports of snoring from your partner or waking during the night).

7. Seek out alternative therapies.

If you suffer from depression or anxiety in addition to insomnia, it’s worth noting that cognitive behavioral therapy (CBT) has shown to be an extremely effective treatment. Patients meet with a psychotherapist and learn how to recognize the anxiety-producing thoughts and behaviors that prevent them from getting quality sleep, and then learn how to replace them with healthier thoughts and habits. In some cases, just a few sessions can eliminate or significantly reduce symptoms.

Besides helping you fall asleep sooner, taking a melatonin can have an anti-inflammatory effect. In the case of cluster headaches and some migraines, it may reduce your migraine symptoms or prevent them.