You want to feel refreshed when you wake up — not beaten down with a headache before you've even put on your slippers. But here you are, with a throbbing headache. What's going on?
"Morning headaches are super common. Research shows that about one in 13 people will experience them in their life," says Raj Dasgupta, MD, assistant professor of clinical medicine at Keck School of Medicine of USC in Los Angeles, California. "The things that happen during the night manifest into what happens during the day."
Relief isn't just popping ibuprofen and hoping it goes away — it's uncovering the trigger. Here's what might be going on.
1. You Have Insomnia
"Having a sleep disorder makes you two to eight times more likely to develop a morning headache," Dr. Dasgupta says.
Part of treating insomnia is getting good sleep hygiene practices into place, including maintaining a consistent sleep-wake routine, sleeping in a cool, dark room and limiting screen time before bed.
2. You Have Depression or Anxiety
Depression is a risk factor for insomnia. And if you have anxiety, you may find it difficult to turn off the worries swirling around your head — something that makes it difficult to fall asleep.
Ultimately, both depression and anxiety can cause poor sleep that triggers a headache in the morning, Dr. Dasgupta says. If you have untreated depression or anxiety, count this as one more benefit to seeking treatment, like teletherapy.
3. You Have Sleep Apnea
Are you snoring? Actually, let's rephrase that question: If you have a bed partner, do they say you snore?
"Sleep apnea is characterized by multiple arousals and awakenings through the night, which impairs your ability to get into deeper and more restful stages of sleep," Dr. Dasgupta says.
Morning headaches are a defining symptom of sleep apnea, per Mayo Clinic. If you are snoring at night, you should see your doctor to rule out obstructive sleep apnea (OSA), as the condition is associated with heart disease and stroke.
4. You’re Sleeping in the Wrong Position
Sleeping on your back encourages snoring — and remember, anything that cuts into sleep can cause a headache.
One older study, published May 2011 in Cephalalgia, found that about one-quarter of snorers also suffered morning headaches. Try rolling over for a sounder and quieter slumber. (And promise not to be offended if your bed partner elbows you to get you to turn.)
5. You Have Heartburn
This one can be sneaky. "Acid reflux may not fully wake you up at night, but it can lead to arousals during sleep," Dr. Dasgupta says.
To help tame the burn, nix eating later in the night — wait at least three hours after a meal to hit the hay, per the Mayo Clinic. And try elevating the head of your bed or sleeping with a wedge between your mattress and box spring to raise your upper body a bit higher.
6. You’re Grinding Your Teeth
It's possible you're grinding your teeth at night — and the repeated pressure and strain from clenching leads to a morning headache.
In fact, in a May 2020 study in the journal Headache, the more often grinding happened, the more often "wake-up headaches" did, too.
See your dentist, who may recommend a mouth guard to protect your teeth. But you'll also want to identify the reasons why you're grinding your teeth in your sleep. Stress is a biggie, but research from the American Dental Association also finds that drinking alcohol, consuming caffeine and smoking may also contribute to grinding.
7. You’re Cutting Back on Caffeine
If you're having trouble sleeping at night, you might take the advice of sleep experts and cut out the java in the afternoon or evening.
"By treating your insomnia, you may cut out caffeine cold turkey and experience a rebound headache," Dr. Dasgupta says.
The good news is that these headaches will go away once your body adjusts.
8. You Drank Too Much Last Night
Headaches are a classic symptom of a hangover — that much is obvious. The body metabolizes alcohol into the toxic substance acetaldehyde, and that, in addition to general dehydration, is what's responsible for morning hangover headaches, notes Johns Hopkins Medicine.
Perhaps more surprisingly, alcohol is a known sleep disruptor, affecting the quality and quantity of sleep you get in the second half of your night. Meaning: You may not think you drank a lot, but you're still saddled with head pain in the morning because the booze messed with your slumber.
The fix: Rethink that drink at night to help you get more restful sleep.
9. It's Your Medication
If you suffer from tension or migraine headaches, you may routinely treat them with over-the-counter pain relievers, such as ibuprofen or naproxen. But taking these meds more than a couple times per week can actually cause rebound headaches, which occur as a result of withdrawal from the medication. These headaches may wake you up in the morning, according to the Mayo Clinic.
If these medications might be the cause of your headaches, talk to your doctor about other ways to treat your tension or migraine pains.
Is This an Emergency?
- JAMA Internal Medicine: “Prevalence and Risk Factors of Morning Headaches in the General Population”
- Mayo Clinic: “Sleep apnea”
- Journal of the American Heart Association: “Obstructive Sleep Apnea in Cardiovascular Disease: A Review of the Literature and Proposed Multidisciplinary Clinical Management Strategy”
- Cephalalgia: “Morning headache in habitual snorers: frequency, characteristics, predictors and impacts”
- Headache: “Wake-Up Headache Is Associated With Sleep Bruxism”
- The Journal of the American Dental Association: “Association between sleep bruxism and alcohol, caffeine, tobacco, and drug abuse”
- Johns Hopkins Medicine: “Hangover Headache”
- Alcohol: “Alcohol disrupts sleep homeostasis”
- Mayo Clinic: "Medication Overuse Headaches"
- Mayo Clinic: "Heartburn: Diagnosis and Treatment"