Getting Headaches at Night? Here's What Your Body's Trying to Tell You

Headaches at night might mean you've gotten too much screen time during the day.
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It's been ​a day​, and now you've got a headache, which is really going to cut into your plans to have a relaxing night on the couch with snacks and made-for-TV holiday movies. Or — even worse — you might be woken up in the middle of the night with an aching noggin and have to decide if you get out of bed to take meds or try to sleep it off.

Uncovering the source of the head pain will help you take action (or get help), so you can reduce the risk that you'll be laid up with a pounder in the future.

1. You're Stressed

This is zero percent surprising for anyone who's ever felt as if they barely survived the constant onslaught of the day (multiple Zoom calls in a row, a boss who's not happy about that thing, kids on e-learning while you try to work), but stress causes headaches.

These are often tension headaches, and once upon a time they were even called stress headaches, according to the Cleveland Clinic.

Stress management or relaxation training is a common treatment to ease your mind and thereby reduce your risk of this type of headache. Deep breathing (download the app Breathwrk if you have iOS), listening to calming music or trying guided imagery (close your eyes and picture a place that's peaceful to you, like a beach or laying in the sun in a park on a warm day), are a few tools to have in your back pocket as you wind down at night and prepare for bed.

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2. You're Spending Too Much Time in Front of Your Computer

Jumping off of the endless Zoom call bandwagon, you might find yourself hanging out in front of your computer more when WFH compared to last winter when you were still in the office. In fact, some estimations say that workers are logging longer hours — about 30 minutes more in the U.S.

So here's the deal: If you're staring at a computer screen, you're at risk of developing "computer vision syndrome," which includes symptoms like eyestrain, neck and shoulder pain and headaches, according to the American Optometric Association (AOA).

If you wear glasses, make sure you have the right prescription for viewing a computer screen, correct your posture when doing work and practice the 20-20-20 rule: For every 20 minutes on your computer, look away for 20 seconds at something 20 feet away.

3. You Have Hypnic Headaches

Also called "alarm-clock headaches," these pains — which are more common in people over age 50 — only happen at night and occur at the same time at night, explains Raj Dasgupta, MD, assistant professor of clinical medicine at Keck School of Medicine of USC in Los Angeles.

They're so regular, in fact, that they wake you up like your own special alarm clock.

It's important to note that these headaches are rare, Dr. Dasgupta says. See your doctor, who will rule out other causes of nighttime headaches. Interestingly, consuming caffeine at bedtime is a common treatment, according to the American Migraine Foundation.

4. You're Grinding Your Teeth

Headache is a common symptom of teeth grinding. The coronavirus pandemic has caused enough psychological stress that more people are suffering from teeth grinding and jaw pain, according to a 2020 study in the ​Journal of Clinical Medicine​.

If you grind your teeth (you may not be truly aware of it, but your dentist might ask you at your next appointment if your teeth show signs), then you may need a mouth guard to protect your teeth from damage.

Developing a stress-management plan — as best as you're able in these trying times — can help you release angst rather than constantly clenching.

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5. You Have a Headache Disorder

Migraine, tension and cluster headaches are the three big categories of headaches.

"These can happen at any time, including nighttime, and are triggered by various factors, like poor sleep or too much sleep, food, medications and stress," Dr. Dasgupta says.

You don't have to live in pain. If headaches are striking often, jot down how they feel — a good description can help your doctor make an accurate diagnosis.

Migraine headaches are characterized by throbbing sensations, are often severe and the onset may come with an aura (like seeing flashing lights), Dr. Dasgupta says. Tension headaches are like a band around your head. Finally, cluster headaches are burning and piercing, aptly called "ice pick" headaches.

6. It's a True Emergency

If you can describe your headache as "the worst headache of my life," that's a buzzword that perks up an emergency physician's ears, Dr. Dasgupta says. One potential cause is a ruptured brain aneurysm that can lead to a brain bleed, which is life-threatening.

Get help immediately and tell emergency personnel that, yes, this is "the worst headache of my life."

7. You Have Anxiety or Depression

By the evening, everything from the day has come to a head. While you can experience symptoms of anxiety or depression at any time of the day, for some people, they may be especially acute once the day is over.

Headaches themselves can indicate that someone is suffering from generalized anxiety disorder, per the Anxiety and Depression Association of America. What's more, people who have more severe symptoms of mood disorders are also more likely to have migraines, March 2018 research in the journal ​Headache​ shows.

There are medications that can treat both headaches and anxiety or depression. Talk to your doctor.

Is This an Emergency?

If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911. If you think you may have COVID-19, use the CDC’s Coronavirus Self-Checker before leaving the house.
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