Headache When Lying Down? Here's What Your Body's Trying to Tell You

If you get a headache when lying down or bending over, it could be due to pressure changes in your head.
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You're settling into bed after a busy day when all of a sudden, a headache hits. Where'd it come from, and how can you get to sleep?


Certain types of headaches can be brought on by changing positions, while others can occur when you're trying to fall asleep or even in the middle of the night.

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Read on to find out which type you might be dealing with and the best way to find relief.

1. It's Idiopathic Intracranial Hypertension

Idiopathic intracranial hypertension, or IHH, is a rare type of headache that "is known to worsen by lying flat and improved upon sitting upright," says Sinifunanya Nwaobi, MD, PhD, a neurologist with the UCLA Goldberg Migraine Program in Los Angeles, California.

IHH is spurred by pressure changes inside the skull that happen when a person has too much cerebral spinal fluid. In addition to headaches, IHH can cause ear ringing, vision changes and neck or shoulder pain.

People assigned female at birth between ages 20 and 50 are most likely to be affected, especially those who have overweight, according to the National Eye Institute.


Fix It

Weight loss and medications such as acetazolamide, which can help reduce cerebral spinal fluid, can often successfully treat IHH, the National Eye Institute says. For some people, surgery may be necessary.

2. You're Getting Hypnic Headaches

If you frequently wake up in the middle of the night with a throbbing head, you could have hypnic headaches.

This rare headache disorder is marked by headache attacks that only happen during sleep, and always around the same time.

"Often we see these headaches around 1 a.m. to 4 a.m., and they can be very severe but often improve as the patient awakens," says Joey Gee, DO, a neurologist at Providence Mission Hospital in Mission Viejo, California.


People over 50 are the most likely to be affected.

Fix It

Over-the-counter pain medications containing a small amount of caffeine (40 to 60 mg), such as Excedrin, can be effective at stopping hypnic headaches without making it harder to fall back asleep, according to the National Library of Medicine. (If you're sensitive to caffeine, though, or don't consume it regularly, even this small amount could disrupt your sleep.)

Prescription meds including indomethacin and lithium can also help.

3. It Could Be Cluster Headaches

Cluster headaches aren't triggered by lying down, but they do often strike within an hour of falling asleep, notes the American Migraine Foundation.


"There may be some involvement with melatonin production that may trigger these nocturnal and cyclic patterns," Dr. Gee says.


The headaches tend to cause intense pain around or behind the eye, and can be accompanied by eyelid drooping, redness or tearing, or a stuffy or runny nostril on the same side where your head hurts.

Fix It

Cluster headaches are often treated by breathing in pure oxygen through a mask, which can relieve pain within 15 minutes.

Triptan drugs delivered as shots or nasal sprays are another option, because they tend to work faster than pills, notes the Mayo Clinic.

The key to finding fast relief is to start your treatment ASAP once your symptoms start, Dr. Nwaobi says. If you get these headaches, chat with a neurologist about what treatment might work best for you.

4. It's a Migraine or Tension Headache

Migraine and tension headaches can strike as you're getting ready to go to sleep. Sometimes, stress that builds up from the day can end up causing a headache in the evening as you're settling into bed, Dr. Gee says.


Migraines can also wake you up in the middle of the night. (Or start as you're waking up in the morning.) If you take meds daily to manage your migraines, it's possible that the headaches could be the result of the meds starting to wear off, notes the American Migraine Foundation.

If you're not sure what type of headache you're dealing with, pay attention to your symptoms and the headache location. Tension headaches tend to start at the back of the head and move forward to both sides. Migraine pain usually happens on one side of the head. It tends to be severe and is usually accompanied by nausea; increased sensitivity to light, sound or smells; dizziness and extreme fatigue.


Fix It

You can get relief from the occasional headache with over-the-counter pain relievers, applying an ice pack or cold compress or massaging your head or neck, notes the Cleveland Clinic.

If you get frequent or severe migraines, your doctor may recommend a triptan, a prescription headache medicine that can stop migraines at the first sign of an attack.

How to Prevent a Headache When Lying Down

Keeping headaches at bay starts with figuring out the underlying cause. If you're regularly experiencing head pain when you lie down or during sleep, try to track your symptoms in a journal. That can help you and your doctor figure out the type of headaches you might be dealing with and the best way to prevent them, the Cleveland Clinic says.

Often, headache management starts with paying attention to your mental health.



"Stress is a common trigger for most primary headache disorders," Dr. Nwaobi says. While meds can ease your symptoms, "if you have untreated anxiety, stress, worry or depression, headaches will persist to some degree despite medicine."

Committing to stress-management techniques like mindfulness might do the trick, Dr. Nwaobi adds.

If you're still struggling, counseling is another way to manage stress-induced headaches.

When to See a Doctor

An occasional nighttime headache likely isn't cause for concern. But you should let your doctor know if you're often getting headaches when you lie down, or if you have headaches that wake you up from sleep, says Dr. Nwaobi.

In rare cases, sleep-related headaches could be caused by a lesion or growth on the brain, which should be evaluated with imaging tests.




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.