Tension headaches are by far the most common type of headache, developing as a result of overly tight or tense muscles within the neck, shoulders and jaw. They usually stem from stress, but may also come about from a lack of sleep, missed meals, alcohol, anxiety or even depression. But when head pain only occurs when lying down, there is likely another culprit.
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Sinus headache is one potential cause for the pain you’re experiencing when lying down. It’s often a result of inflammation within the nasal passages associated with sinusitis, a condition that interferes with the drainage of your sinuses. Lying down can lead to a buildup of mucus, triggering pain and pressure around the forehead. Though sinus headaches are usually accompanied by congestion, fever, sore throat, nasal discharge and fatigue, they can manifest soon after these symptoms clear.
Another potential cause of your pain when lying down is a cluster headache. This type of headache isn’t as well understood as other headaches, but is thought to be associated with the release of neurotransmitters or hormones, such as serotonin or histamine, respectively. Most of the time, cluster headaches develop about two to three hours after falling asleep, advises the National Institutes of Health. This may lead you to mistake the act of lying flat as the cause of your head pain when, in truth, it’s your slumber. While the pain associated with cluster headaches usually manifests around the eyes, it can develop within other areas of the face and head.
A sudden headache when lying down can also be an indication of a stroke, warns the National Institutes of Health. This symptom is typically linked to a stroke caused by a hemorrhage, or bleed, in the brain. More commonly referred to as a hemorrhagic stroke, blood vessels within the brain rupture or burst, allowing blood to spill out and fill the space between the brain and skull. This causes a sudden, sharp headache that’s often described as a thunderclap. Other symptoms frequently manifest, but are largely dependent on the severity of the stroke and location of the hemorrhage, so you may not manifest other symptoms, such as speech disturbances, dizziness, loss of balance, vision changes, numbness or paralysis.
Treating a sinus headache involves remedying the cause of the sinusitis as well as minimizing the associated pain. This often entails antibiotics, corticosteroids and over-the-counter medications, such as decongestant and pain relievers. Treatment for cluster headaches only involves minimizing the severity and frequency of your head pain, since there’s currently no cure for this condition. Triptans can be help some people, while dihydroergotamine is used on others. With a stroke, medical intervention is necessary to control the bleed.