Why Do I Wake Up With a Headache? The 11 Most Likely Causes of Morning Headaches

Headaches are a common health concern. Around 1 in 13 people experience them first thing in the morning. That’s not a good way to start your day. Sometimes this is just a nuisance. But morning headaches may also be a symptom of a health condition that needs attention. Here’s a look at 11 common causes of morning headaches. 

The most common reasons you wake up with a headache

Before talking about morning headaches, let’s review a few basics about headaches in general.

The most common types of headaches are:

• Migraine: These headaches typically cause mild to severe pain, usually on one side of the head. Migraine may also lead to nausea, vomiting, vision changes, and sensitivity to light and sound. 

• Tension: These are usually mild to moderate, and cause pain on both sides of the head. Many people describe the pain of tension headaches as a squeezing sensation.

Both migraine and tension headaches may happen in the morning. Cluster headaches — a less common type of headache — can also occur when waking up. They cause severe, stabbing pain, usually behind one eye.

Stress, sleep problems, and lifestyle factors may contribute to all types of headaches. In one large study, 18% of people had both sleep problems and headaches. And if something affects your sleep, that puts you at greater risk for waking up with a headache.

“Common causes of morning headaches are obstructive sleep apnea, migraine, and bruxism,” said Dr. Juan Herena, a specialist in pulmonary, critical care, and sleep medicine. “Sinus congestion, excessive alcohol intake, and hypertension are less common. Tumors, bleeding, or infection in the brain are the least common causes. But we keep all those possibilities in mind when assessing someone’s headache.” 

Let’s break down some common causes and risk factors for morning headaches. Then we’ll discuss warning signs for more dangerous causes of headaches.

1. Sleep apnea

One common cause of morning headache is obstructive sleep apnea (OSA). In OSA, the airway partly closes during sleep. That can lead to low oxygen levels and disrupted sleep.  

In one study, nearly 30% of people with OSA also reported morning headaches. Those headaches can occur even when the OSA isn’t severe. One way to find out if the headaches are caused by OSA is to treat the OSA with continuous positive airway pressure (CPAP) during sleep. The headaches should improve with OSA treatment.

“Snoring, long pauses between breaths, and gasping or choking during sleep may indicate OSA,” Dr. Herena said. “If someone doesn’t know for sure, a bed partner may describe these episodes.” 

A sleep study is the best way to diagnose OSA. Talk with your primary care provider if morning headaches are frequent. They can help determine if you should see a sleep specialist.

2. Lack of sleep

OSA causes morning headaches by disturbing the usual sleep cycle. But there are other sleep problems that can cause morning headaches for the same reason. People who have frequent migraines often have trouble falling asleep or staying asleep. 

Poor sleep is also associated with cluster headaches, tension headaches, and hypnic headaches. Hypnic headaches occur mostly in older adults and can wake people from sleep.

“If people wake up with a headache,” Dr. Herena said, “we ask them what time they go to bed and wake up, and if they wake from sleep during the night.” He added that fatigue, excessive daytime sleepiness, and a tendency to nap or nod off during daytime hours are also clues to a lack of quality sleep.

3. Oversleeping

If a lack of sleep can lead to headaches, then sleeping a lot should fix it, right? It often doesn’t work that way. 

Any change in circadian rhythm, or your body’s internal clock, may trigger a headache. Some people will experience what’s known as a weekend headache. This happens when you sleep much longer than usual. Oversleeping may also lead to dehydration and caffeine withdrawal. Both of these are risk factors for headaches.

4. Teeth grinding

Sleep bruxism is when you grind or clench your teeth in your sleep. This occurs in about 13% of adults. A morning headache caused by bruxism is usually a tension headache on both sides of the head. Sometimes there’s also tenderness around the temporomandibular joint (TMJ), or jaw muscles.

A primary care provider or dentist can help determine if you have signs of bruxism. Stress management is an important part of treating morning headaches from TMJ dysfunction. Some types of physical therapy and dental appliances may also help.

5. Dehydration

Not having the right fluid balance in your body can lead to headache. This can happen if you don’t take in enough fluid. Or it can happen from losing fluid through vomiting, diarrhea, fever, or sweating. 

Some medications, like diuretics, also help your body get rid of fluid. So do other substances, like alcohol and caffeine. And because you’re not eating or drinking while you sleep, headaches from dehydration may be more common in the morning.

6. Alcohol

For some people, drinking alcohol triggers a headache. That’s especially true with binge drinking, or drinking much more than usual. And a night of heavy drinking is more likely to result in a hangover, which often includes an unpleasant morning headache.

7. Caffeine

Caffeine is another substance that may cause headaches. If the headache is in the morning, caffeine withdrawal is a possible culprit. Caffeine withdrawal headaches usually begin 12 to 24 hours after the last intake of caffeine. So if you drink a lot of coffee in the morning, for example, your body may be waking you up with a craving for more caffeine.

8. Medications

Medication overuse headaches often occur in the morning. These are also called rebound headaches, and occur from high use of medications used to treat them. 

Some of these medications include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen

• Triptans, such as sumatriptan and zolmitriptan

• Migraine medications that contain butalbital, acetaminophen, and caffeine

• Opioids

• Calcitonin gene-related peptide antagonists (erenumab, fremanezumab, atogepant, etc.)

Your healthcare provider can help find the right combination and frequency of headache medications for you.

It’s also important to note that headaches are a possible side effect of many medications — beyond ones that treat headache. Talk with your healthcare provider about morning headaches that begin after starting a new medication or a change in dose.

9. Mood and mental health

Headaches can often go along with mental health conditions. Depression, anxiety, and stress can all affect sleep. And that can lead to morning headaches. 

One large study found that morning headaches are tied to insomnia and depression more than any other health condition. Migraines and depression are also known to occur together. 

10. Sleep position

Sleep positions that put stress on the neck and shoulders may lead to tension headaches — along with neck pain and stiffness. 

Sleeping on your back or side is the best position to keep your spine aligned. It’s also important to find a supportive pillow and mattress that will help you get the best night’s sleep.

11. Food sensitivities

Some foods trigger migraines. If you’re sensitive to certain foods, you may wake up with a headache. 

Common migraine trigger foods include: 

• Chocolate

• Cured meats

• Aged or fermented foods

• Foods that contain the artificial sweetener aspartame

• Foods that contain monosodium glutamate

Morning headache red flags

Adjustments in sleep, medication, or lifestyle treat most morning headaches. But there are some instances when you should get medical help right away.

Dr. Herena points out some red flags that need urgent medical attention:

• New headaches in someone who hasn’t had them before

• The worst headache you’ve ever had

• Severe headache with neck stiffness or fever

• Any confusion or severe lethargy

• Any neurological symptoms, such as double vision, problems with speech, or weakness in the face, arm, or leg

• Loss of consciousness

What to do if you wake up with a headache every morning

Morning headaches are often related to sleep. So it makes sense to pay attention to sleep habits and lifestyle factors that may be affecting you.

Try to maintain a regular sleep schedule. Dr. Herena suggests keeping a “regular wake-up time, and going to bed 8 hours before that time, but only if you’re sleepy.” 

He also recommends:

• Avoiding caffeine after midday

• Not drinking a lot of alcohol or eating a heavy meal within 4 hours of bedtime

• Not looking at screens 1 hour before bedtime

• Avoiding naps unless they’re needed for tasks, such as driving

Exercise is great for managing stress and depression. And it can help to improve sleep quality. But Dr. Herena suggests avoiding heavy exercise 2 hours before bedtime. That could make it harder for you to fall asleep.

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Written by:

Anne Jacobson, MD, MPH

Anne Jacobson, MD, MPH has been a board-certified family physician since 1999. She worked as a full-scope family physician (inpatient, outpatient, obstetrics, and office procedures) in the Cook County Ambulatory Health Network for 15 years.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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