Key takeaways:
Morning headaches are often caused by a lack of sleep or conditions that interfere with sleep, like sleep apnea.
Certain medications, substances, and mental health conditions are also connected with morning headaches.
Red flags include new or severe headaches or symptoms like weakness or double vision. These symptoms should prompt an urgent medical visit.
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, morning headaches are just a nuisance. But they can 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
Stress, sleep problems, and lifestyle factors are common contributors to morning headaches. In one large study, 18% of people had both sleep problems and headaches. And if something affects your sleep, you may be more likely to wake up with a headache.
“Common causes of morning headaches are obstructive sleep apnea, migraine, and bruxism,” said Dr. Juan Herena, a specialist in 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 that may point to more dangerous causes.
1. Sleep apnea
One common cause of morning headache is obstructive sleep apnea (OSA). With 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. These headaches can occur even when OSA isn’t severe. One way to find out if OSA is causing headaches is to treat the OSA with continuous positive airway pressure (CPAP) during sleep. Headaches typically improve with OSA treatment.
“Snoring, long pauses between breaths, and gasping or choking during sleep may indicate OSA,” 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 whether you should see a sleep specialist.
2. Lack of sleep
OSA causes morning headaches by disturbing your 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,” 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 signs of poor sleep.
3. Oversleeping
If a lack of sleep can lead to headaches, then sleeping a lot should fix them, 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 can happen when you sleep much longer than usual. Oversleeping may also lead to dehydration and caffeine withdrawal. Both of these can increase your risk of headaches.
4. Teeth grinding
Sleep bruxism is when you grind or clench your teeth while you sleep. This occurs in about 13% of adults. A morning headache caused by bruxism is usually a tension headache on both sides of your head. You may also have tenderness around your temporomandibular joint (TMJ) or jaw muscles.
A primary care provider or dentist can help determine whether you have signs of bruxism. Stress management is an important part of treating morning headaches linked to 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 headaches. This can happen if you don’t take in enough fluid or have an imbalance of electrolytes in your blood. Dehydration can be caused by things like vomiting, diarrhea, fever, or sweating.
Some medications, like diuretics, also affect your fluid balance. So can substances like alcohol and caffeine. And because you don’t eat or drink while you sleep, headaches from dehydration may be more common in the morning.
6. Alcohol
For some people, drinking alcohol triggers a headache. This is especially true with binge drinking, or drinking much more than usual. A night of heavy drinking is also more likely to cause 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 your last caffeine intake. So if you drink a lot of coffee in the morning, for example, your body may wake you up with a craving for more caffeine.
8. Medications
Medication overuse headaches often occur in the morning. These are also called rebound headaches. They can happen when you take headache medications too often, including:
Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen
Triptans, such as sumatriptan and zolmitriptan
Migraine medications that contain butalbital, acetaminophen, and caffeine
Calcitonin gene-related peptide (CGRP) antagonists, like erenumab, fremanezumab, and atogepant
If you suspect you’re having rebound headaches, it’s important to work with your healthcare team to 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, including ones that don’t treat headaches. Tell your healthcare team about any morning headaches that begin after you start a new medication or change your dose.
9. Mood and mental health
Headaches can often happen along with mental health conditions. Depression, anxiety, and stress can all affect sleep. And poor sleep can lead to morning headaches.
One large study found that morning headaches were 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 your neck and shoulders may lead to tension headaches, along with neck pain and stiffness.
Sleeping on your back or side are the best positions to keep your spine aligned. It’s also important to find a supportive pillow and mattress that help you get the best night’s sleep.
11. Food sensitivities
Some foods can 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 (MSG)
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 your sleep habits and other lifestyle factors that may affect you.
Try to maintain a regular sleep schedule. Herena suggested being consistent with the time you wake each day and getting around 8 hours of sleep each night.
He also recommended:
Staying hydrated throughout the day
Avoiding caffeine after midday
Not drinking a lot of alcohol or eating a heavy meal within 4 hours of bedtime
Avoiding screens for 1 hour before bedtime
Avoiding naps unless they’re needed for tasks like driving
Getting daily exercise, which is great for managing stress and depression and improving sleep
When to see a doctor for waking up with a headache
Adjustments to your sleep, medications, or lifestyle can help treat most morning headaches. But there are some instances when you should get medical help right away.
Herena pointed out some red flags that need urgent medical attention:
New headaches if you’ve never had them before
The worst headache you’ve ever had
Severe headache with neck stiffness or fever
Confusion or severe lethargy
Neurological symptoms, such as double vision, problems with speech, or weakness in your face, arm, or leg
Loss of consciousness
Frequently asked questions
Lack of sleep is one of the most common causes of headaches. So if you frequently feel like you need a nap, sleep deprivation could be causing your post-nap headache. Obstructive sleep apnea (OSA) is also a common cause of both headaches and daytime sleepiness.
Most strokes — especially the kind caused by a blood clot — don’t cause headaches. More common signs of a stroke include facial drooping, difficulty speaking, weakness or numbness on one side of the body.
But strokes caused by bleeding in your brain can cause a severe headache. These headaches feel unlike any you’ve had before and can get worse quickly, in seconds to minutes. They can also be accompanied by vomiting, confusion, or a decreased level of consciousness. If you think you or someone near you is experiencing a headache from a stroke, call 911 right away.
The most common causes of headaches — such as lack of sleep, stress, sleep apnea, and medications — can last for more than one day. So if you’re having daily headaches, it’s important not to ignore your symptoms. There’s likely a cause that can be treated. The best place to start is with a visit to your primary care provider. If your headaches feel severe, visit your nearest emergency room.
Lack of sleep is one of the most common causes of headaches. So if you frequently feel like you need a nap, sleep deprivation could be causing your post-nap headache. Obstructive sleep apnea (OSA) is also a common cause of both headaches and daytime sleepiness.
Most strokes — especially the kind caused by a blood clot — don’t cause headaches. More common signs of a stroke include facial drooping, difficulty speaking, weakness or numbness on one side of the body.
But strokes caused by bleeding in your brain can cause a severe headache. These headaches feel unlike any you’ve had before and can get worse quickly, in seconds to minutes. They can also be accompanied by vomiting, confusion, or a decreased level of consciousness. If you think you or someone near you is experiencing a headache from a stroke, call 911 right away.
The most common causes of headaches — such as lack of sleep, stress, sleep apnea, and medications — can last for more than one day. So if you’re having daily headaches, it’s important not to ignore your symptoms. There’s likely a cause that can be treated. The best place to start is with a visit to your primary care provider. If your headaches feel severe, visit your nearest emergency room.
The bottom line
Morning headaches are often caused by sleep problems. Most will improve with better sleep quality. Medications, substances, and mental health conditions may also play a role. Keep track of any changes in your diet, stress levels, mood, or health conditions that make your headaches worse. And talk with a healthcare professional about headaches that don’t get better or interfere with your quality of life.
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