What causes headache in the morning? Related conditions and treatments

Waking up with a splitting headache is not a great way to start the day. And a poor night’s sleep may be the cause. Understanding what’s interrupting your sleep is the key to preventing sleep-related headaches in the morning. Dehydration, caffeine, sinus congestion, and allergies are among some of the other causes of headaches in the morning. 

Relationship between sleep and headaches

“Headaches and sleep problems share several brain pathways, particularly in the region of the hypothalamus,” says Michael J. Breus, PhD, a psychologist in private practice specializing in sleep disorders. The hypothalamus is a structure deep inside the brain that produces hormones that control various functions, such as body temperature, mood, hunger, and sleep.

When you don’t get enough sleep, your brain doesn’t get the opportunity to fully rest and repair itself. That means your brain isn’t able to fully regulate its neural pathways, and that can and often does lead to headaches.  

Key takeaways:

• A headache in the morning is a common symptom of dehydration, sleep apnea, and sinus congestion, among other causes.
• Typically, mild headaches in the morning don’t require immediate medical attention.
• Treatment of headaches in the morning may include the use of nonsteroidal anti-inflammatory drugs (NSAIDs) to help with mild pain. However, treatment of headaches in the morning varies by cause.  
• Headaches in the morning can also be managed by resting in a cool and dark room, using cold compresses, and drinking water. 
• Use coupons for headache treatments, like ibuprofen, naproxen, and acetaminophen, to save up to 80%.

What causes a headache in the morning?

There are a number of possible causes of headaches in the morning, some of which are more serious than others. 

Lack of sleep

Sleep deprivation is a very common cause of headaches in the morning. In fact, a lack of sleep is a known trigger for migraine and other types of headaches, too. Research suggests that poor sleep quality directly affects the severity and frequency of migraine and tension headaches. 

Sleep apnea

Sleep apnea is a sleep disorder in which a person stops breathing briefly while they’re sleeping. It triggers a response in their body that interrupts their normal sleep cycle. People with moderate sleep apnea experience an average of 15 to 29 breathing interruptions per hour. Obstructive sleep apnea attacks can happen at any stage of sleep, including REM sleep. 

Caffeine

Many people begin the day with a cup of coffee, but if they habitually drink a lot of caffeine, “the brain starts to expect it in the morning when you wake up,” explains Indira Gurubhagavatula, MD, a board member of the American Academy of Sleep Medicine. 

Grinding your teeth

Waking up with a headache could be the result of pain or tension radiating up from the jaw or temporomandibular joint (TMJ). Bruxism is the technical term for grinding one’s teeth, and a case report showed that headaches can arise among people who grind (or clench) their teeth in their sleep. The motion causes tension to build up in the jaw, neck, and head muscles, potentially leading to a headache.

Sinus congestion

A sinus infection can cause the sinuses to fill with fluid, and this congestion or pressure can cause headaches. Allergies can also cause sinus headaches, which can feel like a dull pain behind the eyes, cheekbones, and forehead. 

Sleeping position

A flat pillow or a sagging mattress could also be contributing to morning headaches. People who fall asleep with their head or neck in an awkward position can develop tension in the back of their neck. “That tension can present as a headache upon waking,” Dr. Gurubhagavatula says.

Alcohol

People who drink alcohol before falling asleep may also wake up with a headache in the morning, especially if they drink wine. Sulfites are often added to wine as a preservative, so if you are sensitive to sulfites, you may experience a headache the morning after drinking wine. 

In addition, alcohol suppresses the release of vasopressin, a hormone produced by the brain that’s responsible for fluid retention in the kidneys. As a result, urination becomes more frequent, and the body loses needed fluid. This mild dehydration can cause headaches.  

Dehydration

Dehydration can also lead to a morning headache, although the exact reason is still unclear. Some experts suggest that dehydration causes fluid to shift out of the brain and stimulate the pain receptors in the brain’s lining, causing headaches.

Circadian rhythm disorder

Some people have circadian rhythm disorders, which can disrupt the levels of chemicals in the brain, such as melatonin and cortisol. This disruption can lead to certain types of headaches, including migraines and cluster headaches. According to a recent review and meta-analysis, cluster headaches tend to peak in the late hours of the night and early hours of the morning.

Should I be worried about a headache in the morning?

The causes of headaches in the morning vary, as does the appropriate level of concern about the pain.  

If it’s an occasional mild headache, it’s perhaps not necessary to be concerned. Typically, a headache first thing in the morning doesn’t warrant immediate medical attention, especially if it’s a relatively mild headache and there aren’t any underlying medical conditions or recent injuries that might require additional concern.

“Ongoing morning headaches, however, could be your body’s way of convincing you to stop and assess the situation,” says Dr. Gurubhagavatula, who recommends considering what you could do differently to prevent your headaches.

However, there can be exceptions. A severe headache could be a sign of a more serious medical problem. For example, no one should dismiss a headache if they’ve recently experienced a concussion or head injury.

If a headache persists, worsens, or is accompanied by other symptoms, such as blurred vision, it could be a sign of migraine.

Related: Migraine statistics ⼁What is a silent migraine?

In older adults, the combination of headache and blurred vision could be a sign of a condition called transient ischemic attack (TIA), which is also known as a ministroke. People who experience transient ischemic attacks are at greater risk of having a stroke. Having high blood pressure puts you at greater risk for both.

How is the cause of headache in the morning diagnosed?

Diagnosis usually begins with a medical history, including questions about any existing health conditions that could be a factor. For example, it might be worth exploring allergies as a potential cause of morning headaches. This is also a good opportunity for the doctor to inquire about other possible external causes, such as sleep habits or dependence on caffeine.

A trip to the doctor’s office for a diagnosis is also a good opportunity to assess the frequency and severity of morning headaches. People who experience frequent or long-lasting headaches may have migraine headaches, and people whose headaches or symptoms occur at least 15 days out of the month for three months may have chronic migraine. To make this diagnosis, a doctor may start with a neurological exam, which may be followed by some other tests, including imaging tests such as a computed tomography (CT) scan or a magnetic resonance imaging (MRI) scan.

How long does a headache in the morning last?

Often, morning headaches will resolve fairly quickly on their own. Eating breakfast and drinking water might be a good first step to try if it’s as simple as a morning headache brought on by dehydration.

However, some headaches linger. A headache that persists, worsens, or is accompanied by other symptoms could be a sign of a more serious health condition.

How to stop headaches in the morning

Acetaminophen or an over-the-counter non-steroidal anti-inflammatory drug, such as ibuprofen or naproxen, may help stop relatively mild pain from a headache, according to Dr. Breus. “Other at-home strategies that may help you treat and prevent headaches include resting in a dark and quiet room with your eyes closed, putting a cool compress such as a damp cloth on your forehead, and drinking plenty of water throughout the day,” says Dr. Breus.

Most importantly, headaches in the morning are treatable

Most causes of a headache in the morning are treatable, but headaches often resolve on their own without treatment. However, if a headache in the morning continues or worsens or includes other symptoms, such as blurred vision or jaw pain, it could be a sign of migraine or a more serious health condition that warrants treatment.

Only your healthcare provider can rule out serious health conditions. If you experience headaches in the morning, visit your doctor to determine the best treatment.