Why Do I Wake Up With a Headache?

If you’re jolted awake most mornings with a pang in your head, you know it’s quite possibly the worst way to start your day. Morning headaches are no joke, and if you find yourself frequently wondering why do I wake up with a headache?, there could be plenty of possible culprits.

Whether it’s from how you slept, not getting enough rest (learn all about that in Well+Good’s Rest Issue), or even taking too many headache meds, there are plenty of reasons your head might be pounding before you’ve even had your coffee.

Ahead, we break down the most common reasons for morning headaches and what to do if you wake up feeling foggy and frustrated.

1.Sleep apnea

“Morning headaches are significantly more common in those with sleep apnea,” says neurologist Nolan Pearson, MD, a headache medicine specialist at Cedars-Sinai. This condition happens when a person frequently stops breathing while they sleep, either because their airway is blocked (aka, obstructive sleep apnea) or their brain doesn’t properly control breathing (aka, central apnea).

The connection between sleep apnea and morning headaches isn’t clear, though. Experts still don’t know if headaches in the a.m. are “caused by low oxygen, high carbon dioxide, or simply disrupted sleep,” Dr. Pearson says. Whatever the reason, morning headaches usually go away once you treat sleep apnea.

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“If you have morning headaches as well as symptoms like snoring, choking, or gasping for air during the night, non-restful sleep, daytime sleepiness, or have overweight, talk to your doctor about being screened and treated for sleep apnea,” Dr. Pearson says. Sleep apnea’s no joke—it can seriously spike your risk of heart problems and stroke, per Johns Hopkins Medicine—so don’t ignore the signs.

2.Your sleeping position

Your sleeping position might be the sneaky reason behind your pounding head. “Sleeping in a position that puts stress on your neck, especially if you have a history of cervical spine disease, can trigger tension headaches or musculoskeletal pain,” Dr. Pearson says. It may also worsen problems like cervical stenosis (when the space around your spinal cord becomes too narrow) or radiculopathy (when one of your nerve roots is compressed or irritated) that can lead to head and neck pain in the morning, he says.

Sleeping on your side is usually best for keeping your spine and neck aligned, Dr. Pearson says. Talk to your doctor about seeing a sleep specialist or physical therapist for tips—and maybe a pillow upgrade—for better support.

3.Teeth grinding

Clenching or grinding your teeth during sleep, a condition called bruxism, can increase your risk of morning headaches. Typically, teeth grinding triggers tension headaches, Dr. Pearson says. It makes sense when you think about it: Gritting your teeth all night stresses muscles in your neck, jaw, and face. If this tension travels to your head, it can produce pain.

Other symptoms of bruxism to look out for include the following, per Dr. Pearson:

• Tooth pain or damage
• Jaw ache
• Clicking in the temporomandibular joint (TMJ) when opening and shutting the mouth

“It is important to discuss these symptoms with your dentist, who may recommend a bite guard, physical therapy for your jaw, or medications,” Dr. Pearson says.

4. Migraine

“Up to 71 percent of people with migraines experience morning headaches,” Dr. Pearson says. “We know that migraines are generally more likely to occur in the morning (between 6 a.m. and 12 p.m.), and they can wake people from sleep,” he says.

Emerging research suggests the timing of morning migraines might be linked to circadian rhythm, aka, your body’s 24-hour internal clock. “Migraines and our built-in circadian clock both originate in an ancient part of the brain called the hypothalamus,” Dr. Pearson says. A lot of the things that trigger migraines—like light, exercise, meals (or skipping them), and temperature swings—can also mess with your circadian rhythm, he says.

If you deal with migraines, it can be helpful to stick to a regular schedule (for example, go to bed, wake up, and eat your meals at the same time each day) to help avoid migraine, Dr. Pearson says.

5. Lack of sleep

Running on empty? Not getting enough sleep could be the reason you’re waking up with those pesky morning headaches. Lack of sleep is linked to all kinds of head pain problems, from migraines to tension headaches.

And if poor sleep turns into a habit, your headaches may, too. “Some studies have shown that insufficient sleep over a long period of time can change the way our body senses pain (through a process called habituation), and this can make it more likely for occasional headaches to become chronic headaches,” Dr. Pearson says.

Problem is, many of us aren’t catching enough zzzs (more than a third of Americans log less than seven hours a night, per the National Council on Aging), and there are infinite reasons for it: shifting work schedules, poor sleep hygiene, alcohol use, pain, stress, anxiety, depression, or primary sleep problems like insomnia or sleep apnea, to name a few.

If you frequently find it hard to fall asleep or wake up in the middle of the night, run it by your doctor. They can help get to the root cause of your sleep issues and treat you accordingly. No matter what the cause of your crappy sleep, you can’t go wrong with forming healthier bedtime habits. Try these tried-and-true tips for better sleep, per Dr. Pearson:

• Go to bed at the same time each night (and wake up at the same time each morning)
• Make sure your sleep environment is cool and dark
• Only use the bed for sleep and sex
• Avoid drinking alcohol at least three hours before bedtime (and any liquids at least two hours before bedtime)
• Keep screens (and, if possible, pets) out of the bedroom at night

6. Oversleeping

On the flip side, staying in bed for too long can lead to morning headaches, too. Sleeping later than normal can trigger a headache for a lot of reasons, Dr. Pearson says. A few of these include hormonal disruptions, dehydration, low blood sugar, and caffeine withdrawal, he adds.

Oversleeping can also disrupt your circadian rhythm. As we know, there’s a link between your body’s internal clock and headaches.

Once again, your best bet is to go to bed and wake up at the same time each day, Dr. Pearson says. Sticking to a sleep schedule can keep your internal rhythms consistent and reduce your risk of headaches, he says.

Another note: “Oversleeping can also be a symptom of depression,” Dr. Pearson says. Other signs you might be depressed include the following, per the Mayo Clinic:

• Feelings of sadness, tearfulness, emptiness, or hopelessness
• Angry outbursts, irritability or frustration, even over small matters
• Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
• Tiredness and lack of energy, so even small tasks take extra effort
• Reduced appetite and weight loss or increased cravings for food and weight gain
• Anxiety, agitation, or restlessness
• Slowed thinking, speaking, or body movements
• Feelings of worthlessness or guilt, fixating on past failures, or self-blame
• Trouble thinking, concentrating, making decisions, and remembering things
• Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts, or suicide
• Unexplained physical problems, such as back pain or headaches

7. Certain medications

Sometimes the very medications you take to stop headaches (or pain) can keep the headache cycle going, especially if you use them too often or too long.

Medication overuse headaches are one of the top issues doctors see in headache clinics, Dr. Pearson says. If your morning headache vanishes after meds but returns later, and you’re often using Tylenol, NSAIDs (like Ibuprofen), triptans, or especially barbiturates or opioids, chances are it’s from overuse, he says.

Other medications that commonly cause morning headaches include the following:

• Erectile dysfunction drugs
• Nitrates
• Stimulants
• Blood pressure medications

If you think your meds might be making your head hurt in the morning, tell your doctor, who can help you switch to safer options, says Dr. Pearson.

8. A hangover

Anyone who’s had a little too much booze at night knows the hell of a hangover headache in the morning. Even one cocktail or beer before bed can produce a pounding headache if you’re sensitive to alcohol, according to the Cleveland Clinic.

Drinking alcohol, especially too close to bedtime, causes a perfect storm of headache triggers. These include poor-quality sleep, dehydration, electrolyte imbalances, dilation of blood vessels, and low blood sugar, Dr. Pearson says. Plus, alcohol has substances like tannins, congeners, and other chemical byproducts that can also lead to hangovers and headaches, too, he says.

Luckily, you can avoid hangovers (and morning headaches) by drinking in moderation and sipping water along the way. On top of this, “it may be mildly helpful to take vitamin B6 before drinking,” which might possibly reduce the severity of hangover symptoms, Dr. Pearson says.

If you already have a hangover headache, you may head straight for the medicine cabinet. But be careful with certain OTC pain relievers. “Always, always avoid combining Tylenol with alcohol as this can cause dangerous liver damage,” Dr. Pearson says. You might want to steer clear of NSAIDs, too. Taking NSAIDS with alcohol can increase your bleeding risk, he says.

How to prevent a morning headache

While it may not always be possible to prevent a pounding headache in the morning, making smart choices can minimize your risk. Here are a few simple things you can do, according to Dr. Pearson and the Cleveland Clinic:

• Get on a consistent sleep schedule
• Avoid alcohol three to four hours before bed
• Eat a balanced diet and stay hydrated
• Exercise regularly (but not too close to bedtime, which can affect sleep)
• Don’t skip meals
• Find ways to manage your stress

Another tip: Dr. Pearson says some preliminary research has found that getting more omega-3 fatty acids (think: cold-water fatty fish, walnuts, and flaxseeds) may help with morning headaches, too.

When to see a doctor

Some morning headaches are easy to explain and go away without treatment (like a hangover, for example). But other headaches might hang around and be harder to pin down.

If your morning headaches include any of the following, it’s time to seek medical care:

• New, persistent, more severe, or different in quality from headaches you normally get
• Come on suddenly and severely (also known as “thunderclap headaches,” per the Mayo Clinic)
• Accompanied by other symptoms like changes in vision, weakness or numbness, or severe nausea and vomiting

“Keep track of other symptoms, the timing of when a headache starts and stops, your sleep and diet habits, and any triggers you have identified,” Dr. Pearson says. This info can help give your doctor some context and clues about what might be causing your headaches, so they can effectively diagnose and treat the underlying issue.