Headache when waking up: causes and what helps
Waking with a headache is a rough start to the day. Occasional morning headaches are common and usually have a simple explanation. Regular ones are worth looking into, because several of the causes are very treatable.
How common are morning headaches?
Quite common. A study of nearly 19,000 adults found about one in 13 people had chronic morning headaches. They were more common in women and in people aged 45 to 64, and often lasted for years (Ohayon, Archives of Internal Medicine, 2004).
What causes a headache when waking up?
The most common contributors are poor or short sleep, neck strain from sleeping position or pillow, clenching or grinding the teeth at night, alcohol the night before, caffeine withdrawal, dehydration, and overuse of pain medication. In the study above, morning headaches were most strongly associated with anxiety and depression and with insomnia and other sleep disorders.
Can sleeping position cause headaches?
Yes. Sleeping on your stomach with your head turned, or with a pillow that's too high or too flat, can leave the upper neck strained for hours. The result is often a headache starting at the base of the skull with neck stiffness, which eases as you get moving.
See our posts on neck-related headaches and the best sleeping positions.
Can teeth grinding cause morning headaches?
Yes. Clenching or grinding at night overworks the jaw and temple muscles, often causing a dull headache around the temples, jaw ache and tired jaw muscles on waking. A partner may hear grinding. Your dentist can check for wear and discuss a night splint.
See our post on jaw clicking and locking.
Could it be sleep apnoea?
Sleep apnoea, where breathing repeatedly stops during sleep, can cause morning headaches, along with loud snoring, gasping, unrefreshing sleep and daytime sleepiness. The study found morning headaches weren't specific to sleep-related breathing problems, but they were more common in people with them. If these signs sound familiar, see your GP about a sleep study.
Can caffeine or alcohol cause it?
Both. Alcohol disrupts sleep and dehydrates. If you usually drink coffee, a later-than-usual first cup can trigger a withdrawal headache. Keeping caffeine intake steady, and limiting alcohol in the evening, often helps.
Can painkillers make morning headaches worse?
Yes. Taking pain relief for headaches on many days each month can cause medication overuse headache, which is often present on waking. If you're taking tablets most days, talk to your GP or pharmacist.
See our post on tension headache treatment.
What helps morning headaches?
Regular sleep and wake times, a pillow that keeps your neck level with your spine, sleeping on your back or side rather than your stomach, a glass of water on waking, and steady caffeine intake. Gentle neck movements in the morning, and a warm shower, often ease neck-related headaches.
Does stress play a part?
Often. Stress and anxiety affect sleep, increase jaw clenching and muscle tension, and were strongly linked with morning headaches in the research. Addressing stress, with your GP's help if needed, can reduce them.
See our post on neck pain from stress.
What does the type of headache tell me?
A dull band around the head with neck stiffness, easing within an hour or two of getting up, points to neck or muscle tension. Temple and jaw ache points to clenching or grinding. A throbbing one-sided headache with nausea and light sensitivity is more like migraine, which can start in the early morning. A headache with a blocked nose and pressure over the cheeks or forehead may be sinus-related. Keeping a short diary of sleep, alcohol, caffeine and headache type for two weeks often reveals the pattern.
See our post on migraine and the neck.
What's the best pillow for morning headaches?
There's no single best pillow. The aim is a pillow height that keeps your head in line with your spine: higher for side sleepers with broad shoulders, lower for back sleepers. If you wake with neck pain and headache, try adjusting height with a folded towel under or inside the pillowcase before buying a new one.
How can an osteopath help?
Where the neck or jaw is involved, we assess the upper neck, jaw and shoulders, treat hands-on to ease stiffness and muscle tension, and give you exercises and sleep set-up advice. We'll suggest a GP or dentist review if the pattern points to sleep apnoea, grinding, medication or another cause.
When should I see a doctor?
See your GP for headaches that are new, getting worse, wake you from sleep, or occur most mornings, or that come with snoring and daytime sleepiness. Call 000 for a sudden, severe headache, or a headache with confusion, weakness, numbness, difficulty speaking, vision changes, fever and neck stiffness, or after a head injury.
See our headache page. Book an assessment at our Berwick clinic. A 60-minute initial consultation is $149, with no referral needed and HICAPS on-site.
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Book an initial consultation at RISE Sports & Spinal in Berwick. Clear diagnosis, hands-on treatment, and a plan that actually gets you better.
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