Why Do I Wake Up with a Headache?

Headache upon waking can be caused by migraines, sleep apnea, tooth grinding or medications, among other causes.

Headaches are a common occurrence, and people with sleep disorders have more headaches than the overall population. 

Some causes of waking up with a headache include: 

• Insomnia
• Snoring
• Tooth grinding (bruxism)
• Using the wrong pillow
• Sleeping in a room that’s too cold
• Hangover from drinking too much alcohol
• Migraine 
• Medication overuse headache (MOH) common with chronic use of:
  • Certain pain relievers such as aspirin, acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen and naproxen 
  • Triptans and ergotamines used to treat migraine
  • Opioids such as oxycodone, tramadol, butorphanol, morphine, codeine, and hydrocodone 
  • Caffeine intake of more than 200mg per day 
• Brain tumor (rare)

Symptoms that may accompany waking up with a headache depend on the cause and may include:

• Insomnia
  • Tiredness
  • Anxiety
  • Depression
• Snoring
  • May be a symptom of sleep apnea, which can be dangerous: see a doctor
• Tooth grinding (bruxism)
  • Sore and aching jaw
  • Using the wrong pillow
  • Sore neck and upper back 
• Sleeping in a room that’s too cold
  • Head and neck tension
• Hangover 
  • Nausea
  • Dizziness
  • Irritability
  • Tremors
  • Sweating
• Migraine 
  • Nausea
  • Vomiting
  • Increased sensitivity to light and sound 
  • Sweating
  • Difficulty concentrating
  • Feeling very hot or very cold
  • Abdominal pain
  • Diarrhea
• Medication overuse headache (MOH)
  • Nausea
  • Anxiety
  • Irritability
  • Weakness/lack of energy
  • Restlessness
  • Difficulty concentrating
  • Memory problems 
  • Depression
• Brain tumor
  • Seizures  
  • Problems thinking and/or speaking 
  • Changes in personality 
  • Tingling on one side of the body 
  • Stiffness on one side of the body 
  • Loss of balance 
  • Vision changes 
  • Memory loss 
  • Nausea 
  • Disorientation 
  • Fatigue 
  • Muscle weakness 
  • Anxiety
  • Depression

Treatment for waking up with a headache depends on the cause. 

• Insomnia
  • Practice good sleep hygiene
    • Avoid alcohol and caffeine
    • Exercise earlier in the day
    • Don’t watch TV or read in bed
    • Keep the room cool: 65°F/18.3°C is considered ideal
  • Sleep medications
• Snoring
  • Lose weight if you are overweight
  • Change sleeping positions 
  • Treat allergies
  • Avoid tobacco or alcohol
  • Use a CPAP or BiPAP for sleep apnea
• Tooth grinding (bruxism)
  • Practice stress management techniques such as regular exercise and meditation
  • Improve sleep hygiene habits 
• Using the wrong pillow
  • Experiment with different types of pillows that are meant for your sleep position
• Sleeping in a room that’s too cold 
  • Warm up the room 
• Hangover 
  • Prevention is best: avoid or limit alcohol consumption
  • Drink plenty of water 
  • Get plenty of rest
  • Don’t smoke
• Migraine 
  • Pain relievers, including over-the-counter (OTC) medications such as acetaminophen (Tylenol) and ibuprofen (Advil, Motrin)
  • Migraine headache medications 
  • Anti-emetics to reduce nausea and vomiting
• Medication overuse headache (MOH)
  • Discontinuation of overused medication 
  • Do not stop taking any prescribed medication without first talking to your doctor
• Brain tumor
  • Surgery
  • Radiation
  • Chemotherapy
  • Targeted therapy