As with most symptoms, head pain or headaches are prone to changes that may be related to different times of the day. It is not always the time fthat is a factor as much as the activities that occur during or just before these periods when a headache may worsen. One of the commonly reported modalities in this regard is a morning headache or a headache after sleeping. It can occur for all types of headaches, including migraines. Understanding why this may be occurring and what you can do to prevent it is one step closer to managing your headaches without the drugs, or at least less medication.
Headaches After Sleeping
We all well know that sleep is to a large extent considered to be therapeutic for many ailments, particularly with migraine headaches. It is the time when the body is resting and rejuvenating to some extent. Sleeping is ‘good’ for us provided that we do not overdo it, keep a regular sleep pattern and have sufficient hours to derive the maximum benefit. So waking up with a headache can be puzzling. It may seem like the sleep itself was a precipitating factor in triggering or worsening the pain.
There are several reasons why headaches occur after sleeping, be it a mid-afternoon nap or a full night’s sleep. Some are related to the host of changes that occur in the body during a 24 hour cycle (circadian rhythm) while others are related to the the way you sleep, abnormalities that arise with sleep and even what you do just before you get into bed. Some of these factors can be easily corrected with a few simple dietary an lifestyle measures. It may not always stop a headache altogether but it should be able to reduce the frequency and severity of sleep headaches.
Causes of Sleep-Related Headaches
If you awaken with a headache or find that a headache awakens you after a few hours of sleep then you may be wondering why this is happening. These are some of the causes of sleep-related headaches whether you do suffer with headaches (tension-type, cluster, migraines) on a regular basis or not.
Awkward sleeping positions
Sleeping in an awkward position can cause muscle strain and spasm which is one of the main causes of tension-type headaches. There are usually symptoms like neck stiffness upon waking. Awkward sleeping positions can also aggravate pre-existing musculoskeletal and neurological problems such a nerve root compression (pinched nerve) where headaches may be present.
Disturbances in sleep cycle
Sleep apnea is one of the leading causes of symptoms such as morning fatigue and headaches upon awaking. However, it often remains undiagnosed for long periods of time. In sleep apnea, the airways become blocked (obstructive sleep apnea) or the breathing control ceases (central sleep apnea). This causes repeated interruptions in the sleep cycle.
Respiratory problems like chronic bronchitis, emphysema and pulmonary tuberculosis (TB) are some of the other airway and lung diseases that can affect air intake and interrupt sleeping with symptoms like coughing. Headaches are a common symptom in sleep-related problems and it may also be linked to the abnormalities in oxygen levels that are seen with some of these conditions. A difficulty in breathing can also be related to certain heart diseases.
Clenching and grinding teeth
Bruxism is a condition where people clench and grind their teeth. It can occur consciously during the day while awake or even at night during sleep. It can cause significant strain on the muscles responsible for closing the jaw and the temporomandibular (TMJ) joint. One of these muscles is the temporalis muscle which extends to the the temples. Spasm of this muscle can result in headaches.
Cyclical Drop in Natural Painkillers
The circadian rhythm is a 24 hour cycle which is often referred to as the body’s internal clock. Different biological activities increase or decrease at different times in a day. In the early hours of the morning the levels of natural painkillers and anti-inflammatory substances drops. This may make pre-existing head pain more obvious and can disturb sleep.
Alterations in Blood Glucose
Low blood glucose levels (hypoglycemia) are known to sometimes present with headaches. A person who has not eaten sufficiently at dinner time may awake the next day with a morning headache. Diabetics in particular are prone to abnormalities in blood glucose levels where the drop may beyond the normal range. This morning hypoglycemia is more likely to occur when there is poor management of the diabetes.
Remedies for Sleep Headaches
Although sleep-related headaches may require medical treatment there are some simple lifestyle and dietary measures that may be useful. Based on some of the causes discussed above, the following steps should be incorporated as part of daily management of headaches. Medication should not be stopped and surgery should not be avoided if it has been prescribed or advised by a medical professional.
- Ensure that you sleep in a proper position, either on your back or side. A good quality mattress and pillow are important to ensure that you can maintain an optimal position throughout the night. Falling asleep on the couch can easily strain the neck as it is not designed to maintain the correct posture.
- Ergonomically-designed pillows are widely available these days which can help people with sleep apnea. A CPAP device may be needed for people with severe sleep apnea. These pillows can also help with maintaining a good sleeping position so that your neck and upper back are not unnecessarily strained.
- Stress management may be helpful for people suffering with bruxism which is often associated with anxiety and psychological stress. Techniques like yoga, meditation or even exercise before bedtime help with stress relief. Mouth guards can also be useful for bruxism but should be specially designed for your bite.
- Some people with respiratory and cardiovascular problems where there is difficulty breathing while lying flat may benefit from sleeping slightly elevated. An extra pillow may help provided that it does not cause neck strain or the head of the bed may need to be elevated by a few degrees. This can also help with nighttime GERD (acid reflux).
- It is important to eat a proper meal in the evening but do not eat just before you sleep. Ideally there should be about a 2 to 3 hour gap from the time you have your last meal for the day and the time you turn in for the night. Opt for low GI carbohydrates and protein which will sustain you for longer and prevent a steep drop in your blood glucose levels by the early morning.
- Avoid alcohol or other intoxicants before you sleep. These substances can affect the quality of your sleep. Even a nightcap before bedtime may not be as helpful in aiding with sleep as you may be led to believe.