Headaches are usually accepted as being part of a hangover especially after a period of heavy alcohol consumption. However, not every person who drinks an excessive amount of alcohol at one sitting (binge drinking) will suffer with a headache. In fact, a person who is susceptible to frequent headaches and migraine sufferers are more likely to experience a headache even after consuming small quantities of alcohol.
The origin of a hangover headache has been the subject of many hypotheses and despite the search for the ultimate hangover headache remedy, none of these ‘concoctions’ have proven to successful in majority of the cases of alcohol-induced headaches. This may be due to hangover headaches stemming from multiple factors rather than a single cause.
Causes of Alcohol Induced Headaches
The pain may be intracranial (originating within the cranial cavity) or extracranial (outside of the cranial cavity).
Alcohol is a diuretic and increases urine product. Loss of water and electrolytes may cause the following which could lead to a headache :
- muscle spasm (cramps) particularly of the neck and head muscles
- changes in blood pressure
Low CSF may also cause a headache due to stretching of the meninges by the low lying brain (due to a change in buoyancy). However, a low volume of CSF due to dehydration is unlikely except in very severe dehydration.
Refer to Dehydration and Headache for more information.
Apart from dehydration, neck, back and head muscle spasm may occur for number of reasons including poor sleeping positions when intoxicated, wretching and violent vomiting. Muscle spasm is one of the most common causes of headaches (tension-type headache).
Alcohol itself and the byproduct of alcohol metabolism, acetaldehyde, irritates various tissues including the meninges and walls of blood vessels, including those within the cranial cavity. Inflammation of these areas may elicit pain.
Low Blood Sugar
A decrease in blood sugar levels during and after alcohol consumption may arise due to :
- increased insulin production
- decreased food intake
- disturbances within the liver which affects glucose release
Low blood sugar levels may be exacerbated in diabetics who drink excessive amounts of alcohol.
Serotonin, dopamine and endorphins are known to be affected by alcohol and play a part in the eupohoria experienced during intoxication. The subsequent drop in these brain hormones shortly after consuming alcohol may be another cause of a hangover headache.
Alcohol consumption affects the normal sleep cycle, particularly REM sleep. The effects of poor quality sleep is varied and headaches are common complaint among those with sleep disorders.
Alcohol is a common trigger of migraines and migraine sufferers are more prone to alcohol-induced and hangover headaches.
Refer to Migraine Triggers for more information.
Hangover Headache Remedies
There is no specific remedy that works for every case of a hangover headache. Numerous commercial hangover concoctions have entered the market but as yet, none have provided a definitive solution.
- Rehydration is important but water alone may not be sufficient.
- An oral rehydration solution, similar to those used for dehydration due to other causes like diarrhea, may be the better option.
- Fruit juice, tomato juice and energy/sports drinks may be equally beneficial.
- Avoid caffeinated drinks as these have diuretic effects and may exacerbate the dehydration.
- Avoid further alcohol intake, even small quantities.
- Eat moderate sized meals that are balanced.
- High glycemic index (GI) foods may help to raise blood sugar levels immediately while low GI foods will sustain glucose levels.
- If you are experiencing any gastrointestinal upset like diarrhea, vomiting or cramping, start off with the BRAT diet and switch to bland foods once the vomiting stops.
- Identify any neck, back or head muscle spasm that may be contributing to the headache.
- Massage and pain-relieving rubs may be useful.
- Immobilizing the neck with a brace or collar may also provide some relief.
- Avoid any drugs or other substances that may strain the liver any further.
- This includes pain-killers and anti-inflammatory drugs, even acetaminophen.
- Herbal remedies have pharmacologically active ingredients and may also strain the liver. Despite numerous claims about certain herbal remedies being effective hangover ‘cures’, there is no scientific evidence to verify this.
- Sleep and adequate rest are important to recover from a hangover.
- It can take up to 72 hours to recover.
- It is best to avoid strenuous activity or night activities that may further disturb your regular sleep pattern.