Waking up with a headache can occur for many reasons, like insomnia, using the wrong pillow or sleeping in an uncomfortable position. These situations can be easily resolved, however, by maintaining an optimal sleep routine or swapping your pillow.

Depending on the underlying cause, headaches that occur after waking up can present with other symptoms like fatigue, drowsiness throughout the day, mood changes and decreased overall energy. These types of headaches may be a sign of conditions like sleep apnea, stress or as anxiety.

In most cases, morning headaches are not a concerning finding, however intense and frequent headaches should be assessed by a doctor and treated as necessary.

What causes a morning headache?

The main causes of waking up with a headache are:

1. Insomnia

Insomnia is characterized by difficulty sleeping and staying asleep and can often trigger headaches when waking up. This symptom is typically experienced during periods of stress and may be associated with other conditions, like depression, pregnancy or menopause.

What to do: Insomnia can be treated with many approaches, depending on the intensity, duration and underlying cause. Treatment can include natural remedies, like passionfruit tea or chamomile tea, as well as lifestyle changes that promote a good rest. Check out other teas recipes for insomnia that you can use to get a good night’s sleep.

Some cases of insomnia may benefit from treatment with psychotherapy and medications, like anxiolytics and sleeping pills.

2. Sleep apnea

Sleep apnea is characterized by temporary interruptions to breathing or very shallow breathing while sleeping. It can interfere with a good night’s rest, and can cause morning headaches and fatigue.

What to do: Treatment can be done with lifestyle changes, like quitting smoking and losing weight. Other confirmed diseases, like diabetes, hypertension and cardiac failure, should be well-managed. Some cases of sleep apnea may require the patient to use a C-PAP machine to facilitate breathing, while other cases may even require surgery.

3. Bruxism

Bruxism is characterized by unknowingly grinding or clenching the teeth, which can occur during the day or at night. Bruxism can be provoked by neurological or respiratory problem, and leads to symptoms like tooth breakdown, jaw pain and headaches when waking up.

What to do: There is no cure for bruxism and treatment is usually aimed and relieving pain and preventing tooth damage. The doctor may recommend medications and the use of a mouth guard.

4. Using the wrong pillow

A headache can also be the result of using the wrong pillow or sleeping in an incorrect position. These situations cause muscular tension within the neck and head..

What to do: Ensure your head is well-supported and that you are sleeping in a comfortable position to prevent headaches when waking up.

5. Alcohol and medication side effects

Headaches when waking up may be the result of excessive alcohol intake and is one of the classic symptoms of a hangover. Some medications can also cause headaches as a side effect, especially if these medications are taken at night.

What to do: Headaches caused by excessive alcohol intake can be relieved with plenty of fluids and pain medication, like acetaminophen. Headaches from medications should be discussed with the prescribing doctor.

6. Dehydration

Dehydration occurs when the body does not have enough water to function optimally. It causes symptoms like excessive thirst, dry mouth, intense headache and fatigue.

Not drinking enough water, or drinking too much alcohol, can lead to dehydration and morning headaches.

What to do: To prevent dehydration, you should drink at least 2 L of fluids per day. You can contribute to your fluid intake by drinking water, tea, smoothies, milk and soups. Fruits and vegetables that are rich in water can also help to hydrate the body.

7. Circadian rhythm disorder

The circadian rhythm is a natural cycle in the body that lasts 24 hours. It regulates the main activies and biological processes in the body, from metabolism to sleep periods.

Circadian rhythms that are interrupted can cause headaches when waking up as well as decreased performance, energy and mood. This is common in people who work night shifts or have poor sleep habits.

What to do: Treating this problem may be limited in people with alternating working hours. If the symptoms are very uncomfortable to manage, the doctor may recommend stimulating or sedative medications.

8. Stress and anxiety

Stress and anxiety can lead to excessive tension that interrupts with sleep and sleep quality. The muscles in the head, shoulders and neck can become very tense, and lead to headaches when waking up and other body aches.

Learn more about how to recognize anxiety and what can cause it.

What to do: It is important to adopt strategies that help you to relax throughout the day. This can help to prevent muscle tension, headaches and body aches. You should engage in restful and relaxing activities that promote well-being, like meditation, yoga, walking or dancing.

9. Sinusitis

Sinusitis can cause a headache when you wake up which resolves as the day goes on. This headache occurs due to inflammation of the paranasal sinuses, which leads to accumulation of fluid in the area. Sinusitis can also cause symptoms like nasal secretions and a feeling of heaviness in the face, especially in the front and cheeks, which is where these cavities are located.

What to do: Treatment for sinusitis depends on the underlying cause. Bacterial sinusitis can be treated with antibiotics, while the doctor may also consider antihistamines, nasal decongestants and analgesics. Check-out the sinusitis medications that your doctor may prescribe to help relieve symptoms.

10. TMJ disorder

Waking up with a headache is one of the symptoms of temporomandibular disorder, or TMJ disorder, which is a change in the functioning of the temporomandibular joint. This joint is responsible for the movement of opening and closing the mouth.

Other symptoms that can appear with TMJ disorder are jaw an face pain when chewing and opening the mouth, worn teeth and a more swollen side of the face.

What to do: Treatment involves physiotherapy, massages to relax the muscles of the face and head and the use of a mouth guard, which can be used at night to prevent headaches in the morning.

In addition, the dentist may also recommend the use of anti-inflammatory medications and muscle relaxants to relieve pain. Read more about TMJ treatment and the options available to relieve discomfort.