Some people wake up refreshed in the morning. Others wake to a debilitating morning headache. Maurice M. Ohayon says in his research article on morning headaches that one in every 13 people are affected by morning headaches, and women are more prone than men. He also found those ages 45 to 64 had the greatest risk for morning headaches, as did those who were unemployed or homemakers. The key causes of morning headaches are depression and/or anxiety, sleep apnea or sleep bruxism. In addition, excessive alcohol consumption leads to morning headaches, says Ohayon.
Anxiety and/or Depression
Based on a telephone questionnaire of nearly 20,000 people in the United Kingdom and other European countries, ages 15 years and older, Ohayon found the most significant factors correlating with morning headaches were anxiety and depression. Subjects with anxiety had about twice the risk of morning headache compared with those without anxiety. Those with major depressive disorder alone had 2.7 times the risk for morning headache. The risk was highest for those with both anxiety and depressive disorders, who had a 3.5 times greater risk for suffering from morning headaches. Interestingly, the use of antianxiety medications exacerbated the risk for morning headaches.
Obstructive Sleep Apnea
Obstructive sleep apnea—a disorder in which the individual briefly stops and then resumes breathing multiple times each night—is a common cause of morning headaches, says Jeanetta C. Rains, Ph.D., in an article on sleep disorders and headache. According to Rains, the morning headache occurs in up to 74 percent of those with sleep apnea. Treatment for the sleep apnea usually improves the headache syndrome.
Rains says primary treatments for sleep apnea include treatment of nasal allergies, weight loss among those who are overweight, oral appliances and continuous positive airway pressure—CPAP. According to the American Academy of Otolaryngology, CPAP provides continuous air flow to the patient with the use of a mask or special nasal pillows and creates pressure so that the airway remains open. CPAP is a treatment for both obstructive sleep apnea and snoring.
In an article on sleep apnea and morning headaches, N.K. Loh and colleagues studied 48 subjects with sleep apnea and morning headaches and found the headaches were generally brief—about 30 minutes—and their frequency and severity directly correlated with the severity of their sleep apnea.
Of the 29 subjects who were treated with CPAP, they all reported their headaches improved by about 80 percent. In contrast, subjects with migraines, tension-type and other headaches had only minimal improvement with treatment of their sleep apnea.
An estimated 8 percent of adults grind their teeth at night—sleep bruxism—and this is one cause of morning headaches, according to dental professionals Gilles Lavigne and Sandrom Palla in their 2010 article, titled "Transient Morning Headache." Sleep bruxism may also be accompanied by other problems, such as snoring and sleep apnea. Lavigne and Palla say solutions include avoiding alcohol altogether, avoiding large meals in the evening, keeping a regular sleep schedule, and reducing weight if the patient is overweight or obese. If the patient also has problems with snoring, a dental device might be recommended for sleep time only. They also noted that often dentists work with sleep specialists to manage sleep disorders most effectively.
Ohayon found that individuals consuming six or more alcoholic drinks per day had an elevated risk for morning headaches.