Why am I waking up in the morning with a headache?

Are you waking up with headaches every morning?

Is your headache a dull ache, with little or no effect on your daily activities? Or is it so intense that your plans for a day or more are interrupted? With either experience, you may be enduring chronic daily headaches (CDH).

CDH are defined as the presence of a headache on 15 days or more per month for at least three months. These headaches are further described as short-term, defined as lasting less than four hours, or long-term when they last longer than four hours. The most common types of CDH include chronic tension-type headaches, chronic migraines or medication-overuse headaches. Approximately 1 in 4 adults have someone in their household who has experienced migraine headaches. Women are affected by headaches two to three times more often than men.

Several types of headaches awaken individuals in the early morning or are present upon wakening, such as cluster, migraine or tension headaches. Tension headaches are often the most severe in the morning.

Your morning headaches may be due to some physiological changes that happen during early morning hours as your body produces lower amounts of endorphins and related substances, which are natural painkillers. Adrenalin, released in larger amounts in the early hours of the day, may contribute to migraine headaches due to its effect on blood pressure and its regulation of blood vessel contraction or dilation. More serious diseases, such as severe high blood pressure, brain tumors and sleep apnea may also be the cause of waking with a headache.

There are multiple recommendations to help chronic headaches. These range from changing behaviors, like ceasing caffeine and tobacco use and better sleep to internet-based biofeedback, relaxation techniques, cognitive behavior therapy and peripheral nerve stimulation. A healthcare provider who specializes in treating headaches can create an effective and individualized treatment plan for the management of headaches.

Clinically reviewed and updated by Nancy Kupka, PhD, RN, May 2022.