Causes and treatment of headache when waking up

Stress and anxiety are two of the great triggers of many physiological problems, headaches among them. Find out what to do if you have morning headaches.


The term “headache” does not describe a specific clinical entity , but rather a symptom of an underlying condition. The correct word when we refer to this set of discomforts is “headache”, and this refers to all the pains and discomfort located in any part of the head, in the tissues of the cranial cavity, in the structures that join the base of the skull and in the muscles, nerves and blood vessels that surround the scalp, face and neck.


As the World Health Organization (WHO) indicates, headaches are some of the most common nervous system disorders in general society. Without going any further, in Western countries it is estimated that 50% of the population suffer from them at some point in the year, although only 20% of patients present especially painful and intense forms at least once in their entire life.

In most cases, headache is a benign clinical sign that resolves on its own over time , but it can also be an indication that something is really wrong at a physiological level in a small percentage of patients. patients. Discover in the following lines what are the causes (and treatment) of a headache when waking up, as it is a common form of headache expression.

What is a headache?

There are more than 300 types of headaches or headaches, which can be divided into two large groups. The most common are primary headaches, including tension headache, migraine, cluster headache, chronic daily headache, and trigeminal neuralgia. These variants account for 95% of all headaches .


On the other hand, secondary headaches only account for 5% of all diagnosed headaches. They are of sudden onset and have a specific measurable cause, such as a hemorrhage, a brain tumor, heart attack, infections in the meninges (meningitis) or excessive use of analgesic medication, among other factors.


Below, we briefly describe two of the typical primary headaches in general society: tension headaches and migraines . We will be brief.

1. Tension headaches

As its name suggests, this type of headache is closely linked to tension in the facial or neck muscles . Thus, tension headaches are associated with stress, anxiety, depression or trauma and direct efforts (although in most cases the reason is emotional). These are the types that can be distinguished medically:


  • Of the paranasal sinuses : they are grouped behind the forehead and on the cheekbones, that is, the structures that occupy the paranasal sinuses at the skeletal level.
  • In flare-ups : the pain is located in a stabbing way around one eye.
  • By tension : patients describe this headache as a band that squeezes them in the line of the forehead.
  • Migraine : with symptoms of classic migraine. We will explain it in the next lines.


With these data, perhaps you can already begin to suspect why your head hurts when you wake up, right? In the face of depression, chronic anxiety and stress, sometimes the body does not relax even at bedtime. Surprising as it may sound, these muscle stiffness can cause headaches at many times of the day, including in the morning.


2. Migraines

The term “migraine” is a nightmare for many, because when it arises, it is really bad. Classic migraine causes intense throbbing pain and a “throbbing” sensation in the head , usually on only one side of the face. This characteristic sign is often accompanied by vomiting, nausea, and sensitivity to light (photophobia). Unfortunately, migraine attacks can last from hours to days, leading to various problems both at work, social and personal level.


The causes of migraine are not fully understood, but they are clearly associated with genetic factors and certain environmental triggers. Changes in the brainstem and their effects on the trigeminal nerve (which transmits sensations from the face to the brain) could be involved in this unpleasant but common clinical picture. We will explore the peculiarities of this physiological phenomenon in future opportunities.

Why does my head hurt when I get up?

In exploring the types of primary headaches, we have already outlined more or less where the suspicions are going to go at this point. Next, we show you a small definition and framing of the possible triggers of this event.

1. Bruxism

If you remember the tension headaches that we have previously discussed, it is easy to intuit that bruxism is the cause of morning headaches in many people . Bruxism is defined as the involuntary contraction of the jaw muscles outside the chewing exercise, which causes wear of the teeth and damage to the gums, among many other things. It is estimated that 10 to 20% of the general population suffers from nocturnal bruxism.

When the muscles of the neck and face are in tension throughout the night grinding the teeth, it is normal for the patient to wake up with a characteristic headache. In addition, this is usually accompanied by a ringing in the ear, tooth sensitivity when eating cold foods, a feeling of load and muscle tension and wear of dental structures.


The treatment is simple: go to the dentist and ask for a discharge splint to be modeled based on the patient’s tooth structure. This will be placed at night between the upper and lower jaw in the form of a mold and will absorb the mechanical stress caused by teeth grinding. On the other hand, the patient is also advised to seek psychological help, since addressing anxiety on an emotional level is always the best option.

2. Sleep apnea

Sleep apnea is a nocturnal problem that can be aggravated, as it consists of the stopping and continuation of the patient’s respiratory flow several times throughout the night. This is a direct consequence of a relaxation of the muscles in the back of the throat (which support the soft palate). This relaxation causes the upper respiratory tract to close , which leads to a decrease in oxygen in the blood, as you cannot breathe.


The brain senses this alarming situation, prompting the patient to wake up for brief periods that they may not remember the next morning. This interrupted sleep and lack of rest can lead to a characteristic headache upon waking. Sleep apnea is a potentially serious disorder, so it must be treated with the help of a medical specialist through assisted therapy, oral appliances, and even you can look for surgery from a specialist,  if necessary.

3. Incorrect postures and bad sleep

Along with bruxism, this is perhaps the most common cause of a headache upon waking. Sleeping with poor posture, resting fewer hours than recommended, or waking up several times at night are events that can cause the patient to wake up with headaches and a feeling of chronic fatigue.


Do not worry if you suffer from this condition: in a society where everything is going fast and we have more and more responsibilities, it is common to feel overwhelmed. Allow yourself to be vulnerable and seek professional help, do not get used to pain and discomfort. Most of these situations can be addressed with psychological help, as a specialist can give you the necessary tools to face the daily challenges that life imposes in a healthier way.


If we want you to get an idea from among all these lines, it is the following: if your head hurts when you get up, do not worry about more. When we suffer from these types of symptoms, it is common to feel fear and hypochondria, to search the internet and assume that we have a brain tumor. In the vast majority of cases, this is not the case.


About Author: Dr. R J Shree Charan, 

DR R J SREE CHARAN, a plastic surgeon working as an Asst Professor in Chengalpet Medical College.  He has completed his MBBS, DNB in General surgery and MCh Plastic surgery. With a thriving experience of over 15 years, he has worked with some of the leading hospitals in Chennai, India, specializes in hand trauma and diabetic foot ulcers.

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