Table of ContentsView AllTable of ContentsCausesTension HeadacheMigraineHypnic HeadacheCluster HeadacheDiagnosisCoping and PreventionWhen to Seek Medical Attention
Table of ContentsView All
View All
Table of Contents
Causes
Tension Headache
Migraine
Hypnic Headache
Cluster Headache
Diagnosis
Coping and Prevention
When to Seek Medical Attention
Headachesat night are common and can have many causes and triggers, such as neck tension, sinus pressure, orsleep disorders.
Treatments vary based on the the type of headache—such astension headache,migraine, orhypnic headache—but often include a combination of medications and prevention strategies.
This article covers the basics of nighttime headaches, including their causes and what you can do to treat and prevent them.
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Causes of Nighttime Headaches
While mornings are the most common time of day people have headaches, many occur at night. While the exact mechanisms of nighttime headaches aren’t fully understood, they’re likely related to the activity of thehypothalamus, a brain region associated with both pain perception and your natural sleep-wake cycle, known as yourcircadian rhythm.
As this region changes activity throughout the day and night, it can spur both nighttime headaches as well as those when you wake up.
As a result, there’s a distinct connection between sleep and headaches, with disruptions of the former leading to the latter.This can arise due tosleep apnea, sleep disruptions or disorders, migraines, teeth and grinding, among other causes.
Two common secondary causes of nighttime headaches aretemporomandibular joint issueslikebruxism (teeth grinding)andsleep apnea(in which there are repeated pauses in breathing during sleep). These should be considered and ruled out.
Sleep Disorders and Headache DisordersThere’s a close association between the quality andquantity of sleepyou get and the incidence of headache disorders. For instance, people who experience migraines are 2 to 8 times as likely to experience sleep disorders, such asinsomnia(inability to fall or stay asleep) and sleep apnea (snoring and breathing disruption during sleep), among others.
Sleep Disorders and Headache Disorders
There’s a close association between the quality andquantity of sleepyou get and the incidence of headache disorders. For instance, people who experience migraines are 2 to 8 times as likely to experience sleep disorders, such asinsomnia(inability to fall or stay asleep) and sleep apnea (snoring and breathing disruption during sleep), among others.
Why Am I Getting Headaches Every Day All of a Sudden?
By far the most prevalent headache,tension headachesare a common cause of nighttime headache. They can last anywhere from 30 minutes to a week.
21 Ways to Relieve a Headache Without Medication
Symptoms
Tension headaches cause:
Treatment
Over-the-counter (OTC) analgesics, such as Tylenol (acetaminophen) andnon-steroidal anti-inflammatory drugs(NSAIDs) like Aleve (ibuprofen) and Bayer (aspirin) are typically the first line of treatment for headaches, including tension headaches. The use of these drugs should be monitored, especially in chronic cases.
In more difficult or chronic tension headache cases, medications may be prescribed if OTC drugs aren’t yielding results. These include muscle-relaxers, such as Flexeril (cyclobenzaprine), andtricyclic antidepressantslike Elavil (amitriptyline) and Palemor (nortriptyline).
Medication Overuse HeadacheTaking too many OTC drugs and other kinds of pain medication can cause or worsen headaches (a condition calledmedication overuse headache (MOH)).The risk for this rises if you take these drugs more than three days a week.
Medication Overuse Headache
Taking too many OTC drugs and other kinds of pain medication can cause or worsen headaches (a condition calledmedication overuse headache (MOH)).The risk for this rises if you take these drugs more than three days a week.
Migraine is a recurring type of headache that is moderate to severe in intensity. Migraine is a relatively common headache disorder that represents about 30% of all headache cases. Attacks of this condition go through stages and last anywhere from four to 72 hours.
Migraine doesn’t just cause head pain; its typical symptoms can include:
There are several different kinds of migraine, and specific symptoms can vary from person to person.
In some cases, migraine can set on while you’re asleep and wake you up. They most often arise towards the tail end of your sleep cycle, coming on between 4 and 9 AM. While the exact causes of nighttime migraines are not known, poor sleep and sleep disorders can trigger attacks, and they can also be the result of medications wearing off overnight.
Migraine treatments focus both on managing symptoms and developing ways of preventing attacks. If OTC medications, such as ibuprofen or acetaminophen, aren’t yielding results, you may be prescribed triptans, such as Imitrex (sumatriptan) and Zomig (zolmitriptan), among others. In addition, for more difficult cases, several drugs work to prevent attacks. These include:
Hypnic headaches are rare and occur exclusively at night, waking people up from sleep. Attacks frequently recur 10 or more times a month and last anywhere from 15 minutes to four hours.They are more common in people over 50 and females.
It’s sometimes called an “alarm clock headache” because symptoms tend to arise at the same time at night.
Though hypnic headaches can be severe, they are generally milder than other kinds.
The main feature is waking up during the night due to a headache at least 10 times a month for at least three months.
Symptoms may include:
A common approach to treating hypnic headache is caffeine, as in a cup of coffee or black tea, before bed. While caffeine can sometimes cause insomnia, it doesn’t seem to interfere with a good night’s sleep for most hypnic headache patients.
That said, this condition is notoriously difficult to treat. Several other medications and supplements may help provide relief:
Cluster headache symptoms include:
Cluster headaches, like other primary headache disorders, can be challenging to treat. Several treatments take on attacks, including:
As with migraine, some drugs may also help with prevention. Evidence suggests Verelan (verapamil), lithium carbonate, and Topamax may help reduce the frequency of attack.
What Causes Alarm Clock Headaches (Cluster Headaches)?
To help determine the type of headaches you’re having and potential causes, your healthcare provider will ask a series of questions about your headaches, such as:
Your healthcare provider will also take a detailed personal and family medical history and ask you about any known health conditions.
In some cases, and especially if your headaches are severe or you have other symptoms, your healthcare provider may order additional tests, such as:
What Your Headache Location Means
Prevention strategies are often a key part of an overall treatment plan to help reduce or minimize the frequency and intensity of headaches at night. This may include relaxation strategies, lifestyle changes, complementary therapies, and medical devices.
Relaxation Strategies
Since stress and tension are often at the root of headache problems, working on relaxation therapies is a common means of prevention and minimizing the intensity of attacks. Typically employed strategies include:
Lifestyle Changes
A big part of headache treatment involves making significant changes in your lifestyle, while being strategic about how to practically manage your condition. This can involve:
Keep a Headache DiaryCritical in managing a primary headache disorder like migraine, hypnic headache, or cluster headaches is learning about your condition. This means recording what medications you’re taking, tracking when headaches arise and how severe they are, and any triggers you’re finding.Learn More:Making a Headache Diary Template
Keep a Headache Diary
Critical in managing a primary headache disorder like migraine, hypnic headache, or cluster headaches is learning about your condition. This means recording what medications you’re taking, tracking when headaches arise and how severe they are, and any triggers you’re finding.Learn More:Making a Headache Diary Template
Critical in managing a primary headache disorder like migraine, hypnic headache, or cluster headaches is learning about your condition. This means recording what medications you’re taking, tracking when headaches arise and how severe they are, and any triggers you’re finding.
Learn More:Making a Headache Diary Template
Complementary Therapies
Some evidence has shown some complementary therapies that can accompany other treatments to help with headaches. Stretching-oriented activities like yoga, meditation, andacupunctureare all options.
Medical Devices
In chronic, difficult to manage headache cases, neurostimulation is another option to manage pain. This involves using magnetic fields or mild electrical shocks to stimulate nerves associated with pain perception. Overstimulating these nerve pathways blocks pain perception, and, in some cases, prevents headaches. Among these devices are:
Nerve Stimulation Medical Devices for Migraine Headache
If your headaches at night wake you up from sleep or make it difficult for you to fall asleep, you should see a healthcare provider. You should also check in with a healthcare provider if you experience any of the following:
While headaches can be very debilitating, not all of them require medical attention. However, especially if you live with a condition like a migraine, cluster, or hypnic headache, it’s important to know the signs that you do need help.
Get emergency medical care help if you experience any of the following symptoms:
Does a Headache at Night Mean a Brain Tumor?
Summary
Nighttime headaches can arise due to a range of disorders and health issues. In particular, this issue can be a feature of tension, migraine, and cluster headaches and is the primary symptom of hypnic headache.While the exact causes aren’t known, they’re linked to the activity of the hypothalamus.
Nighttime headache symptoms vary depending on the headache type. Tension headaches cause duller pain and pressure on both sides of the head. More severe migraine headaches focus on one side, with attacks also causing symptoms like nausea and vomiting, light and sound sensitivity, and visual disturbances.Cluster headaches arise as groupings of severe headaches within a short period of time (clusters). Lastly, hypnic are headaches that arise exclusively while you’re sleeping.
Treatments for nighttime headaches focus on managing symptoms, preventing attacks, and making positive lifestyle changes. OTC and prescription medications are available to ease pain when they occur.Additionally, ensuring proper and healthy sleep, not skipping meals, and managing stress can also help.
A Word From VerywellWhen it comes to nighttime headaches, different causes of headaches have different treatments. Since the appropriate treatment can range from a simple cup of coffee to prescription medication, give your healthcare provider as much detail about your headache as you can so they can arrive at the right diagnosis (and the right treatment) for you as soon as possible.—NICHOLAS R. METRUS, MD, MEDICAL EXPERT BOARD
A Word From Verywell
When it comes to nighttime headaches, different causes of headaches have different treatments. Since the appropriate treatment can range from a simple cup of coffee to prescription medication, give your healthcare provider as much detail about your headache as you can so they can arrive at the right diagnosis (and the right treatment) for you as soon as possible.—NICHOLAS R. METRUS, MD, MEDICAL EXPERT BOARD
When it comes to nighttime headaches, different causes of headaches have different treatments. Since the appropriate treatment can range from a simple cup of coffee to prescription medication, give your healthcare provider as much detail about your headache as you can so they can arrive at the right diagnosis (and the right treatment) for you as soon as possible.
—NICHOLAS R. METRUS, MD, MEDICAL EXPERT BOARD
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Sleep Foundation.What is causing your morning headache?
American Migraine Foundation.Sleep disorders and headache.
MedlinePlus.Tension headache.
American Migraine Foundation.Understanding migraine medications.
American Migraine Foundation.Hypnic headache.
Lindner D, Scheffler A, Nsaka M, Holle-Lee D.Hypnic Headache - what do we know in 2022?Cephalalgia. 2023;43(3):3331024221148659. doi:10.1177/03331024221148659
Liang JF, Wang SJ.Hypnic headache: A review of clinical features, therapeutic options and outcomes.Cephalalgia. 2014;34(10):795-805. doi:10.1177/0333102414537914
Torkamani M, Ernst L, Cheung L, Lambru G, Matharu M, Jahanshahi M.The neuropsychology of cluster headache: cognition, mood, disability, and quality of life of patients with chronic and episodic cluster headache.Headache. 2015;55(2):287-300. doi:10.1111/head.12486
Fernandes L, Randall M, Idrovo L.Peripheral nerve blocks for headache disorders.Pract Neurol. 2020:practneurol-2020-002612. doi:10.1136/practneurol-2020-002612
National Institute of Neurological Disorders and Stroke.Headache.
Robblee J, Starling A.SEEDS for success: lifestyle management in migraine.Cleve Clin J Med. 2019;86(11):741-749. doi:10.3949/ccjm.86a.19009
American Migraine Foundation.Holistic treatments for migraine.
Schwedt T, Vargas B.Neurostimulation for treatment of migraine and cluster headache.Pain Med. 2015;16(9):1827-1834. doi:10.1111/pme.12792
MedlinePlus.Headaches: danger signs.
American Cancer Society.Brain and spinal cord tumors in adults: Early detection, diagnosis, and staging.
National Institutes of Health National Institute of Neurological Disorders and Stroke.Migraine.
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