Morning Headaches and Sleep Apnea: When to Get a Sleep Test

Waking up with a dull headache most mornings is not normal, and it is easy to blame on tea, stress or the pillow. Sometimes the cause is what happened to your breathing during the night. This guide explains the link with sleep apnea, the other common causes, and when to get checked.

What a sleep apnea headache is like

Headache specialists describe a particular pattern linked to sleep apnea:

• It is there when you wake up, rather than starting later in the day
• It is felt on both sides of the head, as a pressing or squeezing ache rather than a throb
• It usually comes without nausea or sensitivity to light and sound, which helps tell it apart from migraine
• It fades within a few hours of getting up, often by mid-morning
• It happens on many mornings, not just occasionally

The headache tends to improve, often markedly, once the sleep apnea is treated. That improvement is one of the ways doctors confirm the link.

Why breathing pauses cause a headache

During each pause, oxygen in the blood falls and carbon dioxide rises. Carbon dioxide widens the blood vessels in the brain. Add the repeated small awakenings and surges in blood pressure that come with each pause, and the result, after hundreds of pauses, can be a head that aches by morning. As breathing returns to normal during the day, the headache settles.

Other common causes of morning headaches

Sleep apnea is only one possibility. Others worth considering:

• Caffeine withdrawal in people who drink a lot of tea or coffee during the day
• Overuse of painkillers, which can itself cause daily headaches
• Teeth grinding at night, which often leaves the jaw and temples sore
• Poor or short sleep, or insomnia
• Alcohol the night before
• High blood pressure that is not well controlled
• Low mood or anxiety
• A blocked nose or sinus problems

In people with lung disease or severe obesity, a morning headache can also be a sign of shallow breathing at night with carbon dioxide building up, which is treated differently, sometimes with a BiPAP machine. Another reason to have it checked properly.

When a morning headache points towards sleep apnea

A sleep test is worth discussing if your morning headaches come with any of these:

• Loud snoring, or someone has noticed you stop breathing or gasp
• Waking with a dry mouth or sore throat
• Feeling tired despite a full night in bed
• Waking often during the night, or to pass urine
• High blood pressure

For most adults a home sleep study is a straightforward first test, done in your own bed. Keeping a short sleep diary for two weeks, noting when headaches occur, helps your doctor too.

See a doctor urgently if

Most morning headaches are not dangerous, but get medical help the same day for a headache that:

• is sudden and severe, the worst you have had
• comes with weakness, numbness, confusion, slurred speech or changes in vision
• comes with fever and a stiff neck
• is new and getting steadily worse over days or weeks, or wakes you from sleep with vomiting
• follows a head injury

Frequently asked questions

Can treating sleep apnea cure morning headaches?

When the headaches are caused by sleep apnea, they usually improve markedly once it is treated, often within weeks of starting CPAP.

I get migraines. Could sleep apnea be making them worse?

Poor sleep is a known migraine trigger, and sleep apnea fragments sleep. If you also snore or feel unrefreshed, it is worth asking your doctor about a sleep test.

Are morning headaches common with CPAP?

They are not a usual side effect. If headaches continue after starting CPAP, the pressure or mask fit may need checking.

Waking with headaches and snoring at night? See the sleep study options and prices in Chennai, or call us to arrange a home test.