Morning Headaches: A Possible Sign of Sleep Apnea

Morning headaches are very common and can be attributed to a wide variety of causes, including teeth grinding during sleep, medication side effects, or food sensitivities. For the over 30 million people who suffer from obstructive sleep apnea in the US, morning headaches are one of the telltale signs of this potentially serious sleep disorder.

Symptoms of Obstructive Sleep Apnea

Obstructive sleep apnea (OSA), the most common type, is a sleep-related breathing disorder linked to serious comorbidities such as cardiovascular disease, high blood pressure, and stroke. The most common symptoms of undiagnosed obstructive sleep apnea are snoring, daytime drowsiness, mental fogginess, and morning headaches. During a sleep apnea event, breathing repeatedly starts and stops throughout the night due to airway obstruction. When breathing stops, blood oxygen levels drop, resulting in less oxygen going to the brain. Researchers believe this process can lead to sleep apnea headaches.

Headaches Associated with OSA

There are several different types of headaches associated with OSA. A true sleep apnea headache is defined by the severity of the disease and its frequency. A rating system known as the apnea-hypopnea index determines how many respiratory events a person experiences per hour per night. For a morning headache to be classified as a sleep apnea headache, a person must first be diagnosed with OSA by a sleep specialist and then have an AHI rating of 5 or higher. Sleep apnea headaches are also defined by occurring at least 15 days out of the month. They are characterized by a pressing pain across the head, rather than pain localized to one side. Unlike a migraine, a sleep apnea headache is not associated with nausea or sensitivity to light or sound.

Cluster headaches are also associated with sleep apnea. Unlike a sleep apnea headache, a cluster headache occurs during sleep rather than upon waking. Cluster headaches also have other symptoms, such as congestion, teary eyes, or facial sweat. As their name indicates, cluster headaches occur in groups. You may experience daily cluster headaches for a specific duration, then not get them again for several months. The headaches may start up again at a later time and continue this cycle.

Hypnic headaches are also associated with sleep apnea but are more likely to affect older people. Unlike sleep apnea headaches, hypnic headaches occur at night, usually about four to six hours after falling asleep, and often cause a person to wake up. Hypnic headaches tend to go away on their own, as with sleep apnea headaches, but they are often accompanied by nausea, creating their distinction.

Treating Morning Headaches

The best way to treat reoccurring morning headaches is to find their cause. Your doctor can do tests to determine whether your morning headache is due to obstructive sleep apnea or another health condition. If your diagnosis is positive for sleep apnea, the best way to treat the headache is to treat the underlying disease.

The most common therapy for moderate to severe sleep apnea is continuous positive airway pressure, known as CPAP. CPAP devices deliver air pressure through a hose and mask worn over your nose or mouth (or both). This allows the airway to stay open, resulting in improved sleep and a reduction in symptoms. When used correctly and consistently, CPAP has been shown to reduce the number of apnea events each night, allowing for better blood oxygenation and a reduction in morning headaches.

For mild to moderate sleep apnea, your doctor may recommend a custom oral appliance which you can get from your dentist. Oral appliances keep the airway clear during sleep by keeping your tongue in place and moving the jaw forward.

Lifestyle changes are often the first course of action for sleep apnea. Because obesity is a common risk factor for this sleep health condition, your doctor may suggest lifestyle changes, including a consistent exercise plan and a healthy diet to bring your weight under control. Being at a healthy weight is always a good health target since many of the comorbidities associated with sleep apnea, such as diabetes, high blood pressure, and heart disease, are also associated with elevated weight.

Morning headaches are common and caused by various factors, but if they are accompanied by the other symptoms associated with sleep apnea, it is best to see your doctor for a diagnosis. Controlling sleep apnea is not only essential to restore healthy sleep, but it is good medicine for overall improved health.