Sleep Apnea Headaches: Causes, Symptoms & Treatment

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Raj Dasgupta, MD

About 5% of people wake up with a headache in the morning. These headaches can happen because of different things like drinking alcohol or feeling stressed.

Researchers have found a connection between morning headaches and a sleep problem called obstructive sleep apnea, which affects breathing during sleep.

If you want to learn more about what causes headaches from sleep apnea and how to feel better, keep reading.

What’s a Sleep Apnea Headache?

Sleep Apnea Headaches

A sleep apnea headache is a type of headache that some folks with obstructive sleep apnea (OSA) get when they wake up, happening at least 15 days every month. These headaches feel like pressure, not throbbing, and typically affect both sides of the head. They can stick around for up to four hours. Unlike other headaches, there’s usually no feeling sick or bothered by light and noise with sleep apnea headaches.

It’s thought that about 18% of people with OSA also deal with these headaches. OSA is a sleep problem where your breathing stops and starts during the night. This happens because your airway gets blocked either partially (called hypopnea) or completely (apnea). Doctors rate how serious OSA is by using something called the apnea-hypopnea index (AHI), which counts how many times you have breathing issues per hour each night.

To be diagnosed with a sleep apnea headache, you need to have OSA with an AHI of 5 or more. Otherwise, you might just be having a regular morning headache, which has similar symptoms. People with OSA are up to three times more likely to have morning headaches.

What Are the Symptoms of Sleep Apnea Headache?

Here are the key symptoms of sleep apnea headaches:

  1. Happen at least 15 days a month upon waking.
  2. Felt on both sides of the head, with a pressing sensation instead of pulsing.
  3. Do not cause nausea or sensitivity to light or sound.
  4. Typically go away within four hours after waking up.

The Difference between Sleep Apnea Headaches and Migraines

Here’s the difference between sleep apnea headaches and migraines:

  • Duration: Sleep apnea headaches usually go away within an hour of waking, while migraines can last for several hours or even days.
  • Location: Migraines often affect one side of the head, while sleep apnea headaches can impact both sides.
  • Additional Symptoms: Migraines may come with visual problems, sensitivity to light, and nausea, whereas sleep apnea headaches might not have these additional symptoms.
  • Frequency: Sleep apnea headaches may happen more often than migraines. If you think you have sleep apnea headaches, finding relief might be simpler compared to migraines.

Other Types of Headaches Associated With Obstructive Sleep Apnea

Here are different types of headaches linked with obstructive sleep apnea:

  1. Cluster Headaches: These headaches are related to sleep apnea, but they’re not the same. Cluster headaches happen during sleep, while sleep apnea headaches occur when you wake up. Cluster headaches also come with extra symptoms like a runny or stuffy nose, teary eyes, sweating, and droopy eyes. They often come in clusters, meaning you might get several headaches a day for a few months and then none for a while. They usually last about an hour.

  2. Hypnic Headaches: These headaches also occur at night and are common in older people. They start about four to six hours after falling asleep and can wake you up, earning them the nickname “alarm clock headaches.” They usually go away within 30 minutes to an hour but might come with nausea, unlike sleep apnea headaches.

  3. Migraines: These headaches are different from sleep apnea headaches. Migraines last longer, from a few hours to a few days, while sleep apnea headaches usually disappear within a few hours of waking up. Migraines might affect one side of your head, while sleep apnea headaches can be on both sides. Migraines can happen at any time, even during sleep, and often come with nausea or sensitivity to light and sound.

What Causes Sleep Apnea Headaches?

Sleep apnea headaches may happen due to low oxygen levels in the blood during sleep or disruptions in breathing patterns. When breathing pauses occur, oxygen levels drop, leading to increased carbon dioxide in the bloodstream. This can cause blood vessels in the brain to expand, resulting in headache pain.

However, research suggests that not all people with sleep apnea headaches have low oxygen levels. Other factors, such as disrupted sleep patterns, may also contribute. Interruptions in sleep can lead to hypertension and heart problems over time, increasing the risk of morning headaches.

Certain symptoms of sleep apnea, like choking sensations during sleep or a history of hypertension, are associated with a higher likelihood of morning headaches. This suggests that sleep apnea headaches might be a symptom of poor sleep quality rather than solely low oxygen levels.

Risk Factors for Sleep Apnea Headaches

Factors that might make you more likely to get headaches from sleep apnea are being a woman and having a history of headaches. Some experts argue about whether how bad your sleep apnea is affects how likely you are to get these headaches.

Some say that if you have moderate or severe sleep apnea, you’re much more likely to get headaches. Others say that even if your sleep apnea is really bad, it only slightly increases your chances of getting headaches.

Some studies found that how bad your sleep apnea is doesn’t really change how likely you are to get headaches.

Is Your Morning Headache Caused by Sleep Apnea?

Morning headaches might mean you have sleep apnea, especially if you notice:

  • Loud snoring, gasping, or choking during sleep
  • Waking up suddenly feeling like you’re gasping or choking
  • Feeling tired even after sleeping
  • Daytime sleepiness or low energy

But morning headaches can also come from other issues like:

  • Anxiety or depression
  • High blood pressure
  • Sleep troubles
  • Tension in your head, neck, jaw, or shoulders
  • Medication side effects
  • Teeth grinding during sleep
  • Stress

Talk to your doctor if you’re concerned about your morning headaches or any related symptoms.

Treatment Options for Sleep Apnea Headaches

If you’re waking up with a headache every morning, it’s a good idea to see your doctor. They’ll ask about your symptoms and might run tests to see if your headaches are from sleep apnea or something else.

Sleep apnea headaches often go away once you’re treated for sleep apnea. Treatments include:

  1. CPAP Therapy: You wear a mask over your face or nose while you sleep. It’s connected to a machine that blows air into your airways, keeping them open and stopping breathing pauses. CPAP is the most effective treatment for sleep apnea and can really improve your life quality.

  2. Oral Appliances: These are custom-made by a dentist and are good for mild to moderate sleep apnea. They keep your airways open by moving your jaw forward and holding your tongue. You wear them at night.

  3. Lifestyle Changes: Some things, like alcohol or sleeping on your back, can make sleep apnea worse. Your doctor might suggest avoiding alcohol before bed and sleeping on your side or stomach. Losing weight can also help if you’re overweight.

  4. Surgery: If other treatments don’t work, surgery might be an option. Surgeries like removing extra tissue from your throat or tonsils can make your airway wider.

Whether your headaches are from sleep apnea or something else, it’s important to talk to your doctor. They can help you feel better and start your day without pain.

Learn more: Best Anti-Snoring Devices

When to Consult a Doctor

If you wake up with headaches, talk to a doctor, especially if you might have sleep apnea. Other reasons to consult a doctor about headaches include:

  • Having frequent headaches.
  • Headaches getting worse or not improving with over-the-counter meds.
  • Headaches affecting sleep, work, or daily life.

If you experience a sudden, severe headache or accompanying symptoms like weakness on one side of the body, stiff neck, high fever, trouble speaking, or sudden vision changes, seek emergency medical help.

Need professional help to diagnose and address your sleep problems? Schedule an online consultation with sleep specialist Dr. Owen Napleton.

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