Instead of rising to meet the day refreshed after a night’s rest, if you wake up with your head pulsing and ounding sometimes, doctors tell you the possible reasons and what you can do about it. Among the more common reasons, says Dr Aziz A Mhate, a general physician based in Navi Mumbai, are sleep apnoea and depression-related lack of sleep. The less common ones are food and drug allergies.
Primary headache disorders
If you’ve had recurrent headaches and the doctors have ruled out a medical condition, then it’s probably what is called a primary headache disorder. These can be anything from cluster headaches (on one side), tension headaches (ache and/or tightness on the forehead or back of head and neck) or migraine (throbbing pain).
Triggers are numerous and lifestyle related, relating to stress, caffeine and alcohol consumption, lack of sleep, and in some cases, extreme temperatures, in either summer or winter. You may get the worst headaches during the hot, humid months and you may also get them more frequently. “They may awaken a person in the early hours of the morning (usually after 4 am) or be present when he/she wakes up,” says Dr Neeraj Jain, Associate Professor, Department of Neurology, KEM Hospital, Mumbai.
The body’s production of natural pain killers, like endorphins and enkephalins, is lowest between 4 am and 8 am. Adrenalin is released in larger quantities during the early morning hours. Since adrenalin affects blood pressure and the regulation of dilation or contraction of the blood vessels, it may play a role in migraine attacks, says Dr Jain. The answer: before you sleep, avoid gadgets and any stressful activity. Restrict alcohol and skip caffeine in the evening. Develop healthy sleep practices, such as listening to soothing music and doing a few yoga asanas to help you relax.
Fall in blood sugar
Your body stays without food for over 8 hours when you sleep. This leads to a fall in the blood sugar levels in the body. “Among people living with diabetes, this fall in blood sugar level can lead to a hypoglycaemic headache either at night or on waking up,” says Deepalekha Banerjee, a Chennai-based nutritionist. Ask your doctor how you can change your diet and medication to avoid this.
Poor posture
“An incorrect posture either sleeping or sitting can stretch the musculoskeletal area, producing headache,” says Dr S S Kumar, a Bengaluru-based general physician. If you often wake up with a crick in your back or sore muscles from sleeping in an awkward position, these could be indicators of this sort of headache.
Sleep disorders
Obstructive Sleep Apnoea Syndrome, characterised by repeated breathing pauses during the sleep cycle, is often associated with morning headaches, explains Dr Manoj Agarwal, an ENT specialist in Kolkata. This headache typically manifests as uncomfortable pressure on both sides of the head, similar to a tension headache.
When you suffer from sleep apnoea, your airway is partially or completely blocked during sleep. Because of this closure, the amount of oxygen in the blood being transported to your brain is reduced; there is a repeated fall in the oxygen level below the critical level, leading to a morning headache.
People who have obstructive sleep apnoea disorder are often overweight and have other symptoms, such as excessive daytime sleepiness and snoring.
Other sleep disorders — such as insomnia — affect blood pressure, hormone production, anxiety, stress and several other aspects of well-being. Do consult a sleep specialist.
Bruxism
“Teeth grinding can stimulate pain-sensitive receptor zones, causing a headache. The nerve endings, which are the receptors for pain, can get stimulated,” says Dr Kumar.
If you grind your teeth in your sleep, the vibrations will travel up your skeleton and affect your shoulders, neck and head, often leading to a sore jaw and a morning headache.
Ask your partner to observe you when you sleep.
Medication overuse
One of the ironies of pain medication is that when the medication is used frequently, or in increasing amounts to treat headaches, it can sometimes cause a morning headache.
“These are also called rebound headaches, and are due to the medication effects wearing off while a person sleeps, causing a type of drug withdrawal reaction,” says Dr Mhate. Wean yourself off the medication with the help of a doctor.
Food triggers
Monosodium glutamate (a food additive), tyramine (found in aged cheeses and cured meats), sulphites and nitrites (both used in preserved foods) and caffeine act as triggers.
“Caffeine is a stimulant that stimulates the hypothalamus, thus causing sleep deprivation, leading to a headache,” says Banerjee.
If you are consuming too much caffeine, you could suffer from a withdrawal headache the next morning. Eliminate these foods to make sure they are not causing your headache. Besides, stay hydrated.
Natural causes
Besides disorders, the following factors can cause your morning headache:
Posture Look out for daily wake-up indicators, like a crick in your back or a sore arm caused by poor sleeping posture.
Diet Caffeine, food additives like MSG and elements like tyramine found in cured meats and aged cheese can trigger your headache. Avoid these right before bed.
Lifestyle Stressful activities right before bed, and going to bed with gadgets like a tablet or your phone can affect your sleep.
