Headache on waking up could be a lack of caffeine; check out other causes

I have a headache often in the morning. It gets better when I get up and have coffee, but I can’t figure out how to prevent it. I tried different pillows and sleeping positions. What can I do?

Morning headaches can have a number of causes. One of the most common is caffeine — or lack thereof.

“Sometimes the reason for the headache is that you woke up later and took longer to get your morning caffeine fix,” said Kathleen Mullin, a neurologist and headache specialist at the New England Institute for Clinical Research. It is easy to find out if a lack of caffeine is the cause of the headache, because ingesting caffeine cures it readily.

People generally only get caffeine-related headaches if they usually drink more than 200 milligrams of caffeine a day, Mullin said — the equivalent of two or three eight-ounce cups of coffee.

To reduce this type of headache, decrease your caffeine intake gradually, ideally to less than 200 mg a day, she recommended. But know that during this process the headaches may increase for a few days or even weeks before decreasing.

Another common cause of morning headaches is sleep apnea, often associated with snoring and waking up several times a night. Once apnea has been diagnosed and treated, often with a CPAP (continuous positive airway pressure) device or a special mouthpiece, these headaches usually go away.

Grinding your teeth can also trigger these pains. According to Mullin, mouthparts are also effective in fighting them.

Overuse of medications is another possible cause. This means taking pain relievers like aspirin and acetaminophen or non-steroidal anti-inflammatory drugs like ibuprofen for fifteen or more days a month, or taking pain relievers like opiates or triptans for ten days or more.

“Patients don’t realize that simple drugs like Tylenol, ibuprofen or Excedrin are largely responsible,” Mullin said. The best way to prevent these headaches is to cut back on the drugs, taking them less than three times a week.

In rare cases, morning headaches result from brain injuries, such as tumors that cause intracranial pressure, Mullin said. (It is worth remembering that brain and spinal cord tumors are diagnosed in only 24 out of every 100,000 people per year in the US.)

Lying down increases the pressure, so this type of headache often occurs in the middle of the night or in the morning. And the pain is usually so intense that it causes the patient to wake up.

“A headache that makes you wake up is seen by most neurologists as something to worry about,” she said. The next step may be to do an MRI, to see inside the brain.

According to Merle Diamond, president and medical director of Diamond Headaches Clinics, migraine is also a common cause of morning headaches. For unknown reasons, 40% of migraines start early in the morning.

Many factors can trigger them, including alcohol consumption, dehydration, insufficient sleep, too much or too little caffeine, and the amount of food the patient ate the night before.

Other triggers are processed meats, chocolate, aged cheese, artificial sweeteners, stress, hormonal fluctuations, changes in the weather and bright lights. Even a change in routine can trigger a migraine, Diamond said.

“The brain of a migraine sufferer likes everything to be very regular.”

Migraines are different from other headaches, Diamond said. The pain is often throbbing or throbbing and may be accompanied by nausea and sensitivity to light and sounds. It often occurs on just one side of the head. If migraine is not treated, it can last from four hours to several days, making a person’s life seriously difficult.

To prevent migraines, Diamond recommends that patients keep a journal in which they write down the triggers and patterns that seem to trigger them and then avoid those triggers.

Depending on the frequency and intensity of your migraines, your doctor may also recommend medications to prevent or treat them. Since 2018, the FDA (the food and drug regulatory agency in the United States) has approved some new migraine drugs, many of which have fewer side effects than older drugs.

Finally, Diamond said, one thing that sometimes helps his patients is turning off digital devices at least half an hour before bed and doing stretching, medication or yoga before bed.

When people make a habit of relaxing and clearing their minds before going to bed, Diamond said, they sometimes find that they wake up with a better head, too.

Translation by Clara Allain