Sleep apnea can cause headaches at night.
Approximately 5% of individuals experience morning headaches upon waking up. These headaches can stem from various triggers, such as alcohol consumption and stress. Studies have indicated a connection between morning headaches and obstructive sleep apnea, a breathing disorder related to sleep. We delve into the potential causes of sleep apnea-induced headaches and offer tips for alleviating them.
Sleep Apnea Headache
Headaches associated with sleep apnea are a common occurrence for individuals with obstructive sleep apnea (OSA), happening at least 15 days a month upon waking up. These headaches are described as a steady, non-throbbing pain felt on both sides of the head, lasting up to four hours. Unlike other types of headaches, they do not come with symptoms like nausea or sensitivity to light and sound. Research suggests that around 18% of individuals with OSA may experience these headaches.
OSA is a sleep disorder characterized by repeated pauses in breathing during sleep, caused by either partial or complete blockage of the airway. The severity of OSA is determined by the apnea-hypopnea index (AHI), which measures the frequency of breathing interruptions per hour during sleep. A diagnosis of sleep apnea headache requires an existing OSA diagnosis with an AHI score of 5 or higher; otherwise, it may be classified as a morning headache with similar characteristics. Individuals with OSA are at an increased risk, up to three times more likely, to suffer from morning headaches.
Types of Headaches That Can Happen At Night
Cluster
Obstructive sleep apnea is linked to various types of headaches, including cluster headaches and hypnic headaches. Cluster headaches, although associated with sleep apnea symptoms, differ from hypnic headaches in their timing and accompanying symptoms. Cluster headaches typically occur during sleep and are characterized by additional symptoms like a runny nose, tearing eyes, and sweating. These headaches often come in clusters over a period of months before disappearing for an extended time.
Hypnic
On the other hand, hypnic headaches, which also occur at night and affect individuals with obstructive sleep apnea, usually start a few hours after falling asleep and can wake a person up, earning them the nickname alarm clock headaches. They are more common among older individuals and may involve nausea as an additional symptom.
Migraines
In contrast to migraines that can last for days and have specific side localization on the head, sleep apnea headaches tend to resolve within hours of waking up without additional symptoms like nausea or light sensitivity commonly seen in migraines. Migraines can occur at any time of day or night while sleep apnea headaches specifically manifest upon waking up.
Sleep Apnea Headache Risk Factors
Factors that increase the risk of experiencing headaches related to sleep apnea include being female and having a history of headaches. There is ongoing debate among researchers regarding the correlation between the severity of obstructive sleep apnea (OSA) and the occurrence of sleep apnea headaches.
Some studies suggest that individuals with moderate to severe OSA are more likely to experience sleep apnea headaches, while others indicate that the severity of OSA only slightly raises the chances of developing these headaches. The International Classification of Headache Disorders recognizes that the intensity of sleep apnea headaches may fluctuate in conjunction with OSA severity, yet multiple studies have shown that the likelihood of experiencing these headaches is not influenced by the severity of OSA.
Sleep Apnea Headache Causes
The exact cause of sleep apnea headaches remains uncertain to researchers. One theory suggests that they may be linked to decreased blood oxygen levels during sleep and the interruptions in breathing that occur with sleep apnea. Some experts propose that these headaches could be connected to hypoxemia, a condition where blood oxygen levels drop below normal levels. The breathing pauses characteristic of sleep apnea can lead to reduced oxygen reaching the brain, causing an accumulation of carbon dioxide in the bloodstream and expanding blood vessels in the brain.
This expansion may result in pressure buildup, leading to the development of a sleep apnea headache. However, recent studies have shown that individuals with obstructive sleep apnea (OSA) who experience these headaches exhibit similar oxygen levels and breathing interruptions as those without such headaches. While low oxygen levels may contribute to some morning headaches, there seems to be another underlying cause for sleep apnea-related headaches.
The disruptions in breathing caused by OSA can disrupt a person’s sleep pattern, potentially increasing the risk of hypertension and cardiovascular disease over time. These disturbances in sleep may also impact whether an individual wakes up with a morning headache. For instance, one study identified specific OSA symptoms associated with a higher likelihood of experiencing morning headaches, such as choking sensations during sleep, a history of hypertension, and feeling unrefreshed upon waking up. Researchers suggest that perhaps these headaches are a symptom of poor quality sleep, which is commonly observed in individuals with OSA.
Is Your Nighttime Headache Sleep Apnea Related?
Morning headaches may indicate undiagnosed sleep apnea. If you or your sleep partner observe any of the following symptoms of obstructive sleep apnea, it is advisable to consult your doctor:
– Feeling that your sleep is not restorative
– Awakening abruptly due to gasping or choking
– Daytime signs such as excessive drowsiness or decreased energy levels.
– Noisy snoring, gasping, or choking noises during sleep
However, morning headaches can also occur independently of OSA and are linked to various other health conditions, including:
– Anxiety
– Hypertension
– Tension in the head, neck, jaw, or shoulders
– Sleep disturbances
– Sleep bruxism (teeth grinding)
– Adverse effects of medication use
– Stress
Sleep Apnea Headache Treatment
If you wake up with a headache every morning, it’s important to schedule an appointment with your doctor. They will inquire about your symptoms and conduct tests to determine if obstructive sleep apnea is the cause of your morning headaches or if there is another underlying issue. Treatment for OSA often leads to the disappearance of sleep apnea-related headaches. Options for managing OSA include CPAP therapy, oral appliances, lifestyle adjustments, and surgical interventions.
CPAP Therapy involves wearing a mask connected to a machine that delivers air pressure into your airways during sleep, preventing breathing interruptions and improving symptoms of OSA significantly.
Oral appliances are custom-fitted by dentists and are suitable for mild to moderate cases of OSA by repositioning the jaw and tongue to clear the airways while sleeping.
Lifestyle modifications may also be recommended by your doctor, such as avoiding alcohol before bedtime, changing sleeping positions, or following an exercise and diet regimen. Weight loss can be particularly beneficial for overweight individuals with OSA in alleviating symptoms.
In cases where other treatments have not been effective, surgical procedures like tonsillectomy or uvulopalatopharyngoplasty may be suggested as a last resort. Regardless of the cause of your morning headaches, consulting with your doctor is essential for finding relief and improving your overall quality of life.
