Waking up to a throbbing migraine attack has to be one of the most uncomfortable ways to start the day.
As painful and inconvenient as waking up with a migraine attack is, it’s not really uncommon. According to the American Migraine Foundation, the early hours of the morning are a common time for migraine attacks to start.
Certain migraine triggers occur because of your sleep routine or while you’re sleeping, making the early hours of your day a time when you’re extra vulnerable to migraine pain.
Keep reading to understand why this happens and if there’s anything you can do to treat migraine attacks that show up right when you rise to greet your day.
Migraine attacks in the morning have several potential causes.
How much sleep you get every night is a strong predictor of how likely you are to get a migraine attack in the morning.
That same study points out that 38 percent of people who get migraine attacks sleep for less than 6 hours per night, and at least half reported experiencing sleep disturbances.
Mental health conditions
It’s not hard to understand all of the ways that waking up with a migraine attack plays into your mental health: Waking up with daily pain can make each morning a difficult experience, in turn affecting your depression.
Depression also affects your sleep habits, making you more vulnerable to getting migraine attacks.
Hormones and medications
In the early hours of the morning, the natural hormonal pain relievers your body produces (endorphins) are at their lowest levels. This means that if you have migraine, the early mornings will be when the pain feels the most severe.
It’s also usually the time of day when any pain medications or stimulants used to treat migraine pain will have worn off and cease having their effect.
Some researchers believe that migraine has a genetic cause. This means that if other people in your family have reported having migraine attacks in the morning, it’s more likely you’ll have them, too.
It’s also possible that migraine in families can share the same triggers.
Dehydration and caffeine withdrawal
About one-third of people who get migraine attacks note dehydration as a trigger.
Obviously, you can’t drink water while you’re asleep, so it’s possible that waking up dehydrated is a reason why people are more prone to getting migraine attacks in the morning.
The wee hours of the morning also tend to mark a full day since your last caffeine fix. Coffee and other forms of caffeine dilate the blood vessels in your brain, relieving tension. And caffeine withdrawal has been connected to migraine attacks.
Migraine happens in several different stages. You may wake up with the pain of a migraine attack, but that doesn’t mean you didn’t experience the other phases of migraine in the hours or days before the pain.
Prodrome symptoms happen in the days or hours before a migraine attack. These symptoms include:
- food cravings
- mood swings
Aura symptoms can happen in the hours before a migraine attack or during the pain itself. Aura symptoms include:
- visual disturbances
- nausea and vomiting
- a pins and needles feelings in your fingers or legs
The attack phase of migraine can last anywhere between 4 hours and 3 days. Symptoms of the attack phase of migraine include:
- pain on one side of your head
- throbbing or pulsing pain in your head
- nausea or vomiting
- sensitivity to light and other sensory input
There are some symptoms that make migraine distinct from other kinds of headache conditions. To tell the difference between a migraine attack and a headache, ask yourself these questions:
- Does my head pain last more than 4 hours?
- Is the pain distracting, pulsing, or throbbing?
- Am I experiencing additional symptoms, such as dizziness, flashing lights, or nausea?
If you answered yes to these three questions, it’s likely you’re experiencing a morning migraine attack. Your doctor can give you an official diagnosis using a CT scan or MRI.
If you regularly wake up with headaches that you suspect are migraine attacks, start writing down your symptoms and tracking how often they happen.
If they’re happening more than once a month, make an appointment to speak with your doctor.
If you wake up with more than
If you have any of the following symptoms, go directly to an emergency room or immediately see your doctor:
- headache following a head injury
- headache with fever, stiff neck, or difficulty speaking
- an abrupt headache that feels like a thunderclap
Migraine treatment focuses on pain relief and prevention of future migraine attacks.
Treatment for morning migraine may include over-the-counter (OTC) pain relievers, such as ibuprofen and acetaminophen, as the first line of defense.
If OTC medication doesn’t work, your doctor may prescribe:
- Triptans. Drugs like sumatriptan (Imitrex, Tosymra) and rizatriptan (Maxalt) aim to block pain receptors in your brain.
- Nasal sprays or injections. Classified as dihydroergotamines, these drugs affect the blood flow in your brain to try to prevent migraine attacks. Some triptans are also available as a nasal spray.
- Anti-nausea drugs. These medications treat the symptoms of migraine with aura, which can cause nausea and vomiting.
- Opioid medications. Doctors sometimes prescribe strong pain-relieving drugs in the opioid family for people whose migraine attacks don’t respond to other drugs. However, these medications have a high potential for misuse. Your doctor will discuss the pros and cons with you.
You might also want to look into home remedies for migraine, such as:
- meditation and gentle exercise, such as yoga
- stress-reduction techniques
- warm compresses on your head and neck
- warm showers and baths
To prevent future migraine attacks, you may want to start carefully tracking your fluid intake and your diet. Working to identify triggers is the first step toward preventing migraine attacks. Keep a journal of your symptoms to discuss with your doctor.
If you have morning migraine attacks, work to understand what might be triggering them. Dehydration, poor sleep hygiene, disrupted sleep, and medication withdrawal could all be part of what’s causing you to wake up with a migraine attack.
Sleeping 8 to 10 hours per night, drinking plenty of water, and avoiding excessive alcohol consumption might contribute to fewer migraine attacks.
Researchers don’t yet have a cure for migraine, but they’re learning better methods of treatment and how to help people with this condition be proactive about symptoms.
Speak to your doctor if you’re frequently waking up with migraine attacks. The two of you can make a treatment plan that works for you.
Your primary care team is your go-to resource for your overall health, including migraine, sleep issues, and mood episodes. They can diagnose migraine and may prescribe lifestyle changes and medication. They usually refer patients to specialists only if symptoms don’t improve with these treatments.
A neurologist or other headache specialist evaluates head pain disorders and recommends a treatment plan to reduce the frequency and severity of migraine symptoms. They may prescribe medications, lifestyle changes, and other therapies.
A psychologist who specializes in pain management may use biofeedback, relaxation training, cognitive behavioral therapy, or other techniques to reduce muscle tension and headache pain.
An occupational therapist evaluates your ability to perform daily activities and meet your goals. They may adjust your tasks and environment to help you live better with migraine. This can include developing self-care routines and limiting migraine triggers at work, school, or home.
A physical therapist uses hands-on treatments to reduce muscle tension and pain in your back, neck, jaw, or head. They can teach you exercises and stretches that may help reduce the frequency and severity of migraine symptoms. They may also recommend optimal positions for sleeping, working, driving, and more to reduce muscle strain that could contribute to migraine.
Insomnia and other sleep disorders are more common in people with migraine and may aggravate symptoms. A sleep medicine physician diagnoses sleep disorders. A behavioral sleep medicine specialist helps you adjust your habits, behaviors, and environments to improve sleep.
Mood disorders, such as anxiety and depression, are more common in people with migraine and may worsen symptoms. A psychologist, clinical social worker, or licensed mental health counselor can treat mental health conditions with psychotherapy. A psychiatrist can prescribe medication if needed.