The Connection Between Sleep Apnea and Headaches

A headache is one of the worst ways to greet the day. But those morning headaches might suggest more than stress. They could be a sign of sleep problems.

Common Sleep Disorders

One common sleep disorder is insomnia, which can affect between 50-75% of people with chronic pain, including headaches. Insomnia occurs when you have trouble falling asleep, have difficulty sleeping through the night, or wake up too early and can’t fall back asleep.  

Another sleep problem that can lead to headaches is sleep apnea. Sleep apnea causes breathing to stop and start while you sleep. If you have sleep apnea, you might snore loudly and wake up feeling tired. The different types of sleep apnea are:

• Central sleep apnea (CSA), which happens when the brain fails to communicate with the muscles that manage breathing.
• Obstructive sleep apnea (OSA), which happens when a narrowing of the throat blocks airflow to the lungs. People with untreated obstructive sleep apnea often have morning headaches.
• Treatment-emergent central apnea syndrome, or complex sleep apnea, which happens when OSA turns into CSA during treatment for sleep apnea.

Sleep disorders and headaches are also common for people who live with anxiety and depression. 

The Connection Between Sleep Apnea and Headaches

Studies have shown a strong relationship between headaches and sleep disorders like sleep apnea. Migraines are commonly associated with obstructive sleep apnea, restless leg syndrome and night terrors in children. CSA and OSA are strongly correlated with cluster headaches, while tension headaches commonly occur with insomnia.  

If you have sleep apnea, breathing disruptions during sleep leads to decreased oxygen in your blood and increased carbon dioxide. These changes can cause blood vessels to widen and increase pressure within the skull.  

In addition, people with sleep apnea often wake up several times at night to resume breathing. People with insomnia might wake up multiple times as well. These frequent awakenings affect their quality of sleep, which can lead to headaches.  

Plus, while poor sleep can lead to headaches, researchers also point out that pain can disrupt sleep or healthy sleep behaviors. 

Are Your Headaches Related to Sleep Problems?

You may not even realize you have a sleep problem. If you have frequent headaches, especially in the morning, it might be a good idea to keep a log of your sleep and headaches. In the morning, write down:

• When you go to bed and how quickly you fall asleep
• When you wake up and any headache pain and its severity
• If you wake up during the night and how many times
• Whether you experience excessive daytime sleepiness
• If your partner has noticed that you snore or gasp for air while you sleep

Then, schedule an appointment with your doctor and share your notes. It will help answer questions they have and will help them decide whether you might need a sleep study or other tests.

Treatment for Sleep Disorders and Headaches

Treating morning headaches often begins with addressing sleep issues. Your doctor may recommend a few changes to help you sleep better.  For example:

• Avoid screens before bed
• Avoid sleeping on your back
• Establish a bedtime routine that includes wind-down time
• Exercise regularly
• Go to bed and wake up at the same time every day, even on weekends  
• Limit caffeine and alcohol intake

Cognitive behavioral therapy for insomnia is a drug-free approach that can help improve sleep as well as headaches. Its focus is on helping your body learn how to fall asleep quickly at night.

For people with OSA, a positive airway pressure (PAP) machine uses filtered, pressurized air to prevent their airway from becoming blocked during sleep. Oral appliances you place in your mouth at night can help reduce breathing disruptions by keeping your airway open. If those therapies don’t work, your doctor might talk to you about surge or nerve stimulation therapy.

If you wake up with headaches and think you have sleep issues, don’t despair. There are a lot of treatment options available and we’re here to support you. Talk to your primary care provider or reach out for a sleep medicine referral.