Are Sleep Headaches Rare?

The simple answer is yes, headaches that start during sleep, and that actually wake you from sleep, are quite rare. It is much more usual for a headache to come on during the day. Common trigger factors include tiredness, stress, tension in muscles, and different foods. Sleep usually helps most headaches, even migraines, and most headaches are gone after a restful night. There are various causes of headaches that occur during sleep; some are more serious than others.

Hypnic Headaches That Occur at Night

One of the most likely explanations for a headache that starts during sleep is that you are experiencing a hypnic headache. These are often also called alarm clock headaches, as they tend to come on at the same time during the night and, as the pain intensifies, it wakes you up at the same time, either right in the middle of the night, or very early in the morning, just as an alarm clock would.

This type of sleep headache tends to occur mostly in older people; it is unusual to get hypnic headaches if you are under 50. What causes them is still something of a mystery and they can last anywhere between ten minutes and two hours. The pain experienced is more annoying than disabling, ranging from moderate to mild. Many people may have very mild sleep headaches that don’t develop enough to wake them, but may notice a dull ache if they are awoken by something else.

Sleep Apnea and Sleep Headaches

Another cause of sleep headaches is sleep apnea. This can occur in people who snore very badly, and it is common in very overweight and obese people. When lying down, the soft tissues of the throat and upper airways are dragged down by the weight of the neck, causing compression of the airways. As air is forced in and out, the vibrations of the soft tissue, and the tiny gaps left for air to escape causes the snoring. Apnea occurs when the flow of air is cut off completely – and the person stops breathing for anywhere between a few second and a minute. Eventually, the body recognises that it is not getting enough oxygen, and forces breathing to restart.

People who suffer from sleep apnea often wake up very tired, as their sleep has been constantly interrupted. They can also wake during the night with a bad headache, caused by the variations in their breathing pattern. The brain does not respond well to not getting a good and constant supply of oxygen and the blood vessels in the skull and brain can become disrupted, causing the distension that leads to vascular headaches.

Problems with Arteries

A rare condition that results in generalised inflammation in the arteries of the face and head can cause sleep headaches, as blood vessels in the head tend to dilate when lying down. This condition really only occurs in the elderly, and produces other symptoms, such as fever, pain when chewing, pain when swallowing and impairment of hearing and vision. Just getting a headache at night does not indicate giant cell arteritis, particularly if you are under 70 years old.

Even Rarer Causes of Sleep Headaches

The rarest causes of sleep headaches are brain tumours and strokes. Neither of these conditions tend to cause general headaches. Mini strokes, known as transient ischaemic attacks, tend to cause a range of different symptoms, including dizziness, losing balance, feeling numb in different parts of the body, or vision or hearing problems. All of these tend to be short-lived but can indicate that a more serious stroke is imminent, so these symptoms should always be checked out.

Brain tumours are even less likely to cause night-time headaches, but they can cause headaches that are present first thing in the morning. Brain tumours usually cause a range of other symptoms too – including sickness, very bad headaches in the day, sight problems and fits.