Author: Mary West
A sleep apnea headache involves pressing pain on both sides of the head. It usually happens in the morning after waking up.
Unlike classical migraine headaches, sleep apnea headaches do not cause nausea and increased sensitivity to light and sound.
According to older research sleep apnea — a condition where a person stops breathing periodically during the night — affects about 3% to 5% of middle-aged adults. A headache upon waking happens in 12–18% of those with sleep apnea.
A sleep apnea headache usually happens first thing in the morning or awakening during the night and lasts less than 30 minutes but can last for several hours. If a person receives treatment for sleep apnea, the headaches should resolve.
Unlike migraine headaches, they do not associate with nausea, discomfort of the eyes in bright light, or a fear of loud sounds.
Research shows that a sleep apnea headache occurs on both sides rather than one side of the head. They can feel like pressing on the head. Usually, they will not cause pulsating pain.
A 2021 research article notes the characteristics of migraine headaches and sleep apnea headaches. We outline the similarities and differences below:
|Characteristic||Sleep apnea headache||Migraine headache|
|Location||both sides of the head||one side of the head|
|Duration||less than 30 minutes||a few minutes for migraine without an aura, or sensory disturbances, such as flashes of light; 4–72 hours for migraine with an aura|
|Breathing||pauses in breathing during sleep||no pauses in breathing during sleep|
|Disability||does not cause disability||can cause disability|
|Associated symptoms||daytime sleepiness, decreased libido, waking at night to urinate||nausea and sensitivity to light and sound|
|Complications||no reports of complications||can be associated with serious complications such as seizures or stroke|
According to an older 2010 study there is no connection between sleep apnea headaches and migraine. Researchers looked at the apnea-hypopnoea index (AHI), or the number of times per hour that breathing stops during sleep, in 40,000 people and found no link between the conditions.
The risk factors for sleep apnea headaches are the same as those for sleep apnea. They include:
- Age: The risk of sleep apnea increases as a person gets older.
- Obesity: People with obesity may have fatty deposits in the neck, which can block the airway.
- Thick neck, large tonsils, or a large tongue: These narrow the upper airway, obstructing air flow.
- Smoking and drinking alcohol: Smoking causes inflammation in the airway, and alcohol relaxes the muscles in the mouth and throat, which can close the upper airway.
- Sex: Males are more likely to develop sleep apnea.
- Genetics and family history: A person may inherit sleep apnea. Genes determine the size of the face and upper airway and may also cause conditions that contribute to sleep apnea.
- Respiratory disease: Patients with underlying lung disease may under breathe during sleep and have these types of headaches.
Treatment and relief
The most common treatment for sleep apnea is CPAP. This treatment involves a machine that delivers constant air pressure to an individual’s breathing passage, preventing the airway from closing during inhalation.
During CPAP treatment, a person wears a mask over their nose and mouth during sleep. A tube connects the mask to the machine motor, which blows air into the tube. CPAP treatment benefits include:
- reducing the risk of stroke
- lowering high blood pressure
- improving memory and thinking abilities
Older 2009 researce investigated whether or not CPAP could help prevent or lessen morning headaches in people with sleep apnea. The results indicated that morning headaches completely disappeared in 90% of those who had CPAP treatment. Some types of headaches mimic sleep apnea headaches, so if CPAP resolves the issue, a doctor can rule out other possible causes.
A person should contact a doctor if they have headaches that occur on awakening. If sleep apnea is confirmed, a doctor can evaluate their symptoms and recommend treatment options, such as CPAP.
Headaches may have other causes, some of which are serious. People should also contact a doctor if:
- they have frequent headaches
- their headaches become worse, or they do not improve with over-the-counter medications
- their headaches interfere with sleep, work, and everyday activities
A sudden, severe headache may indicate a medical emergency. If this happens, or if a person has accompanying symptoms, such as those below, they should seek emergency medical attention. Symptoms include:
- weakness on one side of the body
- stiff neck
- high fever
- trouble speaking
- acute changes in vision
A sleep apnea headache occurs upon waking and usually lasts less than 30 minutes. Once someone starts CPAP treatment, headaches usually disappear within 72 hours and do not recur.
Not everyone with sleep apnea experiences morning headaches. Individuals with frequent morning headaches or other types of headaches should contact a doctor.