I
often get
headaches in the morning. They improve when I get up and have coffee,
but I can’t seem to figure out how to prevent them. I have tried various
pillows and sleeping positions. What should I do?
اضافة اعلان
Morning headaches have a number of causes. One of the common
culprits is caffeine — or a lack thereof. “Sometimes, the reason for the
morning headache is that you’ve slept in and you’re late on your morning
caffeine,” said Dr. Kathleen Mullin, a neurologist and headache specialist at
the New England Institute for Clinical Research. It’s easy to tell if caffeine
withdrawal is the cause of a headache because putting caffeine back into your
system quickly cures it.
People usually experience caffeine headaches only if they
regularly drink more than 200 milligrams of caffeine per day, Mullin said,
which is the equivalent of about two to three 8-ounce cups of brewed coffee. To
reduce such headaches, slowly taper your caffeine consumption, ideally to less
than 200 milligrams per day, she said. (Beware that in the process, your
headaches might increase for several days or even weeks before lessening.)
Another common cause of morning headaches is
sleep apnea, which is
often associated with snoring and frequent waking in the night, Mullin said.
Once sleep apnea is diagnosed and treated, often with a continuous positive
airway pressure device or a special mouth guard, headaches usually go away, she
said.
Teeth grinding can also cause morning headaches. Mouth guards can
prevent those, too, she said.
Medication overuse can cause headaches as well. That includes 15
or more days per month of over-the-counter pain drugs such as aspirin,
acetaminophen, or nonsteroidal anti-inflammatory medications like ibuprofen, or
10 or more days per month of prescription pain drugs like opioids or triptans.
“Patients don’t realize that medicines as simple as Advil, Tylenol, and
Excedrin are really big culprits,” Mullin said. The best way to prevent these
headaches is to cut back on the drugs if possible, taking them fewer than three
times a week.
In rare cases, morning headaches are the result of brain lesions,
like tumors, that cause pressure inside the skull, Mullin said. Lying down
heightens this pressure, so these headaches often occur in the middle of the
night or the morning. And the pain is typically so intense that it rouses
patients from slumber. “A headache that wakes you up from sleep in the morning
is something that, for most neurologists, sets off our ‘This is worrisome’
flags,” she said. Often, an MRI is the next step, to see inside the brain.
Migraines are also a common morning headache culprit, said Dr.
Merle Diamond, the president and medical director of the
Diamond Headache Clinics in the Midwest. In fact, for unknown reasons, she said, 40 percent of
migraines start in the early morning. Many factors can set them off, including
alcohol, dehydration,
lack of sleep, too much or too little caffeine, and eating too much or not enough the night
before. Other triggers are cured meats, chocolate, aged cheese, and artificial
sweeteners, as well as stress, hormonal fluctuations, weather changes, and
bright lights. Even a change in routine can trigger a migraine, Diamond said,
because “a migraine brain likes things to be really regular.”
Migraines are different from other headaches, Diamond said. They
often throb or pulsate, and they can come with nausea or sensitivity to light
or sound. They frequently occur on just one side of the head, and they can
endure from four hours to several days if untreated, making it hard for people
to go about their lives.
To prevent migraines, Diamond recommended keeping a headache diary
— noting triggers and patterns associated with their onset — and then avoiding
those triggers. Depending on the frequency and severity of your migraines, a
doctor may also recommend prescription drugs that can prevent or treat
migraines. Since 2018, the
Food and Drug Administration has approved a handful
of new migraine drugs, many of which have fewer side effects than older drugs.
Finally,
Diamond said, it sometimes helps her patients to turn off digital devices at
least a half-hour before bedtime and to stretch, meditate or practice yoga
before going to sleep. When people commit to “relaxing before bed and clearing
their minds,” Diamond said, they sometimes find that their heads feel better in
the morning, too.
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