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Headaches at Night: Common Causes and Factors
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Headaches at Night: Common Causes and Factors

No matter who you are, where you live, or how long you've been around, at some point, you’ve had a nasty headache. Sometimes headaches are light and nagging, and sometimes they’re fierce and debilitating.

Whether it’s the change in season, an accidental bump on the head, or the result of an illness, headaches make life a bit more difficult.

While it’s common to get a headache for any number of reasons, getting headaches, specifically at night, can be confusing. During the nighttime, our body chemistry changes slightly to allow us to sleep. Sometimes, if something is just a little off, this can trigger a reaction that lands us a massive headache.

If you’re getting routine nighttime headaches, read on as we look at some of the different types of headaches and when they affect us.

What Are Primary and Secondary Headaches?

Headaches at Night: Common Causes and Factors

If you think about the times you get headaches, sometimes you know exactly why you have them, and other times you have no idea. Headaches are divided into two main categories based on what’s causing them to occur. Let’s look at primary and secondary types of headaches and some examples for each:

Primary Headaches

If a primary headache is causing the dull head pain you’re experiencing, the main problem is the headache itself. In other words, it’s all in your head! Whether from chemicals in the brain, nerves running through it, blood vessels around it, or the muscles in your head, the source of the pain is the head. Some examples of primary headaches include migraine, cluster, and tension headaches.

Secondary Headaches

Accounting for the other 10% of headaches that we experience, secondary headaches represent a symptom of an underlying disease or condition. These types of headaches can often be due to dehydration, high blood pressure, neck pain, a seizure, or a stroke. The difference from primary headaches is that you must treat secondary headaches at the source, instead of just treating the headache.

Knowing the Difference

It isn’t always easy to discern the difference between a primary and a secondary headache. Sometimes we can think that one thing is causing our pain when it later turns out to be something else.

Headaches that occur at specific times of the day (or night) often fit into certain categories. Let’s look at the different types of primary and secondary headaches to shed light on what kind of headache might be keeping you up at night.

What Are Some Types of Primary Headaches?

Primary headaches can range in severity quite a bit. Sometimes they may be a light ache from some muscle tension, but other times they’re severe and throbbing. If a severe headache wakes you up at night, it can be very disconcerting, while a light headache will cause much less worry.

Migraines

These headaches cause severe pain that’s throbbing and pulsating, usually on one side of the head and often around the eyes.

Other than being very intense, migraines are well known for causing several other symptoms, including:

  • Nausea
  • Vomiting
  • Extreme sensitivity to light and sound
  • Visual distortions and disturbances

Often when someone is getting a migraine, they know in advance because the headache tends to follow a pattern:

  • Prodrome: A day or two before the migraine starts, you might experience symptoms that include constipation, mood changes, food cravings, and neck stiffness.
  • Aura: This period is marked by visual disturbances right before or during the migraine. Usually, these include vision loss, seeing flashes of light, or static-like distortions.
  • Attack: This is when the pain of the headache arrives. It may start in a general area and then settle in a particular part of the head.
  • Post-drome: You may feel tired and nauseous or happy and euphoric because the pain is finally gone.

Migraine headaches can last for a few hours or several days, but they are generally debilitating and hard to cope with. They can affect children, teenagers, and adults but tend to affect women more than men and are generally more common during times of hormonal change.

If you suffer from these headaches, it’s helpful to try and identify the migraine triggers that bring them on and then make changes based on the triggers. These can include your sleep schedule, diet, and when/how you exercise.

Triggers can be difficult to narrow down because of the wide range of factors that could contribute to a headache developing, so if you have migraines, it’s also helpful to have some treatments on hand.

Tension Headaches

These are the most common form of headache, but they can be hard to distinguish from a migraine because, at times, they can become very severe. However, you can’t have a tension headache and migraine at the same time. Unlike migraines, tension headaches aren’t accompanied by visual disturbances, nausea, or vomiting.

Tension headaches are often described as a tight band around the head and usually feel like a dull ache, not a sharp pain. Tension headaches also cause pain in the shoulders and neck, and rubbing the muscles typically helps the headache feel slightly better.

There are two main types of tension headaches:

  • Episodic: These are short “episodes” of headaches, usually as brief as 30 minutes and as long as a few days.
  • Chronic: These can last for hours and may continue for long periods of time. If you get a tension headache for 15 or more days a month for a minimum of three months, then you’re likely experiencing chronic tension headaches.

Tension headaches are physical, so physical therapy, relaxation techniques, lessening stress and anxiety, and pain medications can be helpful in alleviating pain.

Cluster Headaches

Cluster headaches are often considered one of the most intense and painful, and they can cause you to wake up at night. They’re called clusters because they tend to come in cyclical, "clustered " patterns. They are known for affecting the eyes, usually on one side, and causing redness, sinus pressure, tearing, and swelling or drooping eyelids.

Cluster headaches can last for a few weeks to as long as a few months, followed by a period of remission which can last for months or years. Because of how debilitating they can be, other treatments don’t always work with cluster headaches.

Inhaling pure oxygen is one of the main ways to improve cluster headache symptoms quickly, but steroid medication may also be prescribed.

Hypnic Headaches

A rare headache disorder, hypnic headaches generally occur between the ages of 40 to 80. They only happen at night, usually around the same time (between 1 a.m. and 3 a.m.), so they are often called the “alarm clock headache.”

Hypnic headaches usually last about 15 to 60 minutes, and unlike a migraine headache, if you’re experiencing a hypnic headache, you’ll probably want to get up, eat something, and move around instead of lying down in a quiet, dark room.

Hypnic headaches usually hurt all over the head, and not in just one place, and they can go on for years without any remission. Though it might seem counterintuitive, one of the main treatments is drinking a cup of coffee before bedtime. Lithium, a mood stabilizer, may be prescribed by a doctor as well.

What Causes Primary Headaches at Night?

Headaches at Night: Common Causes and Factors

While the exact cause of a primary headache is not always known, certain lifestyle habits seem to trigger or exacerbate them. Some of these include:

  • Alcohol: Drinking too much alcohol can trigger headaches, or in the case of cluster headaches, they can make the pain much worse. Especially if you’re drinking alcohol in the evening, this could be a main contributing factor to your nighttime headaches.
  • Heavily processed diet: Because migraines often involve triggers involving food, a diet that’s overly heavy on processed foods can provide more opportunities for those triggers to start a migraine. If your dinnertime meals tend to rely heavily on processed foods, this could lend itself to a nighttime headache.
  • Poor sleeping habits: A lack of sleep is an extremely common cause of tension headaches, but may also make other types of headaches worse.
  • Bad posture: Sitting at a desk all day with a bent neck and a crooked back puts pressure on the vertebrae in the back, which connects to the head. Poor posture can also cause neck and shoulder tension, and by the end of the day, you could end up with a headache.

What Are the Different Types of Secondary Headaches?

Because the causes of secondary headaches aren’t limited to the head, there’s a long list of potential causes. Some of these include:

  • Sinusitis (nasal and sinus infection)
  • Overusing pain medication
  • Brain tumors
  • Concussion
  • Dehydration
  • Sleep disorders
  • Ear infection
  • High blood pressure

If you’re dealing with an issue that isn’t directly related to the head but is causing a headache, it might affect you more at night, depending on the root cause. Whether it’s a medication, a virus, a bacterial infection, or an injury, it’s always possible for an external cause to bring on a secondary headache.

Because there are many possible causes for secondary headaches, if you suspect something serious may be going on, it’s always best to consult a healthcare professional. A neurologist can schedule a CT scan, MRI, or X-ray, and they can then provide you with the best information about what your best treatment options are.

How Can You Prevent Headaches at Night?

As with most medical issues, preventative care is best! Making the necessary lifestyle changes can go a long way in improving your overall quality of life and even how much you’re affected by headaches.

Sleep deprivation can cause headaches by itself, so don’t settle for poor sleep! If headaches keep you up at night, over-the-counter medications or NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen can help if they aren’t too severe. Herbal supplements like melatonin may be helpful as well.

Dealing With Headaches at Night

If you’re trying to find solutions to persistent headaches and have already ruled out anything serious, first try to narrow down if it’s a primary or secondary headache. If it’s a primary headache, try to narrow down what the trigger might be. If it’s a secondary headache, try to address the root issue.

Either way, there are steps you can take to ensure you don’t have to keep sacrificing your sleep to headaches.

Sources:

Types of Headache | Stanford Health Care

Tension Headaches | Johns Hopkins Medicine

Cluster headache - Diagnosis and treatment | Mayo Clinic

Hypnic Headaches: Causes, Symptoms, and Treatment | Sleep Foundation.

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