Headaches in the morning can be one of the earliest warning signs of sleep apnea. Between 10% and 30% of people with untreated obstructive sleep apnea experience headaches after waking up. Sleep apnea headaches are typically frequent, occurring on most days of the week and can last up to several hours.
In this guide, we’ll cover the causes, symptoms, and treatment options for sleep apnea headaches and when it may be time to talk to a doctor.
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What Is a Sleep Apnea Headache?
As the name states, a sleep apnea headache is a type of morning headache that occurs as a result of the interrupted breathing during sleep that occurs with sleep apnea. Because they often occur daily or near-daily, sleep apnea headaches can be one of the most noticeable signs of untreated sleep apnea.
What Does a Sleep Apnea Headache Feel Like?
A sleep apnea headache usually feels like a dull, pressing pain on both sides of the head rather than a throbbing or pulsating sensation. These headaches typically appear shortly after waking and can last anywhere from a few minutes to several hours. Many people describe the pain as a tight band around the head or a heavy, achy feeling that makes it hard to start the day.
Unlike migraines, they don’t usually cause nausea, light sensitivity, or visual disturbances.
What Causes Sleep Apnea Headaches?
Sleep apnea can cause headaches, but doctors don’t fully understand why. It’s believed that headaches are a result of changes in the body caused by the repeated disruptions in breathing that occur during sleep in people with obstructive sleep apnea (OSA).
Nighttime breathing disruptions in people with OSA can trigger several changes that may contribute to morning headaches. When a person’s breathing is disrupted, it decreases the level of oxygen in their blood and increases carbon dioxide. Changes in these blood gasses cause blood vessels to dilate, or widen, and increase pressure within the skull.
Experts believe that poor sleep quality may also contribute to sleep apnea headaches. People with obstructive sleep apnea often wake up multiple times each night to resume breathing. These frequent awakenings decrease the quality of sleep and may trigger or exacerbate headaches and migraines.
What Are the Risk Factors for Sleep Apnea Headaches?
Several factors can increase the likelihood of developing sleep apnea headaches, especially when they contribute to airway obstruction or poor-quality sleep. People with more severe sleep apnea or more frequent breathing interruptions are at higher risk, as are those with underlying health or lifestyle conditions that affect airflow. Common risk factors include:
- Untreated medical conditions, such as hypertension or hypothyroidism
- Moderate to severe obstructive sleep apnea
- Low oxygen levels during sleep
- Obesity or increased neck circumference
- Sleeping on the back, which can worsen airway collapse
- Alcohol or sedative use before bed
- Nasal congestion or chronic sinus issues
- Smoking, which irritates and inflames the airway
How Do You Know if a Headache Is Related to Sleep Apnea?
It can be difficult to tell whether a headache is caused by sleep apnea, but certain patterns can offer important clues. Sleep apnea headaches almost always occur in the morning, shortly after waking, and tend to feel like a dull, pressing pain on both sides of the head. They also occur frequently, often on most days of the week, and may improve or disappear once sleep apnea is treated.
You may also notice other symptoms of sleep apnea, such as:
- Loud snoring
- Gasping or choking during sleep
- Waking up unrefreshed
- Feeling unusually sleepy during the day
Because many factors can cause headaches, a doctor or sleep specialist can help determine whether a sleep study is needed to confirm an underlying sleep disorder.
How Do You Get Rid of Sleep Apnea Headaches?
Sleep apnea headaches may go away once a person receives treatment for obstructive sleep apnea. There are a variety of treatment methods used to reduce the effects of OSA, including positive airway pressure (PAP) therapy, lifestyle changes, oral appliances, and surgery.
If you're concerned that morning headaches may be related to sleep apnea, it’s important to talk with your doctor. A doctor can diagnose obstructive sleep apnea and rule out other potential causes of headaches. In some cases, a doctor may recommend medications to relieve discomfort from headaches.
PAP Therapy
Positive airway pressure (PAP) therapy is the primary treatment used to reduce the signs and symptoms of obstructive sleep apnea. This treatment uses a machine to push filtered, pressurized air that prevents the airway from collapsing or becoming blocked during sleep.
There are several types of PAP machines. Continuous positive airway pressure (CPAP) is a common form of PAP therapy that delivers a steady stream of air each time a person inhales or exhales. Other PAP types deliver alternating or varied air pressures.
Lifestyle Changes
Exercise, changing sleep position, and reducing or avoiding alcohol and sedative medicines are all lifestyle changes that can help reduce the symptoms of OSA. Doctors may also recommend weight loss for people with obesity.
For some people, the symptoms of obstructive sleep apnea get worse when they sleep on their backs. If this is the case, a person can try sleeping on their side instead.
Other Treatments for Obstructive Sleep Apnea
Several other treatments are available for people in whom PAP therapy and lifestyle changes aren’t able to resolve obstructive sleep apnea.
- Oral appliances: Several oral appliances can be worn in the mouth at night that can reduce breathing disruptions during sleep, including mandibular advancement devices and tongue-retaining devices.
- Surgery: Surgery may be recommended for some people with OSA. It often is considered when other treatment options don't work and a person has severe OSA. Surgery may entail removing extra tissue or addressing structures in the mouth and throat that contribute to symptoms.
- Nerve stimulation: Hypoglossal nerve stimulation is a treatment for obstructive sleep apnea in which a device is surgically placed in the body. Upon activation, the device stimulates nerves in the tongue that help to keep the airway open during sleep.
Is Sleep Apnea Associated With Other Types of Headaches?
In addition to sleep apnea headaches, other types of headaches have been studied for potential links to obstructive sleep apnea.
Sleep Apnea and Migraines
Although sleep apnea itself isn't thought to cause migraines, they can be triggered by a lack of sleep. Because sleep disorders like OSA can affect the quality of sleep, untreated OSA could make migraines worse.
In addition to poor quality sleep, other possible triggers for migraines include stress, hormonal changes, bright lights, loud noises, strong smells, sudden changes in temperature or weather, physical activity, and certain foods and medicines.
Sleep Apnea and Tension Headaches
Some studies have found an association between obstructive sleep apnea and tension headaches, while others have not. However, lack of sleep and other physical effects of obstructive sleep apnea could trigger tension headaches.
Stress, anxiety, and depression are common triggers for tension headaches. Head and neck movements, or holding the head and neck in one position for too long, may also trigger tension headaches. Pain from tension headaches may last from 30 minutes to 7 days.
Sleep Apnea and Cluster Headaches
While there appears to be a connection between cluster headaches and obstructive sleep apnea, experts believe that this relation is likely indirect. Cluster headaches commonly occur during sleep and frequently cause a person to wake up.
Cluster headaches can last for 15 minutes or up to 3 hours and can occur every other day or up to 8 times a day. Cluster headaches may be triggered by drinking alcohol, smoking tobacco, high altitudes, bright light, too much physical activity, certain medicines, certain foods, and heat, among other things.
When to See a Doctor
You should consider seeing a doctor if you experience frequent morning headaches, especially if they occur most days of the week or are accompanied by symptoms such as loud snoring, pauses in breathing during sleep, morning grogginess, or excessive daytime sleepiness. These signs may indicate obstructive sleep apnea or another sleep-related breathing disorder.
It’s also important to seek medical attention if your headaches worsen over time, don’t improve with lifestyle changes, or interfere with your daily activities. A healthcare provider can evaluate your symptoms, rule out other causes of headaches, and determine whether a sleep study or sleep apnea treatment may help.
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Written by
Martinique Edwards, Staff WriterMartinique writes content focused on sleep health, science, and trends. She graduated from the University of Georgia with a bachelor’s degree in Ecology and master’s degree in Environmental Health and has research experience in environmental microbiology and aquatic science. Martinique loves to view the world through an ecological lens, where everything is interconnected. In her free time, she enjoys outdoor activities such as running and parkour.
Reviewed by
Howard Hoffman, DDS, Medical ReviewerDr. Howard J Hoffman was born and grew up in New York. After attending the Ohio State University -B.S. 1970, he attended The University of Maryland School of Dentistry, earning his DDS degree in 1974. Dr. Hoffman served 2 years in the U.S. Public Health Service in Guam from 1974-1976. Upon returning to the continental U.S., he opened a private dental practice and began his studies in Implant Dentistry in the mid-90s, including two 18-month programs, first with the American Academy of Implant Dentistry, followed by a second at Harvard University.
