At a Glance
Sleep apnea headaches are a type of morning headache that can occur when repeated breathing interruptions disrupt sleep and trigger changes in blood gases, blood flow, and pressure in the head. They're usually described as a dull, pressing pain on both sides of the head, often appear upon waking, and may improve once sleep apnea is properly treated.
Morning headaches can be one of the earliest warning signs of sleep apnea. Between 10% and 30% of people with untreated obstructive sleep apnea (OSA) 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.
Why Does Sleep Apnea Cause 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 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. Based on the results of the sleep study, medical professionals rate the severity of a person’s sleep apnea based on the apnea-hypopnea index (AHI), the average number of breathing interruptions that occur per hour of sleep.
A person must have an AHI of 5 or higher to be diagnosed with a sleep apnea headache and often a doctor can see a clear association between the headache and the sleep apnea. For example, the headaches have worsened as the sleep apnea has worsened or the headaches have greatly improved or resolved with sleep apnea treatment.
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 for obstructive sleep apnea. This treatment uses a machine to push filtered, pressurized air that prevents the airway from collapsing or becoming blocked during sleep. Studies have found that up to 90% of sleep apnea headaches resolve with CPAP treatment.
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.
Oral Appliances
Oral appliances may be a treatment option if you're unable to tolerate CPAP therapy. These dental devices keep the airway open during sleep by repositioning your jaw or tongue. Oral appliances are available over-the-counter but most sleep specialists recommend you have them custom fitted to ensure they are comfortable and effective.
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.
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.
Surgery
In rare cases, surgery may be a treatment option for sleep apnea. Surgery is often only considered for adults who have tried other treatment options and weren't successful. The type of surgery depends on several factors but may include removing extra tissue in the throat or removing the tonsils.
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.
Frequently Asked Questions
Yes, obstructive sleep apnea can cause morning headaches due to repeated breathing disruptions during sleep. Poor sleep quality, frequent awakenings, and increased pressure inside the head during apnea events may also contribute to headaches.
Sleep apnea doesn't directly cause migraines, but it may increase the likelihood or frequency of migraine attacks in people who are already susceptible. Disrupted sleep, nighttime drops in oxygen, and changes in blood flow can all act as triggers for migraine in some individuals.
Snoring itself doesn't usually cause headaches. However, loud or frequent snoring can be a sign of obstructive sleep apnea, which is associated with morning headaches, as repeated breathing disruptions can affect oxygen and carbon dioxide levels during sleep.
CPAP doesn't commonly cause headaches, but some people may notice them when first starting therapy. Possible reasons include mask pressure (over-tightening straps or headgear), sinus or nasal irritation, air leaks, or settings that need adjustment. If headaches are new, persistent, or getting worse after starting CPAP, talk with your doctor.
Medical Disclaimer: This content is for informational purposes only and isn't a substitute for professional medical advice. Consult your healthcare provider with questions about any symptoms you're experiencing or before changing or stopping an existing treatment.
Written by
Martinique Edwards, Contributing 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 J. Hoffman, DDS, Medical ReviewerDr. Howard J. Hoffman is a dentist specializing in dental sleep medicine and the treatment of obstructive sleep apnea and temporomandibular joint (TMJ) disorders. With more than four decades of experience in dentistry and over 25 years focused on sleep apnea treatment, he works with physicians and sleep specialists to help patients manage sleep-disordered breathing using oral appliance therapy.
