Six o’clock already and you were just in the middle of a dream.
But as that annoying alarm jars you awake and you rub the sleep from your eyes, you feel something a little more than just a case of the Mondays.
It may start out as a dull pain, but you quickly realize it’s a migraine. Instead of springing out of bed and tackling the day, you struggle to focus on your morning routine.
If waking up with a migraine is a common occurrence for you, it can be frustrating to begin the day at a disadvantage.
And while it can be hard to pinpoint what brought on your migraines, common triggers may include sleep issues, dehydration, overuse of pain medication, and depression and anxiety.
Headache specialist Zubair Ahmed, MD, explains why you may wake up with a migraine and what you can do to get a good night’s sleep and enjoy a peaceful morning.
What is a migraine?
It can be easy to confuse a migraine with just a mild headache, but a migraine is a neurological disease that’s associated with symptoms like:
- Moderate to severe headache.
- Pounding or throbbing pain.
- Sensitivity to light, noise and odors.
- Nausea and vomiting.
- Upset stomach and abdominal pain.
- Dizziness and blurred vision.
Migraines affect about 12% of the U.S. population, with most migraines lasting at least four hours. And if you get migraines at least 15 days per month, you have chronic migraines.
“A migraine is moderate to severe in its intensity,” says Dr. Ahmed. “It affects your ability to do things and reduces your activity level.”
The American Migraine Foundation says that migraines typically happen in the early morning.
What causes you to wake up with a migraine?
Migraines can be disabling, causing you to miss work and not be present in your everyday life. Dr. Ahmed outlines what may possibly trigger a morning migraine.
Having sleep issues
“Sleep plays several important functions that are important for us to be able to function normally during the day,” notes Dr. Ahmed. “For example, we’re learning that during sleep, we get rid of metabolic waste that can build up in the brain. We believe that if processes such as these are hindered, it can result in headaches.”
Not drinking enough water
Hydration plays a key role in staving off migraines. Dr. Ahmed cites a study that looked at people who came to the ER with migraines.
“This study found that if you give patients IV fluids, many will have their headaches improve, indicating that perhaps there’s an element of not being hydrated.”
Overusing over-the-counter pain medication
“If somebody is using Excedrin® or Tylenol® every single day, it actually puts them at risk for developing something called a medication overuse headache,” says Dr. Ahmed.
You may turn to aspirin, acetaminophen or ibuprofen to help relieve your migraine pain. And while that may help in the short term, it can cause a vicious cycle of headaches.
Eating certain foods
If you deal with migraines, you may already know that certain foods like aged cheese, red wine and chocolate may trigger a migraine. Those foods either contain nitrates or monosodium glutamate (MSG), which are known to cause migraines.
“The key thing to keep in mind is that it’s not the same foods for everybody,” says Dr. Ahmed. “So, it requires patience, keeping a food diary and systematically going through your diet to identify if there’s something that might be associated with headaches.”
Drinking too much caffeine
We’re not saying you can’t have a cup of joe, but you want to limit how much caffeine you have each day. When you drink a lot of coffee one day, and then don’t have that same amount the next day, you may develop a migraine thanks to the abrupt drop in caffeine levels in your bloodstream.
So, what should you aim for? Anywhere between 100 milligrams and 150 milligrams — about a cup of coffee — a day. And that amount can actually help with migraines due to caffeine’s ability to restrict blood flow and alleviate pain. More than 400 milligrams of caffeine can put you at higher risk of developing migraine.
Having depression or anxiety
“Depression, anxiety and migraine go hand in hand. We know that patients who have migraines are at higher risk of depression and anxiety and vice versa,” explains Dr. Ahmed. “We think this may have to do with the regulation of certain neurotransmitters associated with migraine and depression like serotonin. In fact, some antidepressants have been shown to be effective in reducing the frequency and severity of migraine.”
Being around bright lights, strong smells and loud noises
Certain stimuli like bright lights, strong smells (for example, smoke or scented candles) and loud noises can trigger a migraine in some people.
And why does this happen to cause migraine? Dr. Ahmed says it’s unknown why certain stimuli can trigger a migraine.
Changes in barometric pressure
Yes, the weather can affect your migraines. A fall in barometric pressure or a sharp rise in temperature can trigger a migraine. The change in pressure affects your nasal and sinus cavities by forcing fluids into your tissues.
There’s also a theory that a significant barometric pressure change may change the amount of pressure on your brain and affects how your brain blocks pain.
Changes to your hormones
Endorphins aid in relieving pain, stress and improving your mood. During the early morning hours, typically between 4 a.m. and 8 a.m., your body produces less of the hormone. At the same time, your body makes more epinephrine, which may cause migraines.
And when your estrogen changes — think during your period, a pregnancy or during menopause — you may experience more migraines.
Treatment options for morning migraines
While there isn’t a cure for migraines, there are many things you can do to manage the disease, from using over-the-counter medication (but according to directions), like Excedrin® Migraine, Advil® Migraine and Motrin® Migraine Pain, to avoiding any triggers.
Prescription medication includes:
- Calcium channel blockers.
- Calcitonin gene-related (CGRP) monoclonal antibodies.
- Antiseizure drugs.
Certain vitamin supplements like riboflavin, magnesium, feverfew, butterbur and coenzyme Q10 may also help, but it’s best to discuss taking or adding any of these to your routine or diet with your healthcare provider beforehand.
“There isn’t a one-size-fits-all approach to treating migraines,” states Dr. Ahmed. “That’s why it’s important to see a headache specialist. They can make sure that any treatment plan is tailored for you. The landscape for treatment is relatively wide from oral medications to once-a-month injections to infusions. It really depends on the person, the severity of their migraines and their lifestyle.”
How to prevent waking up with a migraine
Dr. Ahmed offers up the following tips that may help prevent a migraine:
- Be consistent. Having a daily routine — waking up at the same time, eating meals at the same time, exercising at the same time, going to bed at the same time — can help keep migraines at bay.
- Focus on your meals. In addition to making sure you’re drinking enough water throughout the day, you want to pay attention to what you’re eating and avoid foods that are known triggers for migraines.
- Get moving. Any moderate exercise — think walking, biking, swimming for about 30 minutes — has been shown to reduce the frequency and severity of migraines in some individuals. Activities like yoga and meditation can also help.
When to seek help
Dr. Ahmed says it’s best to see a healthcare provider ASAP if you think you have migraines.
“Migraines are definitely under-diagnosed and there’s also a stigma around them,” he says. “One study found that migraines are the most disabling condition in people under the age of 50. A lot of people just consider it a ‘regular headache.’ But we’re now learning it’s so much more than that.”
And if you have frequent headaches that disrupt your daily life, getting checked out by a healthcare provider can help you make the necessary lifestyle changes.
“There are ways to help reduce the effect migraines have on your quality of life, particularly with your ability to work,” reassures Dr. Ahmed.
“We want to make sure that we address migraines early on and identify things that can be helpful. It might just require some simple lifestyle changes or it might require some medication. But your doctor will be there to figure it out with you.”