Waking up with a throbbing head isn’t just an unfortunate start to the day—it may be a crucial clue pointing to something far more disruptive: sleep apnoea. Known for its hallmark symptoms of loud snoring and interrupted breathing, obstructive sleep apnoea (OSA) also has a less obvious, but highly impactful consequence—headaches.
What Is a Sleep Apnoea Headache?
A sleep apnoea morning headache is typically defined as a dull, bilateral pain felt upon waking. Unlike migraines or tension headaches, these morning episodes tend to resolve within a few hours. The International Classification of Headache Disorders recognises this condition as a distinct entity linked specifically to sleep-disordered breathing.
These headaches stem from the repeated episodes of airway collapse during sleep, characteristic of OSA, leading to oxygen desaturation and fluctuations in carbon dioxide levels—a recipe for vascular changes in the brain that may trigger pain.
What Does a Sleep Apnoea Headache Feel Like?
Most people describe sleep apnoea headaches as:
- Bilateral: Occurring on both sides of the head
- Pressing or tightening in nature, rather than pulsing
- Moderate in intensity
- Typically lasting less than four hours
- Often not accompanied by nausea, photophobia, or aura, differentiating it from migraines
The distinguishing feature? Their consistent appearance in the morning, often several times a week, especially in untreated OSA patients.
Can Lack of Oxygen While Sleeping Cause Headaches?
Yes. Intermittent hypoxia—a recurring reduction in blood oxygen levels—during apneic events is a prime trigger for morning headaches. When the brain receives inadequate oxygen, blood vessels may dilate to compensate, increasing intracranial pressure. Simultaneously, elevated carbon dioxide (hypercapnia) intensifies vasodilation. These mechanisms together lead to the classic symptoms of a sleep apnoea headache.
Risk Factors for Sleep apnoea Headaches
While anyone with OSA can develop these headaches, some are more at risk. Factors include:
- Severe obstructive sleep apnoea (AHI > 30)
- Male gender and middle-aged to older adults
- Untreated or poorly managed OSA
- Obesity
- Coexisting hypertension or cardiovascular disease
- Poor sleep hygiene and alcohol or sedative use before bed
Importantly, studies suggest that successful treatment of sleep apnoea—especially with CPAP or mandibular advancement splints—can significantly reduce or eliminate these headaches altogether.
Types of Headaches Associated with Sleep Apnoea
While sleep apnoea headaches are distinct, OSA can exacerbate or be confused with other headache types:
- Tension-type headaches: Often stress-related, these can coexist with OSA and intensify due to fragmented sleep.
- Migraines: Though pathophysiologically different, poor sleep quality from OSA may increase migraine frequency or severity.
- Cluster headaches: Rare but noteworthy, some evidence suggests REM-related apnoea can trigger cluster headache episodes.
- Hypnic headaches: Also known as “alarm clock headaches,” these occur during sleep and may intersect with the arousal patterns of OSA.
The Role of Bruxism and Jaw Tension
Many people with sleep apnoea also experience sleep bruxism—the involuntary grinding or clenching of teeth. This can lead to temporomandibular joint (TMJ) strain and tension-type headaches, further muddying the diagnostic waters.
A Wake-Up Call Worth Heeding
Sleep apnoea is more than a nighttime nuisance—it’s a full-body burden, with morning headaches serving as a subtle but powerful signal. If you frequently wake up with head pain, especially alongside symptoms like loud snoring, daytime fatigue, or restless sleep, it’s time to investigate the root cause.
At Optima Sleep, we specialise in identifying and treating sleep apnoea with evidence-based, personalised dental solutions—helping you reclaim restful nights and pain-free mornings.