Night headaches - causes and treatment

Headaches are a common complaint, but their occurrence at certain times of the day has specific features and causes. If night headaches wake a person around midnight, then we are talking about rare cases of disorders. Migraines most often interfere with falling asleep, complicate waking up in the morning, and sometimes continue even during the day, forming a vicious circle of triggers. Every fifth person is susceptible to this disease.

Stress is the main source of the problem. Tension headaches, which account for 80% of all cases, usually occur in the evening after a busy day at work. More rare hypnic headaches appear only at night, but regularly.

A third of the adult population does not get enough sleep at night, but the reason for this is not cephalgia. Migraines can make it difficult to fall asleep due to nausea, dizziness, and vomiting. But the problem is that lack of sleep is a major factor in pain. Approximately every seventh person out of ten suffering from cephalgia is diagnosed with lack of sleep.

A study found that people who regularly sleep less than 6 hours experience more frequent and severe migraines than those who get more rest.

Why do night headaches occur?

If you experience headaches at night, it may be due to a mental or physical disorder.
While a one-time episode can be treated with pain medication, regular headaches are a serious reason to visit a doctor.

There are many reasons for the development of pain syndrome, here are the main ones:

1. Excessive overload and severe emotional fatigue.
2. Overexertion, migraine.
3. Blood pressure surges.
4. Side effect of the drug being taken.
5. Cluster disease and cervical osteochondrosis.
6. Regular consumption of alcohol, caffeine and smoking.
7. Depression, depressed state.
8. Uncomfortable sleeping place, posture.

Pain during sleep is a signal of impaired blood supply and metabolic processes in the brain. Since the brain does not have reserves of nutrients, but receives them through delivery through blood vessels, it instantly reacts to a lack of glucose, oxygen and other necessary substances.

The cause will be diabetes mellitus, since it is accompanied by metabolic disorders of several systems at once. Headaches are common in diabetes.

A sudden attack of headache at night in older people will be a signal of a possible stroke or heart attack.

Spasms in the head are complemented by unpleasant pressing sensations in the chest and numbness in the left arm. If you have such symptoms, you should urgently call an ambulance.

The main causes of night attacks

Nighttime headaches that occur at the same time indicate disruptions in circadian rhythms, or sleep-wake patterns, as Dr. E. Kerr wrote in May 2006 in the Ulster Medical Journal. Hypnic headaches often occur during REM sleep, during which people dream. A decrease in the level of the hormone melatonin, which affects sleep, is observed with age and causes a tendency to have attacks.

If your head starts to hurt two to three hours after sleep, then we are talking about a cluster headache - acute, burning, persistent, affecting one side of the head or one eye, the face from the temple to the neck. Accompanied by lacrimation, nasal congestion, swelling of the eyelids. Reaches a peak after 15 minutes and lasts from 30 minutes to two hours. The attacks occur regularly over several months. Scientists believe that the rapid release of serotonin or histamine may trigger a condition that causes headaches at night. Triggering factors include heat, bright light, alcohol consumption, and smoking.

The study found a link between cluster pain and sleep apnea, as well as enuresis and nightmares in childhood. During apnea, there is an episodic decrease in oxygen in the brain throughout the night, which provokes seizures.

Brain tumors increase pressure on tissues, which causes irritation of pain receptors. Over time, the attacks become more frequent and become constant. The condition worsens when lying down, often preventing sleep at night. Pain associated with brain tumors is necessarily accompanied by other symptoms: changes in personality and behavior, loss of balance and coordination, convulsions, dizziness, nausea, vomiting, visual disturbances and drowsiness.

Exploding head syndrome is a rare disorder that disrupts the sleep of people who hear a loud explosive sound without pain. This syndrome is actually a sleep disorder and is treated with the drug clomipramine.

Sleep apnea, or short-term breathing disturbances, causes decreased oxygen levels and transient hypertension, which can trigger morning headaches. They are usually concentrated in the frontal areas, but can be diffuse and without clear localization. The risk of developing sleep apnea increases in overweight people and smokers.

Cluster headaches and migraines are the most common and most often occur during sleep. Treatment depends on the frequency and attacks and involves taking medications.

Why does my head hurt at night but goes away in the morning?

Often headaches go away by morning. This is due to the fact that the brain still manages to rest and relieve stress. Unpleasant sensations may disappear after waking up due to the fact that the person enters the active phase and the brain is more saturated with oxygen.

If the next morning the discomfort goes away only after breakfast, you need to reconsider your diet and add a vitamin complex to it; during sleep, the brain does not have enough substances to produce the hormone of sleep and awakening.

Associated signs of diseases and pathologies

If your headache is accompanied by dizziness or nausea, you should consult a doctor.

When overtired, headaches in a lying position quickly go away after rest, a short vacation and an established sleep schedule. They do not require the help of a doctor and can be easily eliminated with sedatives and herbal teas with a sedative effect.

Doctor's help is necessary if the pain is accompanied by the following symptoms:

• nausea, vomiting;
• pressing sensations from walls and ceiling;
• pulsation increases when bending forward, radiates to the back of the head or frontal lobes;
• increased irritability;
• anxiety for no reason;
• white spots or dots before the eyes.

The reason for a visit to a therapist should be a feeling of intoxication, which complements a throbbing or aching headache. This indicates an imbalance in the functioning of internal organs, pathologies of the heart or brain.

How to eliminate pain

If pain syndrome is caused by increased blood pressure surges, you need to take medications to return it to normal. Osteochondrosis is treated by an orthopedist using preventive physical activity and massage. You need to fight depression by taking antidepressants, they have a hypnotic effect, but for this you need to consult a psychotherapist.

To reduce the risk of unpleasant pain during sleep, follow the rules:

1. You should check your room 20 minutes before bedtime, even if it’s cold outside.
2. An hour before rest, you need to stop watching TV, using a smartphone, and reading e-books.
3. Dinner 2-3 hours before bedtime should be light.
4. You should not drink alcohol or coffee 4-5 hours before bedtime.
5. Sleep at least 7 hours a day, without oversleeping, and avoid naps during the day.
6. Before resting, you need a walk in the fresh air.
7. Sleep in a comfortable position.

You need to adjust your diet and try to give up bad habits. Diseases of the cardiovascular system and spine should be treated under the supervision of a doctor, following his recommendations.

Cramps in the head are a signal to think about your health. After identifying the cause of the discomfort, treatment must begin; the onset of pain syndrome has a bad effect on the quality of life.

Which doctor should I contact?

Often, after physical exertion or mental stress, people feel worse. The nature of the pain can be varied. Compressive, pressing, throbbing pain in one side of the head is possible.

Pain during exercise is often functional in nature. They can occur for many reasons:

• Changes in temperature and atmospheric pressure;
• Stressful state during physical activity;
• Heat and stuffiness in the room;
• Dehydration is often the cause of headaches;
• Eat a large meal before training;
• Overweight people often suffer from hypoxia during exercise.

The likelihood of illness is higher in people with specialties: programmer, accountant, driver, who spend many hours at the computer or constantly strain the muscles of the eyes and neck.

Persistent cephalgia, which occurs regularly, requires mandatory consultation with a doctor in order to exclude serious pathology and prescribe the correct treatment in a timely manner.

The initial appointment should be made by a therapist. He will conduct a general examination, measure blood pressure, write out directions for tests and refer you to specialists.

If you have unpleasant sensations in the head and neck area, it is good to have a home blood pressure monitor, with which you can track pressure surges in different life situations. A rise in blood pressure after physical activity can often be the cause of pain.

The doctor gives a referral to an otolaryngologist to rule out chronic otitis media, sinusitis or inflammation of the maxillary sinuses (sinusitis).

The doctor can give a referral to an ophthalmologist to identify changes in the fundus and possible vision defects.

Most of the causes of discomfort in the head are associated with neurological symptoms, so diseases accompanied by head pain syndrome are treated by a neurologist.

Reasons why your head hurts after sleep

Feeling unwell after a night's rest affects not only a person's mood, but also the efficiency of work. Depressive feelings, increased irritability, and unstable emotional state affect relationships with others and the correctness of professional tasks performed. Along with relatively simple, non-pathological causes of pain, which can be corrected by lifestyle changes, the appearance of an uncomfortable symptom can be influenced by serious illnesses that require urgent medical attention.

What tests are usually prescribed?

At an appointment with a neurologist, a physical examination of the patient is performed: basic neurological reflexes are checked and the neck muscles are examined.

The doctor writes out a referral for tests: general blood test, biochemical blood test, blood sugar test.

A general blood test with an increase in ESR or an increased content of leukocytes indicates inflammation in the body.

Blood biochemistry may indicate a deficiency of one of the vital elements, which leads to discomfort in the head area.

Low blood glucose levels are often accompanied by cephalgia, dizziness and weakness.

The doctor may write a referral for additional tests:

1. The gas composition of arterial blood can reveal cerebral hypoxia.
2. A blood test for hormones determines various abnormalities in the functioning of the hypothalamus.

A neurologist can give a referral to one or more diagnostic methods:

1. Magnetic resonance imaging (MRI) - excludes the presence of various neoplasms (tumors and cysts), aneurysms. The photographs clearly show post-traumatic defects, neurodegenerative abnormalities, and changes in blood vessels affected by atherosclerosis.
2. Computed tomography (CT) is the most informative method for studying the brain. It gives a clear idea of ​​pathological changes in the skull and brain, pathology of bone tissue, blood vessels and brain structures. Provides information about the consequences of traumatic brain injuries. The disadvantage of this method is the significant radiation dose during the study.
3. Electroencephalography gives an idea of ​​the presence of pathological changes in blood vessels and impaired cerebral circulation.
4. Doppler ultrasound (ultrasound of the vessels of the head and neck) - shows the presence of atherosclerotic plaques in the arteries; narrowing and tortuosity of the arteries, leading to brain hypoxia; peripheral vascular resistance.
5. Rheoencephalography (REG) - gives an idea of ​​the tone and blood flow of blood vessels. Using REG, the following are diagnosed: hypertension, atherosclerosis, vegetative-vascular dystonia.
6. MRI of the cervical spine - the presence of cervical osteochondrosis can cause pain in the head and neck, which intensifies when turning the head.
7. Rheovasography of cerebral vessels (RVG) - shows the quality of blood flow through the great vessels, evaluates collateral circulation.
8. Radiography will be less known. In the image you can only see the bone structures of the skull, soft tissues are not visible.

There is no need to panic when scheduling such a serious examination. The doctor excludes rare severe pathologies and looks for the causes of the pain process.

Based on the studies, if no serious organic lesions are found, the cause of the disease is usually diagnosed. It develops as a result of: vascular spasms, cerebral hypoxia, hypertonicity of cerebral vessels, hormonal imbalances, vegetative-vascular dystonia or osteochondrosis, provoked by physical or psycho-emotional stress.

Osteochondrosis

Osteochondrosis is a pressing disease for many residents of modern cities, especially for mental workers. A sedentary lifestyle leads to the development of degenerative-dystrophic processes in the muscular-articular apparatus of the spine. As a result, there is compression of the main vessels and nerves that pass inside the spine to the brain. Since a person lies practically motionless during sleep, the compression increases and an alarm signal arises in the human body - a night headache.

Directly this symptom of osteochondrosis can be eliminated with any painkiller (analgin, tempalgin). However, to completely eliminate this cause of nighttime headache, consultation with a neurologist and complex treatment of osteochondrosis (chondroprotectors, manual therapy, physiotherapy) are necessary.

Groups of drugs effective for episodic attacks of pain

Medicines for the treatment of pathology are non-steroidal anti-inflammatory drugs (NSAIDs). They have an analgesic effect, relieve inflammation, and eliminate swelling.

Often prescribed:

• Ibuprofen-400 mg per day;
• Ketoprofen-100 mg/s;
• Naproxen-500 mg/s;
• Meloxicam-7.5-15 mg/s;
• Celecoxib-200 mg/s.

Most NSAIDs have a negative side effect: with long-term use, they negatively affect the organs of the gastrointestinal tract, including the development of drug-induced gastritis.

Medicines Meloxicam and Celecoxib are new generation drugs that do not have a negative effect on the gastrointestinal tract. The disadvantages of using these drugs include the relatively high price.

Analgesics are often used at home to relieve an attack. They do not treat the disease, but only relieve pain. Drugs in this group are suitable for stopping episodic attacks, but their systematic use leads to the occurrence of abuse syndrome.

During an attack of pain, you can take Paracetamol-100 mg, Citramon, Analgin-500 mg or Mig 200-400 mg.

If the examination revealed the appearance of cephalgia after exercise as a result of increased blood pressure, the doctor will prescribe medications prescribed at an early stage of the development of hypertension. These include: vasodilators, ACE inhibitors, diuretics, calcium channel blockers.

Self-prescribing antihypertensive drugs is unacceptable. Self-medication leads to serious consequences.

For muscle tension, drugs from the group of muscle relaxants are used as part of complex treatment. They relax the spasmodic muscles of the head and neck, relieving pain of a spastic nature, and help restore blood flow.

Often prescribed:

• Mydocalm-150-450 mg per day;
• Sirdalud (Tizanidine) - 4 mg/s;
• Baclofen-15 mg/s.

Nootropic drugs are often prescribed as part of complex treatment: Phenibut, Nootropil, Glycine. Nootropics have an activating effect on brain function and increase its resistance to damaging factors. The drugs improve cerebral circulation and eliminate the consequences of traumatic brain injuries.

Sedatives in combination with basic drugs lead to muscle relaxation and decreased vascular tone. Taking tranquilizers helps relieve pain, but this type of medication quickly causes drug dependence with withdrawal symptoms.

Sedatives that are not addictive: Afobazol, Atarax; alcohol tinctures of valerian, motherwort, Maryina root.

For severe attacks, a combination of drugs is used: Sirdalud 2 mg + Aspirin 500 mg or Analgin 250 mg + sedative.

The use of vitamin B complexes has proven itself. Vitamins B1, B6, B12 have a beneficial effect on the central nervous system and restore the structure of nerve tissue. Vitamin complexes are often prescribed: Neuromultivit, Milgamma, Neurovitan.

If attacks of pain recur more than 10 times a month, a course of treatment with Ibuprofen at a dose of 400 mg per day for 2-3 weeks and treatment with muscle relaxants is prescribed for 2-4 weeks.

There is no single scheme for pain relief. Depending on the cause, each patient needs an individual selection of drugs.

Treatment of morning headaches

The treatment regimen is selected individually and depends on the clinical picture, the exact diagnosis, the patient’s age and other factors. It will include several stages aimed at eliminating the root cause of morning headaches and relieving symptoms.

1. Drug therapy is prescribed for pain of any origin. The regimen may include the use of painkillers and anti-inflammatory drugs, muscle relaxants, and antispasmodics. For hypertension, diuretics and drugs to correct vascular tone are additionally prescribed. Infectious diseases often require the use of antibiotics to kill pathogenic bacteria.
2. Massage, physiotherapy, therapeutic exercises are a complex effective for the treatment of diseases of the cervical spine, inflammatory diseases of the nerves and blood vessels. They help improve blood circulation in the neck and head, relieve muscle spasms, and restore nerve conduction.
3. Surgical intervention is used only in cases where drug treatment does not bring results. Surgery may be required to treat purulent sinusitis, remove tumors and hematomas in the neck and head.

Most patients who experience frequent morning headaches are treated at home. It is important to take medications on the schedule prescribed by your doctor, as well as follow additional instructions. If necessary, the Clinical Institute of the Brain has the opportunity to undergo treatment in a hospital setting, under 24-hour medical supervision.

Treatment of chronic disease

Sometimes cephalalgia becomes chronic. The pain occurs every day, continuously, with varying degrees of intensity.

Tricyclic antidepressants are prescribed for a long course of 2-6 months. They relieve pain and help normalize the psycho-vegetative state of the nervous system.

Amitriptyline 10-100 mg/s is most often prescribed, the dose is increased gradually. The drug relieves pain well, but has many negative side effects and is addictive.

As an alternative, selective serotonin reuptake inhibitors are prescribed: Fluoxetine, Paroxetine, Sertraline. The course of treatment is at least 2 months. These drugs have less toxicity.

In addition to prescribing drug therapy, the doctor will recommend massage, a course of physiotherapy or acupuncture.

Cephalgia during a stroke

A stroke attack is accompanied by a severe headache. A stroke is an acute circulatory disorder in the brain, the causes of which are atherosclerosis, hypertension or abnormalities of organ development.

One of the main signs of a stroke is severe cephalgia, which not only accompanies the attack, but also persists for a long time after it. Why do you have a headache after a stroke? This is due to nerve damage and inflammation in the brain. To alleviate the patient's condition, analgesics and non-steroidal anti-inflammatory drugs are used:

• Pentalgin;
• Ketorol;
• Aspirin;
• Paracetamol.

Complications of various types of headaches

Headaches are:

• Primary
• Secondary.

Complications of primary headache

In particular, she has no complications. It includes hemicrania, tension-type headache, PHB, trigeminal autonomic cephalgia.

Migraine is a one-sided, throbbing pain that occurs due to bright light, noise, fatigue, eating foods such as chocolate, spices, cheese and wine. The disease is based on irritation of the nervous system of the head and neck, after which the blood joints narrow and sharply expand. Main complications of migraine:

1. Status migraine is a severe attack. The disease causes swelling of the brain, seizures, stroke, heart attack,
2. Migraine infarction - a migraine attack with an aura lasting 60 minutes,
3. Migraine-associated seizures,

Complications of secondary headache

It occurs as symptoms of other diseases such as head trauma, cerebral vascular damage, infection, mental illness, damage to homeostasis and others. It disappears when the underlying disease is treated.

Intracranial hypertension

Intracranial hypertension is an increase in intracranial pressure. When pressure increases to 30 mmHg, blood circulation in the brain is disrupted. If it rises above 50 mm Hg, death is possible. A person experiences a pressing headache, nausea (in the morning), fatigue, drowsiness, depression of consciousness and prolonged hiccups. Pathology can cause structural damage.

Intracranial hypertension has serious complications:

1. Cerebral ischemia, resulting from compression of the brain substance,
2. Dislocation – displacement of brain structures,
3. Wedging.

Giant cell arteritis (Horton's disease)

Giant cell (temporal) arteritis is an inflammation of the lining of the red blood joint, which affects the arteries of the temporal region of the head. The causes of the disease have not been fully identified. The disease occurs due to immune disorders. Pathogens enter the body and produce antibodies that cause inflammation.

Complications:

1. Blindness. Vision loss is irreversible. Occurs as a result of impaired blood supply,
2. Stroke. Rarely found
3. Aortic aneurysm. Can happen at any time and lead to internal bleeding.

Meningitis

Meningitis is a lesion of the meninges. Pathogenic microorganisms (viruses, bacteria, protozoa and fungi) cause disease. When sick, patients experience headaches and nausea.

Complications after meningitis:

1. Paralysis,
2. Blindness,
3. Deafness,
4. Ischemic stroke,
5. Intellectual impairment
6. Paresis,
7. Convulsive syndrome,
8. Hydrocephalus,
9. Epilepsy,
10. cerebral edema,
11. SIADH
12. Speech disorders
13. Brain abscess
14. Aneurysm,
15. Transverse myelitis,
16. Sphincter dysfunction.

The chance of death from bacterial meningitis is 10%. The mortality rate for viral meningitis is much lower (only 1%).

Glaucoma

Glaucoma – intraocular pressure (IOP).

The process begins with deterioration of peripheral vision. If left untreated, the nerves of the eye die.

The disease can occur due to old age, farsightedness, diabetes, hereditary predisposition, etc.

Complications:

1. Blindness,
2. Nerve dystrophy.

Sinusitis

Sinusitis is an inflammation of the maxillary sinuses that occurs as a result of complications of rhinitis. Inflammation occurs when viruses and bacteria enter the maxillary sinuses.

Complications:

1. Chronic sinusitis lasting 12 weeks
2. Frontitis - inflammation of the frontal sinus,
3. Meningitis,
4. Osteomyelitis,
5. Hearing and vision problems.

Brain hematoma

A brain hematoma is an injury in which blood enters the skull from the joint. As a result, blood compresses the brain. This condition threatens human life and therefore requires timely treatment. The causes of the disease are arterial hypertension, tumors and injuries.

Intracranial hematoma causes disturbances in the brain. The blood squeezes the brain and oppresses it.

Complications:

1. Deterioration of blood supply and blood outflow,
2. Increased intracranial pressure,
3. Problems with the movement of cerebrospinal fluid,
4. Disorders related to movement and feeling. Appears due to limited signal transmission.

Why does my head hurt when lying down?

Often the cause of headaches when lying down is overwork and stress.

Normal and sound sleep is the basis for excellent well-being during the day. But headaches that begin while lying down can disrupt rest at night, causing chronic insomnia and irritability. The discomfort quickly disappears after getting up, so the person cannot remain calmly in bed.

Normally, the human body works more actively when walking and standing: basic processes are launched, blood flow accelerates, and blood pressure rises. In a horizontal position, metabolism slows down and rest mode starts. At the same time, the load on internal organs, joints and blood vessels is reduced.

If a person has a headache when lying down, it is necessary to exclude ordinary fatigue and stress. They cause disruption in the functioning of the body, lack of sleep, which affects well-being. Otherwise, the help of a neurologist, therapist, endocrinologist or cardiologist is required for a more thorough diagnosis.

Lying down often causes a headache during pregnancy: the growing uterus and fetus compress large arteries, disrupting the blood supply to the woman’s brain. This natural complication may worsen in the last trimester. Does not require treatment. To eliminate the problem, it is recommended to lie down and sleep on your side, using special bolsters and pillows.

Literature

1. L. G. Akhmadullina: Headache
2. D. Marcus: Headache
3. Evgeny Rozner: Headache. Migraine
4. Gyuzal Tabeeva: Headache. Management
5. Alekseev, Alyabyeva, Amirov: Glaucoma. National leadership
6. V. I. Morozov, A. A. Podshivalin, G. E. Chigvintsev, G. A. Yulmetov: Natal damage to visceral organs
7. V.N. Shtok: Headache. Practical guide
8. A. I. Ermolaeva, G. A. Baranova: Headache
9. A. M. Satybaldyev: Giant cell arteritis. Part 1. Terminology, classification, clinical manifestation, diagnosis
10. Kolosova O. A., Osipova V. V.: Classification of headaches

Diabetes

Why do people with diabetes have headaches at night? The presence of such a disease requires strict adherence to the dosage of the necessary medications. If you do not follow medical recommendations, a person’s sleep can be disrupted by a severe headache. Its causes in diabetes mellitus are:

• diabetic neuropathy, which causes pain due to damaged blood vessels and nerves in the brain. The disease requires treatment only from a specialist;
• hyperglycemia. Cephalalgia is associated with the toxic effects of excess glucose in the blood on blood vessels. The patient experiences severe weakness due to developed intoxication. It is possible to normalize glucose levels in this situation only in a specialized hospital;
• hypoglycemia. The head begins to hurt due to low blood glucose levels. Such pain occurs along with symptoms such as acute hunger, profuse sweating, and confusion. The patient must be given immediate assistance by injecting him with a glucose solution or giving him sweet tea to drink.

Treating ailments with improvised remedies at home

If a severe pain attack takes you by surprise, and there is no way to get help from a doctor, the following measures will help:

• Short sleep, head slightly raised;
• Rest in a relaxed position with pieces of ice wrapped in a scarf applied to your temples;
• Compress on the head, especially in the temple area, using the pulp of a lemon, grated;
• Light neck massage to relax the muscles;
• Warm sweet tea with lemon;
• Inhalation of essential oils of mint, lavender, lemon, basil, clove, sage, eucalyptus; you can drop a few drops on your forehead and temples;
• Warm (not hot) bath with an extract of soothing herbs or essential oils;
• Foot baths with a temperature of 40 degrees for 15 minutes.

Following a healthy lifestyle helps you get rid of tension pain forever without the help of medications:

1. Sound sleep of at least 7 hours with the window open. It is advisable to take an evening walk before going to bed.
2. Daily contrast shower strengthens blood vessels, making them more resistant to stress.
3. Maintaining water balance. It is recommended to drink at least 2 liters of fluid per day, not counting soups and drinks.
4. Proper balanced and vitamin-rich nutrition.
5. Drinking large portions of alcohol and smoking leads to vascular spasms.
6. Avoid physical and mental overload and stress.
7. While working at the computer, take breaks every hour; Exercises for the eyes and muscles of the cervical region are useful.
8. Regular moderate physical activity and an active lifestyle.

Migraine

Why does my head hurt at night and go away in the morning? The cause may be a neurological disease - migraine. It manifests itself as acute throbbing pain in the forehead and temples. A person can be influenced by bright light stimuli, loud sounds, smells, nausea, and apathy. Migraines can occur after waking up.

Treatment is based on triptans, non-steroidal anti-inflammatory drugs. Traditional medicine is also used. It is also important to change your lifestyle. Herbal medicine and psychotherapeutic methods are used.