What should you know about cluster headache after waking up?

Cluster headache can produce severe pain around one eye with tearing, redness, nasal blockage or restlessness. Attacks may follow a regular time pattern, including during sleep or soon after waking. Morning headache is not specific to cluster headache: disrupted sleep, migraine, jaw clenching, medication effects and other conditions can also be involved.

Record whether pain woke you or began after you got up, which side was affected, how long it lasted, and whether you noticed eye or nasal symptoms. Also note snoring, poor sleep, alcohol, medicines and any daytime symptoms.

Keep a consistent sleep routine, drink fluids and avoid alcohol if it has triggered attacks. Do not repeatedly increase pain medicine without advice. Arrange a GP assessment for a new or recurring morning pattern, especially when attacks are severe, occur at a similar time or include eye changes.

Seek emergency help for a sudden severe headache, weakness, confusion, fainting, seizure, stiff neck with fever, repeated vomiting or new vision loss. Prompt medical review is needed for headaches that progressively worsen, wake you repeatedly, occur with a painful red eye or come with unusual neurological symptoms.

Ask whether the timing and eye symptoms fit cluster headache; whether sleep, medicines or jaw tension could contribute; what treatment should be available at the start of an attack; and which changes need emergency help.