What should you know about early morning headache?

A headache on waking may follow poor sleep, jaw clenching, an awkward neck position, missed fluids or alcohol. Facial pressure, blocked or runny nose and reduced sense of smell can accompany allergic rhinitis or chronic sinusitis. Fever, cough, body aches or recent exposure may point toward an infection such as a common cold or COVID-19. Anxiety can also tighten scalp, jaw and neck muscles. A diary of timing, location, severity, sleep and associated symptoms helps a clinician identify patterns.

Drink fluids regularly, eat at usual times and keep a consistent sleep routine. Check whether your pillow, screen use or teeth grinding is straining your neck or jaw. Rest in a quiet room and use a simple pain reliever only as directed and only if it is suitable for you. Avoid repeatedly taking pain medicine without advice, because frequent use can perpetuate headaches. Treating nasal symptoms or an underlying illness may help when those features are present.

Seek emergency care for a sudden severe headache, new weakness, trouble speaking, fainting, confusion, seizure, stiff neck with fever, or a headache after a significant head injury. Arrange medical review for a new or steadily worsening morning pattern, repeated vomiting, vision changes, pregnancy, or headaches that wake you from sleep. Fever with a severe headache also deserves prompt assessment.

Tell your doctor when the headache starts, where it hurts, how long it lasts and what relieves it. Ask whether your nasal, sleep, medication or blood-pressure history changes the evaluation, and whether an examination or testing is needed.