Headache sufferers have a great risk for sleep disorders. This risk is 2 to 8 times greater than the general public. In specialty headache clinics, well over half of headache patients have chronic sleep problems. Sleep disorders increase as headaches become more frequent and severe. Regular restful sleep improves headache. Fortunately, specific sleep patterns identify sleep disorders for treatment.
Nearly half of all migraines occur between 4AM and 9AM. The pattern of waking often or daily with a headache is an important sign that sleep may be provoking headache. This is often called "awakening headache." This may present as migraine, tension type or other headache. The key features are the timing of the headache and tendency to come on during or shortly following sleep. To wake up first thing in the morning often with a headache suggests the need to assess sleep as a cause.
Chronic daily or awakening headache patterns, regardless of diagnosis, are suggestive of sleep disorders. It appears that almost any sleep disorder can provoke headache. Obstructive sleep apnoea and insomnia are the most common. Others common conditions include restless legs, excessive daytime sleepiness and the abnormal sleep behaviour of bruxism. Others include circadian rhythm or ‘body clock’ disorders, narcolepsy and sleepwalking.