If you experience migraines — including severe headaches, visual auras, or nausea — you know that they can be triggered by a host of factors. For some people, migraine attacks happen in the morning, an occurrence that highlights a connection between migraine and sleep problems.

Members of MyMigraineTeam have talked about getting migraines in the morning. One member wrote, “I had to get up at 5 a.m. because of the migraine I had this morning, like every other morning. I really hate these morning migraines.” Another commented, “From the time I woke up yesterday morning I’ve had the worst migraine. It starts in the back of my neck and only gets worse.”

To learn more about the personal experience of morning migraine attacks, MyMigraineTeam spoke with Natalie D’angelo, a member of MyMigraineTeam and head of partner solutions at MyHealthTeam. She spoke about her experience living with migraines, particularly when they happen in the morning. “I have woken up in the morning with a migraine. If I do, it’s going to be a bad day. It’s usually a continuation of [a migraine from] the day before, or if there’s been a severe weather change overnight.”

According to the American Migraine Foundation, about half of migraine attacks happen between the early morning hours of 4 and 9 a.m. The time of day doesn’t play a role in migraine attacks for everyone who gets them. However, for those who do experience attacks in the morning, this article will discuss why they happen, what they feel like, and how to manage them.

What Causes Migraines in the Morning?

There are several common causes of morning migraines.

Sleep Problems

Sleeping problems can be both a cause and an effect of morning migraine attacks. Triggers can include:

• Insufficient sleep
• Too much sleep
• Poor sleep posture
• Irregular sleep patterns or sleep habits (caused by shift work or jet lag)
• Sleeping problems due to mental health issues, such as depression, anxiety, and stress

According to the American Migraine Foundation, people living with migraine are two to eight times more likely to have sleep disorders, compared to the general population. These include:

• Insomnia
• Sleep apnea
• Snoring
• Jaw clenching and tooth grinding (bruxism) while sleeping

Caffeine and alcohol can also contribute to poor sleep and sleep loss, which can lead to migraines in the morning. Drinking alcohol causes dehydration, hangover headaches, and other types of headache pain. If you drink caffeine in the late afternoon or evening, caffeine withdrawal in the early morning could cause a migraine attack. Caffeine and alcohol are known triggers for migraines at any time of the day.

Dehydration

Dehydration is a trigger for about one-third of people with migraine. You can experience dehydration while you’re asleep, which can contribute to a migraine headache — or other type of headache — in the morning. To prevent morning headaches due to dehydration, make sure to get the daily recommended amount of water — about two liters — every day.

Medications

Medications can be a trigger for migraine headaches at any time of the day. They’re listed as a side effect for some medications, like birth control pills. Medications such as triptans or pain medications, such as opioids, may also cause these headaches if you take them at night and their effects wear off by the morning hours.

Other Triggers

Other general migraine triggers may lead to headaches in the morning. These include:

• Certain foods, like chocolate, aged cheeses, MSG, and artificial sweeteners
• Changes in weather patterns
• Bright lights

“The other trigger for my migraines in the morning is if there was a major weather change overnight,” D’angelo said.

Symptoms of Morning Migraines

Symptoms of morning migraines are similar to those that happen at any time of the day. Migraine symptoms may change as you move through the different phases of a migraine. Early phases of a migraine attack might start the day or evening before, then cause more noticeable symptoms — like head pain or visual disturbances — the morning after.

“If I’m waking up with a migraine in the morning, it’s because the migraine was triggered the day before,” said D’angelo.

Common migraine symptoms include:

• Severe headache pain, sometimes described as pulsing or throbbing pain
• Visual disturbances, loss of vision, or seeing flashing lights
• Migraine pain on one side of the head
• Nausea and vomiting
• Pins-and-needles feelings in the legs or fingers
• Mood changes
• Light and other sensory sensitivity

A MyMigraineTeam member described their morning migraines, saying, “I have been up since 4:30 a.m. I have nausea, dehydration, and dizziness before getting out of bed; and stabbing pain in the left side of my eye.” Another said, “I woke at 1 a.m. this morning like every morning — with a full-blown migraine and vomiting.”

How To Manage Migraines in the Morning

Most treatment options for morning migraines are the same as those for other types of migraines.

Try To Address the Underlying Causes of Morning Migraines

Understanding what’s causing your morning migraine attacks will help you to consider which treatment and management options will be the most useful for you. If your morning migraine attacks are connected to insomnia, for example, it’s a good idea to see a doctor or sleep specialist to address the insomnia.

One member commented about how treating their sleep disorder with a continuous positive airway pressure (CPAP) machine, a common therapy for sleep apnea, has helped their morning migraines. “My CPAP machine has been helping with my migraines. I’m slowly weaning off all my insomnia medication. I don’t miss the morning migraines,” they said.

Following are some ways to address underlying causes of morning migraine attacks:

• Keep a migraine journal to track the occurrence, duration, and severity of migraine attacks and help you identify potential triggers, such as foods, medication withdrawal, or weather changes.
• Stick to a regular sleep schedule and practice healthy sleep hygiene. Here are some tips from The Migraine Trust.
• Find ways to relieve stress through lifestyle changes or activities, such as yoga or meditation.
• Stay hydrated.
• Limit your caffeine and alcohol intake.
• Avoid known migraine triggers.
• Be observant of prodromal (early migraine) cues and respond with medication or other treatment.

D’angelo commented about managing her morning migraines, saying, “Some of the ways that I manage my morning migraines is regulating my food and drink the night before, getting sleep, drinking apple cider vinegar in the morning to help with my digestive system, and meditation every single morning.”

Sometimes it’s difficult to know what’s causing your morning migraines. If you’re still having trouble managing them, try seeing a neurologist or migraine specialist, and talk to them about medical treatment options for migraines.

Over-the-counter Medications

Over-the-counter medications are a common first-line treatment for migraine headaches at any time of the day. These include nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin, and pain relievers like acetaminophen (Tylenol).

Prescription Medications

When over-the-counter medications don’t work, a doctor may prescribe a medication, depending on your symptoms and other lifestyle and risk factors. These could be preventive medications, which are either pills taken daily or skin injections and intravenous (IV) treatments given less frequently to prevent the onset of migraines. Medications can also be acute, or abortive, meaning they’re taken to stop a migraine attack that’s already underway.

Common prescription medications intended to prevent migraines include:

• Antidepressants like amitriptyline
• Beta-blockers like propranolol
• Anticonvulsants
• Calcitonin gene-related peptide (CGRP) antagonists (skin injections or IV treatments)
• OnabotulinumtoxinA (Botox) injections

Others migraine medications include:

• Prescription NSAIDs
• Triptans (like sumatriptan, sold as Imitrex)
• Nasal sprays

“I woke up at 3 a.m. this morning with a bad migraine. However, after taking my acute migraine medication, it has eased up a lot,” wrote a MyMigraineTeam member.

Speak with a neurology health care professional or migraine specialist to discuss the best migraine treatment plan for you. If you’re experiencing morning migraine attacks for the first time with vomiting, it’s important to be evaluated by a physician as soon as possible to rule out other potentially serious causes besides migraine.

Talk to Others Who Understand

MyMigraineTeam is the social network for people with migraine and their loved ones. On MyMigraineTeam, more than 76,000 members come together to ask questions, give advice, and share their stories with others who understand life with migraine.

D’angelo offered suggestions to others living with migraine, saying, “If you need support, find others that are living with migraines and connect with them. We understand you. We will support you.”

Do you experience migraines in the morning? How do you manage them? Share your experience in the comments below, or start a conversation by posting on your Activities page.