Contributing factors of waking up with a migraine episode may include dehydration, poor sleep quality, and caffeine withdrawal. Medications and home remedies may help treat migraine.

Waking up with the intense, throbbing pain of a migraine episode after a period of sleep can be a frustrating way to start the day. Many people experience migraine upon waking, and pre-sleep trigger exposures, disrupted slumber, and medication timing can all play a role.

Trying available treatments and preventive techniques may reduce the frequency and severity of morning migraine.

Read on to learn more about morning migraine episodes, including why they occur, and what to do about them.

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Migraine is a complex disorder encompassing various subtypes and has a large genetic component. These episodes can arise from a variety of factors, including the slight narrowing of blood vessels in the brain, mild inflammation, or both.

Migraine causes severe throbbing or pulsing pain, typically in one side of the head. People with migraine headaches often experience other symptoms, such as nausea, vomiting, and sensitivity to stimuli such as light, sound, and smell.

Several types of migraine headaches exist. The two most common are migraine with aura (also known as classic migraine) and migraine without aura (common migraine). An “aura” refers to a variety of neurological experiences that often develop 10 to 60 minutes before the onset of throbbing head pain.

Other types of migraine include:

Migraine can be further defined by how frequently it occurs. Experiencing headaches on 15 or more days each month for at least 3 months, with 8 or more of those headaches meeting the criteria of a migraine, is considered “chronic” migraine.

Migraine headaches occurring less frequently is known as “episodic” migraine.

Migraine episodes are more than just headaches, although headaches usually occur as part of migraine. They involve four distinct phases, each with its own set of symptoms.

Below are the phases of a migraine headache.

Prodrome

This stage occurs before the onset of a migraine headache and usually lasts for about 24 hours, but it can also last for a few days. Symptoms are subtle and may include:

Aura

Not everyone experiences aura, which refers to sensory sensations that occur during migraine headaches. Auras typically cause visual disturbances, although they may also affect other senses.

Examples of aura symptoms, which do not usually last more than 60 minutes, include:

  • difficulty speaking
  • hearing sounds
  • tingling, or pins and needles sensations
  • seeing shapes or lights
  • temporary partial loss of vision
  • weakness or numbness of the face or body

Attack

This stage involves severe, debilitating pain that can last for several hours or days. Symptoms include:

  • unilateral throbbing or pulsing pain on one or both sides of the head
  • nausea
  • vomiting
  • sensitivity to light, sounds, and smells

Postdrome

This is the recovery stage, where people may feel:

  • confused
  • drained
  • exhausted

Symptoms of migraine can be severe and impact a person’s quality of life. Not everyone will experience all stages of migraine.

There is no single, universal cause underlying migraine episodes in the morning. Migraine, overall, is a complex neurological condition that can present with a variety of symptoms across a spectrum of severity.

On the neurological level, migraine can involve a cascade of physiological processes related to neurotransmitter imbalances, activation of the brain’s trigeminal nerve, and heightened sensitivity of neurons in the central nervous system (brain and spinal cord), among many other contributing factors.

Why and how all these factors come together to generate a migraine is not fully understood, but for many people, migraine is often traced to a trigger. Triggers are internal or external circumstances that can increase the likelihood of a migraine attack.

A person experiencing morning migraine regularly may be exposed to a trigger before bed or during sleep, though not all migraine is caused by an identifiable trigger.

According to the American Migraine Foundation (AMF), early morning is the most common time for migraine headaches to occur. Multiple types of non-migraine headaches also tend to occur in the morning.

A systematic review from 2021 found morning migraine attacks were most frequently reported between the hours of 6 a.m. and 12 p.m., with Saturdays cited as the most frequent day for migraine onset.

A 2019 study indicates the likelihood of developing a migraine early in the day could suggest a relationship between migraine, sleep, and circadian rhythm.

Many factors can contribute to the onset of a migraine headache in the early morning, including:

Sleep problems

There is a well-known relationship between migraine and sleep disorders. Research indicates that people with insomnia, for example, have an increased risk of migraine headaches and other types of headaches compared to people without insomnia.

Disrupted sleep for any reason may be enough to trigger a morning migraine.

In a large-scale study from 2024, researchers found participants experiencing morning migraine were more likely to report a lack of quality sleep from the night before and low energy from the day before. Those with poorer perceived sleep quality had an average 22% increased chance of migraine with headache the next morning.

Sleep-related factors that may trigger migraine attacks include:

Dehydration

Waking up dehydrated may trigger migraine episodes in some people. Research shows that dehydration is linked to migraine headache frequency and severity.

Dehydration is a physiological state where a person’s body does not have enough water to support its function. It can contribute to a migraine through several mechanisms that promote pain and inflammation.

Without enough body water, for example, blood volume can decrease and reduce blood flow to the brain. Less blood flow can restrict the brain’s supply of essential nutrients, electrolytes, and oxygen.

Stress hormone levels may increase, and vessels in the brain can narrow. When fluid loss is severe, the brain can temporarily shrink and cause pain by pulling on surrounding tissues.

Signs of dehydration upon waking include:

Medication, alcohol, and caffeine use

Migraine attacks may commonly occur in the early morning in people who are using over-the-counter (OTC) or prescription pain medications. These medicines typically wear off within 4 to 8 hours, which can trigger a medication withdrawal migraine in the morning if taken right before sleep.

Caffeine withdrawal can also occur after several hours without caffeine, which may trigger a migraine episode.

In a 2020 study, caffeine and caffeine withdrawal were found to cause migraine attacks in 2% to 30% of participants. How much caffeine a person consumes may also matter. A population-based study from 2023 found the chance of a migraine attack was 42% higher among people with a caffeine intake of 400 milligrams (mg) or more a day.

For comparison, on average, a single cup of 8-oz coffee contains between 80 mg and 100 mg of caffeine.

Finally, alcohol is a migraine trigger for some people, and drinking alcohol before bed may result in a morning migraine episode. Alcohol, in general, does not appear to increase migraine risk among all people with migraine, however.

A large, prospective cohort study from 2022 found drinking alcohol in moderation was not associated with any significant increased risk for migraine 24 hours after consumption.

Like caffeine, the amount of alcohol intake may matter. Drinking to extreme intoxication, for example, could contribute to dehydration and hangover symptoms which might increase the chance of a morning migraine attack.

Depression and anxiety

Depression and anxiety can contribute to migraine onset, as these mental health issues affect sleep and increase stress, which is another migraine trigger.

Many people with migraine live with anxiety, depression, or both.

According to the Anxiety and Depression Association of America, people with migraine are 5.8 times more likely than people without migraine to develop depression, and a 2022 study found that more than 50% of people with migraine will be diagnosed with an anxiety disorder during their lifetime.

Anxiety and depression are not limited to psychological symptoms. They are often accompanied by somatic (physical) experiences like nausea, headache, and fatigue.

That same 2022 study found that migraine headaches and anxiety disorders were bidirectional, meaning recurring headaches lead to anxiety and vice versa.

Hormonal changes

Hormonal changes in the early hours may cause migraine attacks and non-migraine headaches.

Other hormonal changes also cause migraine episodes, including the estrogen changes that take place before or during menstruation, pregnancy, and menopause.

Other migraine triggers

Many other triggers can cause migraine attacks at any time of day, including:

A person with migraine may want to consider the following treatments:

OTC medication

Over-the-counter (OTC) medications do not require a prescription to purchase. They include pain relievers, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin IB), and aspirin.

OTC medications are considered evidence-based, first-line treatments for migraine. They offer effective, low cost symptom management with limited risk for side effects.

Certain OTC products are advertised as migraine-specific. These contain caffeine, aspirin, and acetaminophen and are formulated with migraine pain as their primary focus. Excedrin Migraine is one example of a targeted OTC migraine medication.

Prescription medication

Prescription drugs for migraine require a prescription from a doctor to purchase. They are typically stronger than OTC products and are regulated because they may not be safe for general public use, might be potentially habit-forming, or require special monitoring and testing.

Examples of prescription medications used when a migraine develops include:

  • triptans, such as sumatriptan (Imitrex, Tosymra) and rizatriptan (Maxalt), which block pain signals
  • dihydroergotamines, which are nasal sprays or injections that alter blood vessel constriction in the brain
  • anti-nausea drugs, which doctors prescribe to address the symptoms of nausea and vomiting
  • nonsteroidal anti-inflammatory drugs (NSAIDs), medications that reduce inflammation throughout the body
  • calcitonin gene-related peptide antagonists (CGRP) medications that prevent CGRP from binding to CGRP receptors

Home remedies

There is no universal cure for migraine, but some people report symptom improvement with home remedies. People who are experiencing a migraine can try the following options alone or in combination with drug treatments:

  • lying down in a dark, quiet room
  • sleeping or resting
  • applying warm or cold compresses to the head and neck
  • taking a bath or shower
  • drinking caffeine (if it is not a trigger)
  • practicing yoga or meditation to reduce pain levels
  • a hot foot soak

It is not always possible to prevent a migraine attack, but medications and lifestyle changes may help.

Medications

Medications are used to treat migraine at the time it occurs and to help prevent it in certain circumstances. A doctor might prescribe preventive medications for people with chronic migraine, for example, or for migraine episodes that are severely impairing.

Preventive medications used for migraine treatment include:

  • anticonvulsants to alter neurotransmitter levels and reduce pain signals
  • beta-blockers, which can help reduce vascular pressure in the head
  • calcium channel blockers, which are drugs that reduce high blood pressure and improve vascular stability
  • antidepressants to regulate neurotransmitters associated with migraine, like serotonin
  • Botox injections
  • CGRP antagonists

If migraine attacks are attributed to another health condition, like a sleep disorder, treating that health concern may also reduce migraine frequency or severity.

Self-care tips

Self-care habits can go a long way toward reducing the frequency and severity of migraine episodes. Here are a few things a person can do:

  • Identify and avoid triggers: Keep a journal to determine migraine triggers and avoid or limit these where possible.
  • Practice sleep hygiene: If possible, go to bed and get up at the same time each day. Avoid screens, caffeine, nicotine, and alcohol before bed, as these can negatively affect sleep quality.
  • Eat a balanced, nutrient-dense diet: Inflammatory foods, like highly processed foods, may contribute to migraine by causing inflammation in the body and disrupting the gut-brain communication pathway.
  • Stay hydrated: Drink plenty of water and other fluids throughout the day to prevent dehydration upon waking.
  • Exercise regularly: Moderate exercise may reduce migraine frequency and severity in some people.
  • Cultivate beneficial coping strategies: In-the-moment and long-term coping strategies, like meditation or grounding, can help reduce stress and anxiety that may trigger a migraine.

A person should seek guidance from a doctor if they regularly wake up with migraine headaches or other headaches, especially if their headache patterns or symptoms change suddenly.

It is important to seek immediate medical attention if any of the following signs and symptoms occur:

  • headache after a head injury
  • an abrupt, severe headache
  • neurological symptoms of weakness, vision changes, or sensory changes
  • a headache accompanied by a fever, confusion, seizures, or difficulty speaking
  • chronic headaches that get worse during exertion, straining, or sudden movement
  • new headache pain in those over 50 years old

Waking up with a migraine is a common occurrence. It may result from medication or caffeine withdrawal, not getting quality sleep, or natural hormonal changes, among other triggers. If a person has morning migraine attacks, they can have migraine episodes at other times of day too.

People who experience regular or severe migraine should consult a doctor. Treatments include medications and home remedies. Preventive strategies include self-care habits and medications.