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This study examines the relationship between morning headache and various sleep parameters, including sleep apnea and early morning arousal.

May 10, 2026

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1158 Morning Headache, Apnea and Early Morning Arousal

Key Points

This study examines the relationship between morning headache and various sleep parameters, including sleep apnea and early morning arousal.
Participants aged 18–89 completed surveys and polysomnography at the University of Iowa.
Measured sleep parameters included OSA severity, sleep efficiency, REM sleep, and arousal patterns.
Survey assessed headache frequency and other sleep-related issues.
20% of participants reported morning headache upon waking.
No significant differences in OSA prevalence or severity between those with and without morning headaches.
Teeth grinding occurred more frequently in those with morning headaches (33% vs. 6%, p=0.004).

Abstract

Abstract Introduction Morning headache (MH), a headache that occurs upon waking, affects ~10% of the population. Despite its prevalence, its cause(s) remain speculative. Previously, we found that in 383 Veterans MH was not associated with the presence of obstructive sleep apnea (OSA) or its severity, nor multiple other sleep parameters; sleep efficiency and total sleep time were non-significantly higher in those with MH. Therefore, we investigated MH with more detailed sleep parameters, including early morning arousal. Methods Participants aged 18–89, who visited the University of Iowa for a polysomnogram, and who consented to our study, completed a survey about headaches the morning after their polysomnogram. We collected sleep parameters from their polysomnogram. Results Of 100 enrolled participants, 89 did not have a headache at bedtime the night of their polysomnogram. Of those 89, 18 (20%) reported MH upon waking the next morning. There were no significant differences between those with MH (MH) and those without (non-MH) regarding the presence of OSA or OSA severity; lowest oxygen saturation; %REM sleep; presence of vivid dreams; presence of RSWA, WASO, PLMI, PLMAI, or SAI; or arousal past 4:00 AM. Moreover, 6% of MH and 21% of non-MH had prolonged arousal past 4:00 AM (p=0.2). Only 26 of 89 reported whether they woke up at night and went back to sleep; of those 26, 80% of MH and 100% of non-MH did. Sleep efficiency was non-significantly higher in MH vs non-MH (89% and 82%, respectively, p=0.12). A significant finding was that MH slept a bit longer than non-MH the night of the polysomnogram (median 6.4 vs 6.0 hours; p=0.03). Other significant findings were that 33% of MH and 6% of non-MH complained of teeth grinding that night (p=0.004), and 56% of MH and 24% of non-MH complained of teeth grinding at home (p=0.01). Conclusion • Consistent with our prior study, there were no positive associations between MH and OSA or OSA severity, nor multiple sleep parameters. Sleep efficiency was non-significantly higher in MH. • Novel parameters of early morning arousal were not associated with MH. • Teeth grinding and slightly longer sleep time were associated with MH. Support (if any)

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Cite This Study

Asgarli et al. (Fri,) studied this question.

synapsesocial.com/papers/6a002147c8f74e3340f9c248 https://doi.org/https://doi.org/10.1093/sleep/zsag091.1157

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