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Medically Reviewed
How to Prevent Morning Migraine
If you wake up with a pounding head, nausea, or other migraine symptoms, quick action can help keep things from spiraling into something more severe.
By
Jump To
Morning Migraine
When Is It Migraine
Triggers
Treatments
Prevention
Emergency
Bottom Line
You wake up with a throbbing pain in your head, which quickly gets more intense. When you open your eyes, your vision may seem a little blurry, or you may start seeing zigzag, shimmering, or polka-dot patterns. There are probably worse ways to start a day than with a migraine headache, but not many.
“It's not uncommon for patients with migraine to wake up with a headache,” says
Emad Estemalik, M.D
., director of the Center for Neuro-Restoration at the Cleveland Clinic in Cleveland, OH. “Usually what we advise in that case is to treat it like any other migraine that they experience.”
According to the
American Migraine Foundation
, the most common time for migraine to occur is in the early morning. And a study in the journal
Cephalalgia
found that 40% of people with migraine reported that their headaches began in the early hours of the day. “When we look at the times that patients most commonly tend to develop
migraines
, it’s between 4 a.m. and 8 a.m.," says
Hope O’Brien, M.D.,
founder and CEO of Headache Center of Hope in Cincinnati, OH. “That is when migraine is common.”
Let’s take a look why this pattern prevails and if you’re prone to migraine attacks what you can do to prevent them.
A morning migraine attack isn’t different than migraine at any other time of the day in terms of its length or intensity. It’s just that “people who have migraine more commonly have morning headaches than at other times,” says Dr. Estemalik. “It's more the triggers play a bigger role at that time.”
There are a couple of reasons why migraine attacks may strike in the morning hours. For starters, since most over-the-counter and prescription pain medications wear off in four to eight hours, any meds you took before bed will likely no longer be working, per the American Migraine Foundation. In addition, if a migraine begins during the night while you’re asleep, you may not feel the pain and thus miss the crucial early-onset window to take your migraine medicine—which anyone with migraine knows is key to keeping head pain at bay.
There are a few signs that your headache may be a migraine. These include headaches that:
Affect mostly one side of the head
Are associated with nausea, vomiting, and light and sound sensitivity.
Are throbbing in nature
Come on abruptly
In general,
migraine symptoms
last about four hours, no matter what time of day you have them, says Dr. O’Brien. “That's all you need for the diagnosis of migraine.” For people with more severe migraine attacks, the episode can last 24, 48, or even 72 hours.
“Migraine triggers differ from individual to individual,” says Dr. O’Brien. That said, there are a few common issues that often seem to set off a migraine attack in the a.m. These include:
Dehydration
“If you're not drinking enough water it can trigger a migraine,” says Dr. O’Brien. While there’s no set reason,
some experts believe
a balance of water, ions (an atom or group of atoms that has an electric charge), and other fluids may be involved. If fluid levels in the body become too concentrated because you’re dehydrated, researchers believe receptors in the brain may be activated, causing a migraine.
A study published in
The European Journal of Neurology
found that subjects who drank an extra 1.5 liters of water a day had less intense and shorter episodes of migraine. And a study in
The Journal of Clinical Neuroscience
showed that the severity of migraine disability, pain severity, migraine frequency, and duration were significantly lower in those who consumed more water. If you last had something to drink by around 7 p.m., by the time you wake up 12 hours later you may already be slightly dehydrated.
Interrupted Sleep
“Sleep is big on the list” of triggers, says Dr. Estemalik. Many people with migraine have an underlying sleep disorder: In fact, a study in
The Journal of Headache and Pain
found that about 25% of people with migraine had
insomnia
compared to only 15% of those with non-migraine headaches. Another study in
The Journal of Headache and Pain
found that poor sleep quality was prevalent among study participants with probable migraine and was associated with an exacerbation of migraine symptoms. (
Probable migraine
is a term used for migraines that meet all but one criterion for a migraine diagnosis.)
“Any changes in your sleep patterns, whether it’s getting too much or not getting enough, can trigger a migraine,” adds Dr. O’Brien. “If you’re staying up late, and have to get up early in the morning, you are more likely to get one. For example, if you stay up late on Friday and Saturday and then have to get up early on Monday morning, you'll likely wake up with a morning headache because you did not get enough sleep.” It could also work the other way: Migraine can also cause disrupted sleep, setting off a vicious cycle.
Caffeine
Caffeine can often affect migraine, for better or worse. And the morning hours are when most of us get our daily caffeine fix. Drinking too much caffeine can set off a migraine attack, but so can cutting back on caffeine, notes Dr. O’Brien. “It also causes changes in the blood vessels, which can then trigger a migraine,” she adds.
Having that extra-large latte can also cause other problems. “Caffeine is a diuretic, meaning whatever fluid [you’ve ingested], you pee it out, which can exacerbate dehydration,” says Dr. O’Brien.
And if you drink coffee or have a lot of cola before bed, it can disrupt your sleep, notes Dr. Estemalik, which (as noted above) is another migraine trigger.
That said, for some people a moderate amount of caffeine can reduce migraine symptoms, so you might want to consider having a cup of coffee or tea when you wake up with a migraine to help it subside.
Weather Changes
Some people report that
changes in the weather
are triggers, says Dr. O’Brien. High humidity, bright sunshine, thunder and lightning storms, changes in season, and changes in barometric pressure that occurred while you were sleeping can all be associated with morning migraine. A 2022 analysis in
Atmosphere
found 46% of people surveyed said that weather affected their health, with the most common complaints being headaches including migraines.
Food Triggers
Some patients link their migraines to certain foods, says Dr. O’Brien.
Common offenders
include aged cheese, processed meats, pickled foods, hot dogs, and chocolate—so that sausage, egg, and cheese breakfast sandwich might be causing problems. The specific food triggers differ widely from person to person, says Dr. O’Brien. Keeping records of your migraines can give you insight into your personal triggers, according to
The National Headache Foundation
.
Medication Overuse
“For people with migraine, it’s very important to understand the concept of medication overuse headache or rebound headache,” says Dr. Estemalik. “People with migraine should not take over-the-counter analgesics [such as Advil (ibuprofen), Aleve (
naproxen
) or Tylenol (acetaminophen)] more than two to three times a week, or prescription medicines like triptans, because that can give them rebound or overconsumption-of-medication headache.” In other words, loading up on meds just before bed can result in waking up with an even worse headache.
Alcohol
Alcohol is not a trigger for every migraine patient, and not every type of alcohol may be a problem—some people may be able to drink whiskey but not wine, for example. In fact, a 2022 study in
Headache
found participants who mostly consumed low doses of alcohol, “reported no significant effect on the probability of a migraine attack in the 24 hours following alcohol consumption.” The researchers believe this suggests that the role of alcohol as a migraine trigger might have been overestimated.
Still, to avoid migraine in the morning you may want to avoid alcohol overconsumption the night before. That’s especially true for drinks like red wine, which contains tyramine,
an amino acid that helps control blood pressure
and which tends to be a trigger for those who have migraine, says Dr. Estemalik.
Hormonal Changes
The days leading up to your period or during it can trigger migraine for many women. In fact, 60% to 70% of women report a link between their periods and their migraine, according to the
Cleveland Clinic.
Hormonal changes caused by oral contraception,
perimenopause
,
menopause
, and pregnancy can also kick off a migraine attack, perhaps due to
shifting estrogen levels
.
Wake up with a throbbing headache? Here’s how to best stop it in its tracks.
Take Your Meds Quickly
“If you wake up with significant headache, nausea, or vomiting, you should address it right away,” says Dr. Estemalik. “The most important thing is taking
the prescribed medication that aborts a migraine
. The longer you wait, sometimes the harder it is to get rid of. I always make sure the patient has access to their medication.”
These medications may include:
Over-the-counter drugs
such as Advil/Motrin (ibuprofen), Aleve (naproxen), or Tylenol (acetaminophen), or a combo that contains acetaminophen, aspirin, and caffeine (such as Excedrin Extra Strength and Excedrin Migraine).
Prescription medications:
“We use a lot of different drugs: seizure meds, blood pressure meds, antidepressants, injections, monoclonal antibodies, and neuromodulators,” says Dr. Estemalik.
Get Mindful
Relaxation therapies such as deep breathing and mindfulness meditation may help to mitigate the effects of a migraine attack early on,
according to research
. One deep breathing exercise to try when you feel a migraine attack coming on the a.m. is
square breathing
:
Inhale through your nose for a count of 4.
Hold your breath for a count of 4.
Exhale through your mouth for a count of 4.
Pause for a count of 4.
Repeat this pattern a few times.
Try Home Remedies
“Nonpharmaceutical treatments can help [reduce migraine],” says Dr. O’Brien. There are a few different
natural remedies
that are easy to do in the morning, even before you get out of bed.
Essential oils:
Apply a few drops of peppermint essential oil to your temples or the base of your neck;
one small study
found this technique to be helpful in improving headache intensity.
Cold therapy:
Use a cold compress like a cool towel or ice pack, which
has been found
to reduce pain when placed on the neck.
Dark rooms:
Avoid the temptation to reach for your phone. The light from screens
can worsen the migraine attack
. Similarly, if you can stay in a low-light space during your migraine, it may help mitigate symptoms.
Drink Water
When you wake up with a migraine, have a glass or two of water, recommends Dr. O’Brien. Then keep drinking water throughout the day, to help prevent dehydration. In addition to water, she says, “make sure you're eating as well, to get those electrolytes in that can hydrate you a little bit faster.” Electrolytes are common in whole foods like fruits, vegetables, dairy products, and nuts and seeds, and beverages including sports drinks, according to the
Cleveland Clinic
.
While migraine can often be unpredictable, following a few lifestyle strategies may help keep attacks from happening.
Get Ample Sleep
As noted, too-little sleep can be a significant migraine trigger for many people, so the more you can do to get consistent shut-eye, the better. “Schedule a regular bedtime,” advises Dr. O’Brien. “Aim to get at least seven to eight hours for adults, and more for kids.” Create
a healthy sleep environment
by keeping your room cool, quiet, and comfortable.
Get Moving
Physical activity is a part of every healthy lifestyle, and migraine is no exception. “Establish a regular routine in terms of exercise,” Dr. O’Brien says. “Exercise can help increase endorphins, which help you tolerate pain better.” It can also help you sleep better and reduce stress, per the
American Migraine Foundation.
Eat Breakfast
And for that matter, make sure you’re not hungry at other points of the day, either, especially before bed. “Skipping meals is one of the most common triggers for patients with migraine,” says Dr. O’Brien. “So don’t let yourself getting hungry [which leads to] changes in glucose levels.”
Stay Compliant With Your Meds
Take your migraine medicines consistently, says Dr. O’Brien. “If you're missing doses of preventive medications, especially if the frequency or impact of the migraine is severe, that can make you more susceptible to migraine in general,” she says.
In most cases, a migraine attack can be handled at home with the strategies listed above. But there are times when you should
seek immediate help
from a healthcare professional or emergency room, including:
Confusion
Difficult speaking
Fever
Neck stiffness
Numbness or weakness
Severe migraine symptoms
Vision changes
In addition, “anyone ever experiences a new onset morning headache that is not ordinary or who doesn't have a history of migraines, that is a presentation that we take quite seriously,” says Dr. Estemalik. Rarely, these can be signs of
stroke
or brain aneurisms, so it’s best to err on the side of caution and seek medical attention.
If your child keeps waking up with a morning headache, you should also consult your pediatrician. “You want to rule out any type of lesion in the back part of the head that could be compressing and causing problems,” says Dr. O’Brien.
Waking up with a migraine doesn’t have to mean the whole day is ruined. By taking action quickly—having your go-to prescription or OTC migraine med, rehydrating with water, eating something like a piece of fruit or drinking a sports drink—can often help cut off initial migraine symptoms before they get more severe. Maintaining a healthy lifestyle with regular exercise, meals, sleep, ample water consumption, and reducing or eliminating alcohol, can also help prevent a.m. issues and keep migraine at bay altogether. | |||||||||
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Medically Reviewed
# How to Prevent Morning Migraine
If you wake up with a pounding head, nausea, or other migraine symptoms, quick action can help keep things from spiraling into something more severe.
Updated Feb 5, 2024
By
[Anne Marie O’Connor](https://www.healthcentral.com/author/anne-marie-oconnor)
Medical Reviewer[Jason H. Lin, M.D.](https://www.healthcentral.com/author/jason-h-lin)
[GettyImages/Doucefleur](https://www.gettyimages.com/detail/photo/asian-woman-drinking-clean-water-in-the-morning-royalty-free-image/1145440706)
###### Jump To
- [Morning Migraine](https://www.healthcentral.com/condition/migraine/waking-up-with-migraine#morning-migraine)
- [When Is It Migraine](https://www.healthcentral.com/condition/migraine/waking-up-with-migraine#when-is-it-migraine)
- [Triggers](https://www.healthcentral.com/condition/migraine/waking-up-with-migraine#triggers)
- [Treatments](https://www.healthcentral.com/condition/migraine/waking-up-with-migraine#treatments)
- [Prevention](https://www.healthcentral.com/condition/migraine/waking-up-with-migraine#prevention)
- [Emergency](https://www.healthcentral.com/condition/migraine/waking-up-with-migraine#emergency)
- [Bottom Line](https://www.healthcentral.com/condition/migraine/waking-up-with-migraine#bottom-line)
You wake up with a throbbing pain in your head, which quickly gets more intense. When you open your eyes, your vision may seem a little blurry, or you may start seeing zigzag, shimmering, or polka-dot patterns. There are probably worse ways to start a day than with a migraine headache, but not many.
“It's not uncommon for patients with migraine to wake up with a headache,” says [Emad Estemalik, M.D](https://my.clevelandclinic.org/staff/18050-emad-estemalik)., director of the Center for Neuro-Restoration at the Cleveland Clinic in Cleveland, OH. “Usually what we advise in that case is to treat it like any other migraine that they experience.”
According to the [American Migraine Foundation](https://americanmigrainefoundation.org/resource-library/sleep/), the most common time for migraine to occur is in the early morning. And a study in the journal [*Cephalalgia*](https://pubmed.ncbi.nlm.nih.gov/28944680/) found that 40% of people with migraine reported that their headaches began in the early hours of the day. “When we look at the times that patients most commonly tend to develop [migraines](https://www.healthcentral.com/condition/migraines), it’s between 4 a.m. and 8 a.m.," says [Hope O’Brien, M.D.,](https://www.hcohcincy.com/our-model) founder and CEO of Headache Center of Hope in Cincinnati, OH. “That is when migraine is common.”
Let’s take a look why this pattern prevails and if you’re prone to migraine attacks what you can do to prevent them.
Morning Migraine
## What Is Morning Migraine?
A morning migraine attack isn’t different than migraine at any other time of the day in terms of its length or intensity. It’s just that “people who have migraine more commonly have morning headaches than at other times,” says Dr. Estemalik. “It's more the triggers play a bigger role at that time.”
There are a couple of reasons why migraine attacks may strike in the morning hours. For starters, since most over-the-counter and prescription pain medications wear off in four to eight hours, any meds you took before bed will likely no longer be working, per the American Migraine Foundation. In addition, if a migraine begins during the night while you’re asleep, you may not feel the pain and thus miss the crucial early-onset window to take your migraine medicine—which anyone with migraine knows is key to keeping head pain at bay.
When Is It Migraine
## When Is Your Headache a Migraine?
There are a few signs that your headache may be a migraine. These include headaches that:
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- Affect mostly one side of the head
- Are associated with nausea, vomiting, and light and sound sensitivity.
- Are throbbing in nature
- Come on abruptly
In general, [migraine symptoms](https://www.healthcentral.com/condition/migraine-symptoms-causes) last about four hours, no matter what time of day you have them, says Dr. O’Brien. “That's all you need for the diagnosis of migraine.” For people with more severe migraine attacks, the episode can last 24, 48, or even 72 hours.
Triggers
## What Triggers Morning Migraine?
“Migraine triggers differ from individual to individual,” says Dr. O’Brien. That said, there are a few common issues that often seem to set off a migraine attack in the a.m. These include:
### Dehydration
“If you're not drinking enough water it can trigger a migraine,” says Dr. O’Brien. While there’s no set reason, [some experts believe](https://migrainecanada.org/posts/the-migraine-tree/branches/self-care-lifestyle/hydration-and-migraine/) a balance of water, ions (an atom or group of atoms that has an electric charge), and other fluids may be involved. If fluid levels in the body become too concentrated because you’re dehydrated, researchers believe receptors in the brain may be activated, causing a migraine.
A study published in [*The European Journal of Neurology*](https://pubmed.ncbi.nlm.nih.gov/16128874/) found that subjects who drank an extra 1.5 liters of water a day had less intense and shorter episodes of migraine. And a study in [*The Journal of Clinical Neuroscience*](https://www.jocn-journal.com/article/S0967-5868\(20\)30941-3/pdf) showed that the severity of migraine disability, pain severity, migraine frequency, and duration were significantly lower in those who consumed more water. If you last had something to drink by around 7 p.m., by the time you wake up 12 hours later you may already be slightly dehydrated.
### Interrupted Sleep
“Sleep is big on the list” of triggers, says Dr. Estemalik. Many people with migraine have an underlying sleep disorder: In fact, a study in [*The Journal of Headache and Pain*](https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-018-0916-5) found that about 25% of people with migraine had [insomnia](https://www.healthcentral.com/sleep/insomnia) compared to only 15% of those with non-migraine headaches. Another study in [*The Journal of Headache and Pain*](https://pubmed.ncbi.nlm.nih.gov/30046921/) found that poor sleep quality was prevalent among study participants with probable migraine and was associated with an exacerbation of migraine symptoms. ([Probable migraine](https://pubmed.ncbi.nlm.nih.gov/38019845/) is a term used for migraines that meet all but one criterion for a migraine diagnosis.)
“Any changes in your sleep patterns, whether it’s getting too much or not getting enough, can trigger a migraine,” adds Dr. O’Brien. “If you’re staying up late, and have to get up early in the morning, you are more likely to get one. For example, if you stay up late on Friday and Saturday and then have to get up early on Monday morning, you'll likely wake up with a morning headache because you did not get enough sleep.” It could also work the other way: Migraine can also cause disrupted sleep, setting off a vicious cycle.
### Caffeine
Caffeine can often affect migraine, for better or worse. And the morning hours are when most of us get our daily caffeine fix. Drinking too much caffeine can set off a migraine attack, but so can cutting back on caffeine, notes Dr. O’Brien. “It also causes changes in the blood vessels, which can then trigger a migraine,” she adds.
Having that extra-large latte can also cause other problems. “Caffeine is a diuretic, meaning whatever fluid \[you’ve ingested\], you pee it out, which can exacerbate dehydration,” says Dr. O’Brien.
And if you drink coffee or have a lot of cola before bed, it can disrupt your sleep, notes Dr. Estemalik, which (as noted above) is another migraine trigger.
That said, for some people a moderate amount of caffeine can reduce migraine symptoms, so you might want to consider having a cup of coffee or tea when you wake up with a migraine to help it subside.
### Weather Changes
Some people report that [changes in the weather](https://www.healthcentral.com/slideshow/can-weather-cause-migraine-attacks) are triggers, says Dr. O’Brien. High humidity, bright sunshine, thunder and lightning storms, changes in season, and changes in barometric pressure that occurred while you were sleeping can all be associated with morning migraine. A 2022 analysis in [*Atmosphere*](https://www.mdpi.com/2073-4433/13/11/1865) found 46% of people surveyed said that weather affected their health, with the most common complaints being headaches including migraines.
### **Food Triggers**
Some patients link their migraines to certain foods, says Dr. O’Brien. [Common offenders](https://www.healthcentral.com/slideshow/chronic-migraine-food-triggers) include aged cheese, processed meats, pickled foods, hot dogs, and chocolate—so that sausage, egg, and cheese breakfast sandwich might be causing problems. The specific food triggers differ widely from person to person, says Dr. O’Brien. Keeping records of your migraines can give you insight into your personal triggers, according to [The National Headache Foundation](https://headaches.org/resources/headache-diary-keeping-a-diary-can-help-your-doctor-help-you/).
### Medication Overuse
“For people with migraine, it’s very important to understand the concept of medication overuse headache or rebound headache,” says Dr. Estemalik. “People with migraine should not take over-the-counter analgesics \[such as Advil (ibuprofen), Aleve ([naproxen](https://www.healthcentral.com/drugs/monograph/153228-919/naprelan-cr)) or Tylenol (acetaminophen)\] more than two to three times a week, or prescription medicines like triptans, because that can give them rebound or overconsumption-of-medication headache.” In other words, loading up on meds just before bed can result in waking up with an even worse headache.
### Alcohol
Alcohol is not a trigger for every migraine patient, and not every type of alcohol may be a problem—some people may be able to drink whiskey but not wine, for example. In fact, a 2022 study in [*Headache*](https://headachejournal.onlinelibrary.wiley.com/doi/full/10.1111/head.14428) found participants who mostly consumed low doses of alcohol, “reported no significant effect on the probability of a migraine attack in the 24 hours following alcohol consumption.” The researchers believe this suggests that the role of alcohol as a migraine trigger might have been overestimated.
Still, to avoid migraine in the morning you may want to avoid alcohol overconsumption the night before. That’s especially true for drinks like red wine, which contains tyramine, [an amino acid that helps control blood pressure](https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/maois/faq-20058035#:~:text=Tyramine%20\(TIE-ruh-meen,excess%20tyramine%20in%20the%20body) and which tends to be a trigger for those who have migraine, says Dr. Estemalik.
### Hormonal Changes
The days leading up to your period or during it can trigger migraine for many women. In fact, 60% to 70% of women report a link between their periods and their migraine, according to the [Cleveland Clinic.](https://my.clevelandclinic.org/health/diseases/8260-menstrual-migraines-hormone-headaches) Hormonal changes caused by oral contraception, [perimenopause](https://www.healthcentral.com/condition/perimenopause), [menopause](https://www.healthcentral.com/condition/menopause), and pregnancy can also kick off a migraine attack, perhaps due to [shifting estrogen levels](https://www.uptodate.com/contents/estrogen-associated-migraine-headache-including-menstrual-migraine#:).
Treatments
## How to Treat Morning Migraine
Wake up with a throbbing headache? Here’s how to best stop it in its tracks.
### Take Your Meds Quickly
“If you wake up with significant headache, nausea, or vomiting, you should address it right away,” says Dr. Estemalik. “The most important thing is taking [the prescribed medication that aborts a migraine](https://www.healthcentral.com/slideshow/preventive-vs-abortive-medication-for-chronic-migraine). The longer you wait, sometimes the harder it is to get rid of. I always make sure the patient has access to their medication.”
These medications may include:
- [**Over-the-counter drugs**](https://www.healthcentral.com/condition/migraine/otc-migraine-medicine) such as Advil/Motrin (ibuprofen), Aleve (naproxen), or Tylenol (acetaminophen), or a combo that contains acetaminophen, aspirin, and caffeine (such as Excedrin Extra Strength and Excedrin Migraine).
- **Prescription medications:** “We use a lot of different drugs: seizure meds, blood pressure meds, antidepressants, injections, monoclonal antibodies, and neuromodulators,” says Dr. Estemalik.
### Get Mindful
Relaxation therapies such as deep breathing and mindfulness meditation may help to mitigate the effects of a migraine attack early on, [according to research](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213534/). One deep breathing exercise to try when you feel a migraine attack coming on the a.m. is [square breathing](https://americanmigrainefoundation.org/resource-library/breathing-exercises-for-migraine/):
- Inhale through your nose for a count of 4.
- Hold your breath for a count of 4.
- Exhale through your mouth for a count of 4.
- Pause for a count of 4.
Repeat this pattern a few times.
### Try Home Remedies
“Nonpharmaceutical treatments can help \[reduce migraine\],” says Dr. O’Brien. There are a few different [natural remedies](https://www.healthcentral.com/condition/migraine/home-remedies-for-migraine) that are easy to do in the morning, even before you get out of bed.
- **Essential oils:** Apply a few drops of peppermint essential oil to your temples or the base of your neck; [one small study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4316718/) found this technique to be helpful in improving headache intensity.
- **Cold therapy:** Use a cold compress like a cool towel or ice pack, which [has been found](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3727573/) to reduce pain when placed on the neck.
- **Dark rooms:** Avoid the temptation to reach for your phone. The light from screens [can worsen the migraine attack](https://gpacmigraine.org/managing-migraine-and-screen-time/). Similarly, if you can stay in a low-light space during your migraine, it may help mitigate symptoms.
### Drink Water
When you wake up with a migraine, have a glass or two of water, recommends Dr. O’Brien. Then keep drinking water throughout the day, to help prevent dehydration. In addition to water, she says, “make sure you're eating as well, to get those electrolytes in that can hydrate you a little bit faster.” Electrolytes are common in whole foods like fruits, vegetables, dairy products, and nuts and seeds, and beverages including sports drinks, according to the [Cleveland Clinic](https://health.clevelandclinic.org/best-electrolyte-sources).
Prevention
## Preventing Morning Migraine
While migraine can often be unpredictable, following a few lifestyle strategies may help keep attacks from happening.
### Get Ample Sleep
As noted, too-little sleep can be a significant migraine trigger for many people, so the more you can do to get consistent shut-eye, the better. “Schedule a regular bedtime,” advises Dr. O’Brien. “Aim to get at least seven to eight hours for adults, and more for kids.” Create [a healthy sleep environment](https://www.sleepfoundation.org/sleep-hygiene) by keeping your room cool, quiet, and comfortable.
### Get Moving
Physical activity is a part of every healthy lifestyle, and migraine is no exception. “Establish a regular routine in terms of exercise,” Dr. O’Brien says. “Exercise can help increase endorphins, which help you tolerate pain better.” It can also help you sleep better and reduce stress, per the [American Migraine Foundation.](https://americanmigrainefoundation.org/resource-library/exercise-migraine/)
### Eat Breakfast
And for that matter, make sure you’re not hungry at other points of the day, either, especially before bed. “Skipping meals is one of the most common triggers for patients with migraine,” says Dr. O’Brien. “So don’t let yourself getting hungry \[which leads to\] changes in glucose levels.”
### Stay Compliant With Your Meds
Take your migraine medicines consistently, says Dr. O’Brien. “If you're missing doses of preventive medications, especially if the frequency or impact of the migraine is severe, that can make you more susceptible to migraine in general,” she says.
Emergency
## When Is Your Migraine Attack an Emergency?
In most cases, a migraine attack can be handled at home with the strategies listed above. But there are times when you should [seek immediate help](https://americanmigrainefoundation.org/resource-library/understanding-migraine-treatment-in-the-emergency-room/) from a healthcare professional or emergency room, including:
- Confusion
- Difficult speaking
- Fever
- Neck stiffness
- Numbness or weakness
- Severe migraine symptoms
- Vision changes
In addition, “anyone ever experiences a new onset morning headache that is not ordinary or who doesn't have a history of migraines, that is a presentation that we take quite seriously,” says Dr. Estemalik. Rarely, these can be signs of [stroke](https://www.healthcentral.com/condition/stroke) or brain aneurisms, so it’s best to err on the side of caution and seek medical attention.
If your child keeps waking up with a morning headache, you should also consult your pediatrician. “You want to rule out any type of lesion in the back part of the head that could be compressing and causing problems,” says Dr. O’Brien.
Bottom Line
## Bottom Line
Waking up with a migraine doesn’t have to mean the whole day is ruined. By taking action quickly—having your go-to prescription or OTC migraine med, rehydrating with water, eating something like a piece of fruit or drinking a sports drink—can often help cut off initial migraine symptoms before they get more severe. Maintaining a healthy lifestyle with regular exercise, meals, sleep, ample water consumption, and reducing or eliminating alcohol, can also help prevent a.m. issues and keep migraine at bay altogether.
This article was originally published January 26, 2024 and most recently updated February 5, 2024.
© 2026 HealthCentral LLC. All rights reserved.
Sources
**Morning Migraine:** American Migraine Foundation. (2019.) "Migraine Triggers: Sleep Disorders and Headache." <https://americanmigrainefoundation.org/resource-library/sleep/>
**Onset Time:** *Cephalalgia.* (2018.) "Chronotypes and circadian timing in migraine." <https://pubmed.ncbi.nlm.nih.gov/28944680/>
**Hydration and Migraine:** Migraine Canada. (2022.) "Hydration and Migraine." <https://migrainecanada.org/posts/the-migraine-tree/branches/self-care-lifestyle/hydration-and-migraine/>
**Dehydration (1):***The European Journal of Neurology*. (2005.) "Increasing the daily water intake for the prophylactic treatment of headache: a pilot trial." <https://pubmed.ncbi.nlm.nih.gov/16128874/>
**Dehydration (2):***The Journal of Clinical Neuroscience*. (2020.) "Association of drinking water and migraine headache severity." <https://www.jocn-journal.com/article/S0967-5868(20)30941-3/pdf>
**Sleep (1):** *The Journal of Headache and Pain.* (2018). "Impact of migraine on the clinical presentation of insomnia: a population-based study." <https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-018-0916-5>
**Sleep (2)**: *The Journal of Headache and Pain*. (2018.) "Poor sleep quality in migraine and probable migraine: a population study." <https://pubmed.ncbi.nlm.nih.gov/30046921/>
**Sleep (3):***PLoS One*. (2023.) "Most bothersome symptom in migraine and probable migraine: A population-based study." <https://pubmed.ncbi.nlm.nih.gov/38019845/>
**Weather Changes** : *Atmosphere.* (2023.) "The Prevalence of Weather Sensitivity in Germany Derived from Population Surveys." <https://www.mdpi.com/2073-4433/13/11/1865>
**Food Triggers:** The National Headache Foundation. (2024.) "Headache Diary: Keeping a Diary Can Help Your Doctor Help You." <https://headaches.org/resources/headache-diary-keeping-a-diary-can-help-your-doctor-help-you/>
**Alcohol (1):** *JAMA Internal Medicine.*(2004.) "Prevalence and Risk Factors of Morning Headaches in the General Population." <https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/216451>
**Alcohol (2):***The Journal of Headache and Pain*. (2008) "Alcohol and migraine: trigger factor, consumption, mechanisms. A review." <https://thejournalofheadacheandpain.biomedcentral.com/>
**Alcohol (3):***Headache.* (2022.) "Alcohol as a trigger of migraine attacks in people with migraine. Results from a large prospective cohort study in English-speaking countries." <https://headachejournal.onlinelibrary.wiley.com/doi/full/10.1111/head.14428>
**Hormone Issues:** Cleveland Clinic. (2024.) "Menstrual Migraines (Hormone Headaches)." <https://my.clevelandclinic.org/health/diseases/8260-menstrual-migraines-hormone-headaches>
**Relaxation Therapies:** Expert Review of Neurotherapeutics. (2020.) "Mindfulness in migraine: A narrative review." <https://www.tandfonline.com/doi/full/10.1080/14737175.2020.1715212>
**Square Breathing:** American Migraine Foundation. (2023.) "Relaxation and Paced Breathing Exercises for Migraine." <https://americanmigrainefoundation.org/resource-library/breathing-exercises-for-migraine/>
**Peppermint Essential Oil:** *Frontiers in Neurology*. (2015.) "Efficacy and Tolerability of STOPAIN for a Migraine Attack." <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4316718/>
**Cold Compress:** *Hawaii Journal of Medicine and Public Health*. (2013.)" Randomized Controlled Trial: Targeted Neck Cooling in the Treatment of the Migraine Patient."<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3727573/>
**Screen Time:** Global Patient Advocacy Coalition. (2022.) "Managing Migraine and Screen Time." <https://gpacmigraine.org/managing-migraine-and-screen-time/>
**Electrolytes** : Cleveland Clinic. (2023.) "Rebalance, Replenish: 4 Sources of Electrolytes." <https://health.clevelandclinic.org/best-electrolyte-sources>
**Sleep Hygiene:** The Sleep Foundation. (2023.) "Mastering Sleep Hygiene: Your Path to Quality Sleep." <https://www.sleepfoundation.org/sleep-hygiene>
**Exercise:** American Migraine Foundation. (2020.) "Exercise and Migraine." <https://americanmigrainefoundation.org/resource-library/exercise-migraine/>
**ER Treatment:** American Migraine Foundation. (2018.) "Understanding Migraine Treatment in the Emergency Room." <https://americanmigrainefoundation.org/resource-library/understanding-migraine-treatment-in-the-emergency-room/>
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Jason Lin is a practicing neurologist in the San Francisco Bay Area. He received his medical degree from Virginia Commonwealth University in 2014 and completed a neurology residency at Mount Sinai Beth Israel in New York City.
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Medically Reviewed
## How to Prevent Morning Migraine
If you wake up with a pounding head, nausea, or other migraine symptoms, quick action can help keep things from spiraling into something more severe.
By
###### Jump To
- [Morning Migraine](https://www.healthcentral.com/condition/migraine/waking-up-with-migraine#morning-migraine)
- [When Is It Migraine](https://www.healthcentral.com/condition/migraine/waking-up-with-migraine#when-is-it-migraine)
- [Triggers](https://www.healthcentral.com/condition/migraine/waking-up-with-migraine#triggers)
- [Treatments](https://www.healthcentral.com/condition/migraine/waking-up-with-migraine#treatments)
- [Prevention](https://www.healthcentral.com/condition/migraine/waking-up-with-migraine#prevention)
- [Emergency](https://www.healthcentral.com/condition/migraine/waking-up-with-migraine#emergency)
- [Bottom Line](https://www.healthcentral.com/condition/migraine/waking-up-with-migraine#bottom-line)
You wake up with a throbbing pain in your head, which quickly gets more intense. When you open your eyes, your vision may seem a little blurry, or you may start seeing zigzag, shimmering, or polka-dot patterns. There are probably worse ways to start a day than with a migraine headache, but not many.
“It's not uncommon for patients with migraine to wake up with a headache,” says [Emad Estemalik, M.D](https://my.clevelandclinic.org/staff/18050-emad-estemalik)., director of the Center for Neuro-Restoration at the Cleveland Clinic in Cleveland, OH. “Usually what we advise in that case is to treat it like any other migraine that they experience.”
According to the [American Migraine Foundation](https://americanmigrainefoundation.org/resource-library/sleep/), the most common time for migraine to occur is in the early morning. And a study in the journal [*Cephalalgia*](https://pubmed.ncbi.nlm.nih.gov/28944680/) found that 40% of people with migraine reported that their headaches began in the early hours of the day. “When we look at the times that patients most commonly tend to develop [migraines](https://www.healthcentral.com/condition/migraines), it’s between 4 a.m. and 8 a.m.," says [Hope O’Brien, M.D.,](https://www.hcohcincy.com/our-model) founder and CEO of Headache Center of Hope in Cincinnati, OH. “That is when migraine is common.”
Let’s take a look why this pattern prevails and if you’re prone to migraine attacks what you can do to prevent them.
A morning migraine attack isn’t different than migraine at any other time of the day in terms of its length or intensity. It’s just that “people who have migraine more commonly have morning headaches than at other times,” says Dr. Estemalik. “It's more the triggers play a bigger role at that time.”
There are a couple of reasons why migraine attacks may strike in the morning hours. For starters, since most over-the-counter and prescription pain medications wear off in four to eight hours, any meds you took before bed will likely no longer be working, per the American Migraine Foundation. In addition, if a migraine begins during the night while you’re asleep, you may not feel the pain and thus miss the crucial early-onset window to take your migraine medicine—which anyone with migraine knows is key to keeping head pain at bay.
There are a few signs that your headache may be a migraine. These include headaches that:
- Affect mostly one side of the head
- Are associated with nausea, vomiting, and light and sound sensitivity.
- Are throbbing in nature
- Come on abruptly
In general, [migraine symptoms](https://www.healthcentral.com/condition/migraine-symptoms-causes) last about four hours, no matter what time of day you have them, says Dr. O’Brien. “That's all you need for the diagnosis of migraine.” For people with more severe migraine attacks, the episode can last 24, 48, or even 72 hours.
“Migraine triggers differ from individual to individual,” says Dr. O’Brien. That said, there are a few common issues that often seem to set off a migraine attack in the a.m. These include:
### Dehydration
“If you're not drinking enough water it can trigger a migraine,” says Dr. O’Brien. While there’s no set reason, [some experts believe](https://migrainecanada.org/posts/the-migraine-tree/branches/self-care-lifestyle/hydration-and-migraine/) a balance of water, ions (an atom or group of atoms that has an electric charge), and other fluids may be involved. If fluid levels in the body become too concentrated because you’re dehydrated, researchers believe receptors in the brain may be activated, causing a migraine.
A study published in [*The European Journal of Neurology*](https://pubmed.ncbi.nlm.nih.gov/16128874/) found that subjects who drank an extra 1.5 liters of water a day had less intense and shorter episodes of migraine. And a study in [*The Journal of Clinical Neuroscience*](https://www.jocn-journal.com/article/S0967-5868\(20\)30941-3/pdf) showed that the severity of migraine disability, pain severity, migraine frequency, and duration were significantly lower in those who consumed more water. If you last had something to drink by around 7 p.m., by the time you wake up 12 hours later you may already be slightly dehydrated.
### Interrupted Sleep
“Sleep is big on the list” of triggers, says Dr. Estemalik. Many people with migraine have an underlying sleep disorder: In fact, a study in [*The Journal of Headache and Pain*](https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-018-0916-5) found that about 25% of people with migraine had [insomnia](https://www.healthcentral.com/sleep/insomnia) compared to only 15% of those with non-migraine headaches. Another study in [*The Journal of Headache and Pain*](https://pubmed.ncbi.nlm.nih.gov/30046921/) found that poor sleep quality was prevalent among study participants with probable migraine and was associated with an exacerbation of migraine symptoms. ([Probable migraine](https://pubmed.ncbi.nlm.nih.gov/38019845/) is a term used for migraines that meet all but one criterion for a migraine diagnosis.)
“Any changes in your sleep patterns, whether it’s getting too much or not getting enough, can trigger a migraine,” adds Dr. O’Brien. “If you’re staying up late, and have to get up early in the morning, you are more likely to get one. For example, if you stay up late on Friday and Saturday and then have to get up early on Monday morning, you'll likely wake up with a morning headache because you did not get enough sleep.” It could also work the other way: Migraine can also cause disrupted sleep, setting off a vicious cycle.
### Caffeine
Caffeine can often affect migraine, for better or worse. And the morning hours are when most of us get our daily caffeine fix. Drinking too much caffeine can set off a migraine attack, but so can cutting back on caffeine, notes Dr. O’Brien. “It also causes changes in the blood vessels, which can then trigger a migraine,” she adds.
Having that extra-large latte can also cause other problems. “Caffeine is a diuretic, meaning whatever fluid \[you’ve ingested\], you pee it out, which can exacerbate dehydration,” says Dr. O’Brien.
And if you drink coffee or have a lot of cola before bed, it can disrupt your sleep, notes Dr. Estemalik, which (as noted above) is another migraine trigger.
That said, for some people a moderate amount of caffeine can reduce migraine symptoms, so you might want to consider having a cup of coffee or tea when you wake up with a migraine to help it subside.
### Weather Changes
Some people report that [changes in the weather](https://www.healthcentral.com/slideshow/can-weather-cause-migraine-attacks) are triggers, says Dr. O’Brien. High humidity, bright sunshine, thunder and lightning storms, changes in season, and changes in barometric pressure that occurred while you were sleeping can all be associated with morning migraine. A 2022 analysis in [*Atmosphere*](https://www.mdpi.com/2073-4433/13/11/1865) found 46% of people surveyed said that weather affected their health, with the most common complaints being headaches including migraines.
### **Food Triggers**
Some patients link their migraines to certain foods, says Dr. O’Brien. [Common offenders](https://www.healthcentral.com/slideshow/chronic-migraine-food-triggers) include aged cheese, processed meats, pickled foods, hot dogs, and chocolate—so that sausage, egg, and cheese breakfast sandwich might be causing problems. The specific food triggers differ widely from person to person, says Dr. O’Brien. Keeping records of your migraines can give you insight into your personal triggers, according to [The National Headache Foundation](https://headaches.org/resources/headache-diary-keeping-a-diary-can-help-your-doctor-help-you/).
### Medication Overuse
“For people with migraine, it’s very important to understand the concept of medication overuse headache or rebound headache,” says Dr. Estemalik. “People with migraine should not take over-the-counter analgesics \[such as Advil (ibuprofen), Aleve ([naproxen](https://www.healthcentral.com/drugs/monograph/153228-919/naprelan-cr)) or Tylenol (acetaminophen)\] more than two to three times a week, or prescription medicines like triptans, because that can give them rebound or overconsumption-of-medication headache.” In other words, loading up on meds just before bed can result in waking up with an even worse headache.
### Alcohol
Alcohol is not a trigger for every migraine patient, and not every type of alcohol may be a problem—some people may be able to drink whiskey but not wine, for example. In fact, a 2022 study in [*Headache*](https://headachejournal.onlinelibrary.wiley.com/doi/full/10.1111/head.14428) found participants who mostly consumed low doses of alcohol, “reported no significant effect on the probability of a migraine attack in the 24 hours following alcohol consumption.” The researchers believe this suggests that the role of alcohol as a migraine trigger might have been overestimated.
Still, to avoid migraine in the morning you may want to avoid alcohol overconsumption the night before. That’s especially true for drinks like red wine, which contains tyramine, [an amino acid that helps control blood pressure](https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/maois/faq-20058035#:~:text=Tyramine%20\(TIE-ruh-meen,excess%20tyramine%20in%20the%20body) and which tends to be a trigger for those who have migraine, says Dr. Estemalik.
### Hormonal Changes
The days leading up to your period or during it can trigger migraine for many women. In fact, 60% to 70% of women report a link between their periods and their migraine, according to the [Cleveland Clinic.](https://my.clevelandclinic.org/health/diseases/8260-menstrual-migraines-hormone-headaches) Hormonal changes caused by oral contraception, [perimenopause](https://www.healthcentral.com/condition/perimenopause), [menopause](https://www.healthcentral.com/condition/menopause), and pregnancy can also kick off a migraine attack, perhaps due to [shifting estrogen levels](https://www.uptodate.com/contents/estrogen-associated-migraine-headache-including-menstrual-migraine#:).
Wake up with a throbbing headache? Here’s how to best stop it in its tracks.
### Take Your Meds Quickly
“If you wake up with significant headache, nausea, or vomiting, you should address it right away,” says Dr. Estemalik. “The most important thing is taking [the prescribed medication that aborts a migraine](https://www.healthcentral.com/slideshow/preventive-vs-abortive-medication-for-chronic-migraine). The longer you wait, sometimes the harder it is to get rid of. I always make sure the patient has access to their medication.”
These medications may include:
- [**Over-the-counter drugs**](https://www.healthcentral.com/condition/migraine/otc-migraine-medicine) such as Advil/Motrin (ibuprofen), Aleve (naproxen), or Tylenol (acetaminophen), or a combo that contains acetaminophen, aspirin, and caffeine (such as Excedrin Extra Strength and Excedrin Migraine).
- **Prescription medications:** “We use a lot of different drugs: seizure meds, blood pressure meds, antidepressants, injections, monoclonal antibodies, and neuromodulators,” says Dr. Estemalik.
### Get Mindful
Relaxation therapies such as deep breathing and mindfulness meditation may help to mitigate the effects of a migraine attack early on, [according to research](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213534/). One deep breathing exercise to try when you feel a migraine attack coming on the a.m. is [square breathing](https://americanmigrainefoundation.org/resource-library/breathing-exercises-for-migraine/):
- Inhale through your nose for a count of 4.
- Hold your breath for a count of 4.
- Exhale through your mouth for a count of 4.
- Pause for a count of 4.
Repeat this pattern a few times.
### Try Home Remedies
“Nonpharmaceutical treatments can help \[reduce migraine\],” says Dr. O’Brien. There are a few different [natural remedies](https://www.healthcentral.com/condition/migraine/home-remedies-for-migraine) that are easy to do in the morning, even before you get out of bed.
- **Essential oils:** Apply a few drops of peppermint essential oil to your temples or the base of your neck; [one small study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4316718/) found this technique to be helpful in improving headache intensity.
- **Cold therapy:** Use a cold compress like a cool towel or ice pack, which [has been found](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3727573/) to reduce pain when placed on the neck.
- **Dark rooms:** Avoid the temptation to reach for your phone. The light from screens [can worsen the migraine attack](https://gpacmigraine.org/managing-migraine-and-screen-time/). Similarly, if you can stay in a low-light space during your migraine, it may help mitigate symptoms.
### Drink Water
When you wake up with a migraine, have a glass or two of water, recommends Dr. O’Brien. Then keep drinking water throughout the day, to help prevent dehydration. In addition to water, she says, “make sure you're eating as well, to get those electrolytes in that can hydrate you a little bit faster.” Electrolytes are common in whole foods like fruits, vegetables, dairy products, and nuts and seeds, and beverages including sports drinks, according to the [Cleveland Clinic](https://health.clevelandclinic.org/best-electrolyte-sources).
While migraine can often be unpredictable, following a few lifestyle strategies may help keep attacks from happening.
### Get Ample Sleep
As noted, too-little sleep can be a significant migraine trigger for many people, so the more you can do to get consistent shut-eye, the better. “Schedule a regular bedtime,” advises Dr. O’Brien. “Aim to get at least seven to eight hours for adults, and more for kids.” Create [a healthy sleep environment](https://www.sleepfoundation.org/sleep-hygiene) by keeping your room cool, quiet, and comfortable.
### Get Moving
Physical activity is a part of every healthy lifestyle, and migraine is no exception. “Establish a regular routine in terms of exercise,” Dr. O’Brien says. “Exercise can help increase endorphins, which help you tolerate pain better.” It can also help you sleep better and reduce stress, per the [American Migraine Foundation.](https://americanmigrainefoundation.org/resource-library/exercise-migraine/)
### Eat Breakfast
And for that matter, make sure you’re not hungry at other points of the day, either, especially before bed. “Skipping meals is one of the most common triggers for patients with migraine,” says Dr. O’Brien. “So don’t let yourself getting hungry \[which leads to\] changes in glucose levels.”
### Stay Compliant With Your Meds
Take your migraine medicines consistently, says Dr. O’Brien. “If you're missing doses of preventive medications, especially if the frequency or impact of the migraine is severe, that can make you more susceptible to migraine in general,” she says.
In most cases, a migraine attack can be handled at home with the strategies listed above. But there are times when you should [seek immediate help](https://americanmigrainefoundation.org/resource-library/understanding-migraine-treatment-in-the-emergency-room/) from a healthcare professional or emergency room, including:
- Confusion
- Difficult speaking
- Fever
- Neck stiffness
- Numbness or weakness
- Severe migraine symptoms
- Vision changes
In addition, “anyone ever experiences a new onset morning headache that is not ordinary or who doesn't have a history of migraines, that is a presentation that we take quite seriously,” says Dr. Estemalik. Rarely, these can be signs of [stroke](https://www.healthcentral.com/condition/stroke) or brain aneurisms, so it’s best to err on the side of caution and seek medical attention.
If your child keeps waking up with a morning headache, you should also consult your pediatrician. “You want to rule out any type of lesion in the back part of the head that could be compressing and causing problems,” says Dr. O’Brien.
Waking up with a migraine doesn’t have to mean the whole day is ruined. By taking action quickly—having your go-to prescription or OTC migraine med, rehydrating with water, eating something like a piece of fruit or drinking a sports drink—can often help cut off initial migraine symptoms before they get more severe. Maintaining a healthy lifestyle with regular exercise, meals, sleep, ample water consumption, and reducing or eliminating alcohol, can also help prevent a.m. issues and keep migraine at bay altogether.
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