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WHAT’S UP WITH MORNING
HEADACHES?
I wake with a headache every morning and go to
bed with a headache. When I wake in the morning
I always seem to have congestion at the back of
my nose. I’m being treated for sinus headache with
decongestants and antihistamines but symptoms
never go away. This has been going on for 3 years
and I’m not sure what to do next. – Jennifer M.
Headaches that occur when you wake up in the morning
could be caused by several things. First, the nasal congestion you are experiencing could produce sleep apnea. If
you cannot breathe through your nose at night then you
are likely “mouth breathing” and snoring becomes more
likely. Snoring is often associated with sleep apnea particularly if you are sleepy during the day. Your physician
could order a sleep study to diagnose this if the above
symptoms apply to you. Second, you could be suffering
from rhinitis, which could trigger headaches in some
people. If your nose becomes engorged with blood upon
lying down this could activate the trigeminal nerve in
your nose and produce headache. This could be relieved
by a variety of medications prescribed by your physicians.
Third, you could be experiencing hypnic headaches.
These are headaches that wake people from sleep–usually in the middle of the night. These can be treated by
a headache physician. Fourth, migraine–particularly
chronic migraine–can cause headaches upon wakening.
These headaches could be diagnosed and treated by your
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Volume 3, Issue 3 • 2013
primary care physician or a specialist in headache disorders. Fifth, cluster headaches commonly occur at night
and often awaken patients from sleep. These headaches
always occur on the same side of the head, are severe and
only last 30 minutes to 3 hours. They also commonly
have tearing of the eye or running of the nose on the
same side as the headache. Sixth, headaches related to
pseudotumor can occur at night and worsen with lying
down. Pseudotumor headaches result from increases in
the pressure of spinal fluid within the head. They can be
suspected by your physician by noting swelling of the
optic nerve upon examination and later confirmed by a
spinal tap. These headaches also have specific treatments.
Therefore, your first step would be to obtain a diagnosis
for your morning headaches. If you are having problems
I would suggest that you consult a headache physician in
your area.
Vincent Martin, MD
Department of Internal Medicine
University of Cincinnati Medical School
Cincinnati, OH
EFFECTIVE TREATMENT
FOR TMJ
I’ve worn a mouth guard for years and the pain
I have from TMJ has never gotten better. Now it
has been recommended to me to get jaw surgery
to help TMJ and bite issues as well as consistent
headaches. Can TMJ surgery help relieve headaches? – Kris O.