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Guide · Sleep

Waking up with a headache: 7 causes, including grinding at night.

If the headache is already there when you wake up, the timing reveals a lot. Often clenching or grinding at night is behind it, but sometimes a breathing disorder during sleep. Here you can read how to tell the difference.

Dr. med. dent. Bodo S. von Gadomski Dr. med. dent. Bodo S. von GadomskiDentist · Founder of the CMD-Klinik
9 min read Grinding · Sleep apnoea · Evening routine
Contents · 7 questions
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Morning headache develops during the hours when you notice nothing. That is why it is hard to pin down. The good news: most causes leave traces that you or those around you can recognise.

Question 01 of 7

Why do I have headaches in the morning?

In shortThe most common reasons are clenching or grinding at night, too little or too much sleep, caffeine withdrawal, alcohol, too many painkillers, a breathing disorder during sleep and an unfavourable sleeping position.

  1. Clenching and grindingThe jaw muscles work against resistance at night. Typical: pressure at the temples and a tired jaw on waking.
  2. Sleep apnoeaPauses in breathing lower oxygen and raise carbon dioxide in the blood. Typical: a dull headache that fades within a few hours of getting up, plus snoring and daytime tiredness.
  3. Amount of sleepToo little sleep, but also sleeping in much longer at the weekend, can trigger headaches.
  4. Caffeine withdrawalIf you drink a lot of coffee during the day, you may have headaches in the morning before your first cup.
  5. Alcohol in the eveningIt disturbs sleep, dehydrates and increases clenching and snoring.
  6. Too many painkillersMedication-overuse headache is often already there in the morning.
  7. Pillow and sleeping positionA pillow that is too high or too flat, and sleeping on your stomach, strain the neck for hours.
Question 02 of 7

How do I know I grind at night?

In shortFrom traces: worn teeth, tooth marks on the edge of the tongue, a tired or stiff jaw in the morning and noises someone else hears.

  • Flat, shiny wear facets on the canines
  • Sensitive tooth necks or fine cracks in the enamel
  • Tooth marks on the edge of the tongue, a white line on the inside of the cheek
  • Pressure at the temples in the morning, tension in the cheeks, difficulty opening the mouth
  • Your partner hears grinding noises at night

Many people clench rather than grind. Clenching is silent and goes unnoticed, but strains the muscles just as much. More on this in the article Teeth grinding (bruxism).

Question 03 of 7

How does grinding cause headaches?

In shortThe temple muscle is a chewing muscle. If it works against resistance for long periods at night, it is overloaded in the morning and hurts where many people feel their headache.

Then there is the trigeminal nerve, which supplies the chewing muscles and jaw joint and is also the main nerve for head and facial pain. Constant irritation can sustain tension-type headache and, in people with migraine, favour attacks.

From the perspective of CMD systems medicine, this is not purely mechanical wear but a dysregulation: during sleep the nervous system maintains a tension that nobody can switch off at will. Stress, an unfavourable bite position and poor sleep reinforce each other.

Question 04 of 7

Could it be sleep apnoea?

In shortIf you snore loudly, pauses in breathing are noticed and you are very tired during the day despite enough sleep, yes. This should be checked by a doctor before thinking about the jaw.

  • Loud, irregular snoring
  • Observed pauses in breathing or waking at night short of breath
  • Marked daytime tiredness, falling asleep while reading or watching TV
  • Needing to urinate at night, dry mouth in the morning
  • High blood pressure

With these signs, please speak to your GP first. Sleep apnoea is diagnosed with a measurement during sleep. It is very treatable and should not be overlooked.

Grinding and pauses in breathing often occur together. That is why, if suspected, we assess both and work with sleep medicine.

Question 05 of 7

What can I do in the evening?

In shortWind down consciously, avoid caffeine and alcohol in the evening, relax your jaw and choose a suitable pillow.

  1. Coffee until early afternoonCaffeine-free after that. The effect lasts longer than many people think.
  2. Reduce alcohol in the eveningEspecially in the three hours before sleep.
  3. An hour without screensReading, a walk, a quiet conversation. This lowers baseline tension.
  4. Relax your jawWarmth on the cheeks, gently massage the chewing muscles, keep your teeth apart. Instructions in the article CMD exercises at home.
  5. Check your pillowWhen lying on your side, your head should be in line with your spine. Lying on your stomach strains neck and jaw.
  6. Same timesThe same bedtimes every day, at weekends too.
Question 06 of 7

Does a splint help with morning headaches?

In shortIf clenching or grinding is the cause, a splint can relieve teeth, joint and muscles. Whether the headaches ease as a result varies from person to person.

An individually planned splint is made on the basis of functional diagnostics and adapted to your bite position. A splint from the chemist protects tooth substance but does not address the bite position. With sleep apnoea, the splint must be adapted to it, so breathing during sleep should be clarified first.

In the CMD Systems Check we measure how hard your chewing muscles work and with what force your teeth meet. Only from this can we tell whether a splint is the right step.

Question 07 of 7

When should I have this checked?

In shortIf you wake up with a headache several times a week, have signs of grinding or your jaw clicks, and serious causes have been ruled out.

See a doctor immediately: a new, increasing headache that wakes you at night · headache with vomiting in the morning · visual or speech disturbances or paralysis · fever with a stiff neck.

A first assessment of the jaw system is provided by the CMD self-test. On the link with sleep and exhaustion, also read the symptom page Sleep and energy.

More questions, already answered

Sources

  • International Classification of Headache Disorders, 3rd edition (ICHD-3): sleep apnoea headache, medication-overuse headache
  • International consensus on the definition and assessment of bruxism
  • Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)

This article is for general information and does not replace a medical assessment. If you suspect sleep apnoea, please contact your GP practice.

Do you grind at night?

The self-test gives you an initial assessment. Or call us: +41 44 888 99 44

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