Nighttime Headaches: Causes and When to Seek Help

Q: Nighttime Headaches: Causes and When to Seek Help

Hello： The commonly referred to "wet ears" is actually oily earwax. <br>It is not recommended to use cotton swabs for cleaning, as they often push the earwax further in, leading to impaction. <br>The external auditory canal has its own self-cleaning mechanism, so it is advisable

Headache during sleep at night?

Hello Doctor: I have a history of migraines, occurring about 2-3 times a month, usually while I am awake.
However, in the past month, I have been experiencing headaches frequently during the night, waking up suddenly from sleep due to pain.
On a pain scale of 1 to 10, the pain is about a 6, located in the area from the right temple to the top of my head.
While lying down, I do not feel dizzy or nauseous, and after falling back asleep, I do not experience any headaches.
I also do not take any specific medication for it, and during the day after waking up, I feel normal.
However, in the past week, the frequency has increased significantly, occurring almost 2-3 times a week.
I would like to ask the doctor what factors might be causing this situation.
Is it necessary for me to see a doctor? Which specialties should I consult? Thank you!

Xiao Wen, 40~49 year old female. Ask Date: 2021/03/05

Dr. Jiang Junyi reply Neurology

Hello: The commonly referred to "wet ears" is actually oily earwax.
It is not recommended to use cotton swabs for cleaning, as they often push the earwax further in, leading to impaction.
The external auditory canal has its own self-cleaning mechanism, so it is advisable to simply observe.
If you wish to use a metal ear scoop, please be cautious to avoid injuring the external auditory canal, or you may visit a clinic to have a doctor perform the cleaning.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the ENT Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2021/03/05

More Info

Nighttime headaches can be a perplexing and distressing issue, especially for individuals with a history of migraines. Your experience of waking up in the middle of the night with a headache that rates around 6 out of 10 in pain intensity, localized primarily around the right temple to the top of your head, is noteworthy. Given your history of migraines occurring during waking hours, it is essential to consider several potential factors that could be contributing to these nighttime headaches.

Possible Causes of Nighttime Headaches
1. Migraine Variants: Migraines can manifest in various forms, and some individuals experience nocturnal migraines. These headaches can be triggered by factors such as sleep disturbances, changes in sleep patterns, or even specific dietary triggers consumed earlier in the day.

2. Sleep Disorders: Conditions like sleep apnea can lead to fragmented sleep and oxygen deprivation, which may trigger headaches. If you snore or experience pauses in breathing during sleep, it might be worthwhile to discuss this with a healthcare provider.

3. Medication Overuse: If you have been using over-the-counter pain relievers frequently, this could lead to rebound headaches. It’s essential to monitor your medication use and discuss it with your doctor.

4. Stress and Anxiety: Emotional stress can lead to muscle tension in the neck and shoulders, which may contribute to headaches. If you are experiencing increased stress or anxiety, this could be a significant factor.

5. Hormonal Changes: Fluctuations in hormones, particularly in women, can lead to headaches. If your headaches coincide with your menstrual cycle, this might be a contributing factor.

6. Environmental Factors: Changes in your sleeping environment, such as noise, light, or even the position in which you sleep, can influence headache occurrence.
7. Dehydration or Hunger: Sometimes, going to bed without adequate hydration or after a long period without food can trigger headaches.

When to Seek Help
Given the increased frequency of your nighttime headaches—occurring 2-3 times a week—it would be prudent to seek medical advice. Here are some recommendations on how to proceed:
1. Consult a Neurologist: Since you have a history of migraines, a neurologist would be the most appropriate specialist to evaluate your condition. They can conduct a thorough assessment, including a detailed history and possibly imaging studies, to rule out any underlying conditions.

2. Sleep Study: If sleep apnea or another sleep disorder is suspected, your doctor may recommend a sleep study to monitor your sleep patterns and identify any abnormalities.

3. Keep a Headache Diary: Documenting your headaches, including their frequency, duration, intensity, and any associated symptoms, can provide valuable information to your healthcare provider.

4. Lifestyle Modifications: In the meantime, consider implementing lifestyle changes such as maintaining a regular sleep schedule, managing stress through relaxation techniques, and ensuring proper hydration and nutrition.

Conclusion
Nighttime headaches can arise from a variety of causes, and understanding the underlying factors is crucial for effective management. Given your history of migraines and the recent change in your headache pattern, it is advisable to seek medical evaluation. A neurologist can help determine the cause of your headaches and recommend appropriate treatment options. Remember, early intervention can often lead to better outcomes and improved quality of life.

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