Evening Headaches: Nighttime Pain and Its Causes

I experience headaches every evening?

Hello doctor, my partner has been experiencing headaches that start after 10 PM for the past two to three nights.
Sometimes, there is also a tingling sensation in the face.
However, after getting some sleep, there are no symptoms during the day.
Why does the pain occur only at night? They do not smoke or drink alcohol, but they have a history of depression and are taking sleeping pills and antidepressants.
Occasionally, they go to sleep around 3 or 4 AM.
However, their roommate does smoke, and they are exposed to secondhand smoke at home.

Niming, 20~29 year old female. Ask Date: 2021/07/17

Dr. Hong Yuanbin reply Internal Medicine

Hello, the causes of headaches are often multifactorial, including medication, irregular sleep patterns, lack of exercise, stress, and coffee consumption habits, among others.
Based on the situation you mentioned, the potential contributing factors could be: 1.
Irregular sleep patterns and frequent insomnia; 2.
High levels of stress; 3.
Medications taken during the day that may wear off by evening, sometimes triggering headaches; 4.
If there is a habit of consuming coffee during the day, the withdrawal of caffeine effects in the evening could also lead to headaches; 5.
Long-term lack of exercise.
These are all potential causes, but it is usually a combination of multiple factors.
I recommend starting with establishing a regular sleep schedule and incorporating regular exercise.
Additionally, you may want to discuss your headache symptoms with your prescribing physician for depression to see if medication adjustments are necessary.
Thank you for your inquiry.

Reply Date: 2021/07/17

More Info

Evening headaches can be a perplexing issue, particularly when they occur consistently at a specific time, such as after 10 PM, and are accompanied by other symptoms like facial tingling. Understanding the underlying causes of these headaches requires a multifaceted approach, especially considering the various factors that could contribute to this condition.

Firstly, the irregular sleep schedule is a significant factor. Your partner's habit of going to bed around 3 or 4 AM can disrupt the body's natural circadian rhythm. This disruption can lead to a variety of health issues, including headaches. Sleep deprivation or poor-quality sleep can trigger tension-type headaches or migraines. The brain and body need adequate rest to recover and function optimally, and when this is compromised, it can lead to increased sensitivity to pain.

Secondly, the psychological aspect cannot be overlooked. Your partner's history of depression and the use of medications such as antidepressants and sleep aids may also play a role in the occurrence of evening headaches. Certain medications can have side effects, including headaches, especially as their effects wear off. If your partner is taking medication that affects serotonin levels, fluctuations in these levels could lead to headaches. It would be prudent for your partner to discuss these symptoms with their healthcare provider to evaluate whether their current medications might be contributing to their headaches.

Additionally, the presence of secondhand smoke in the environment could be a contributing factor. Even if your partner does not smoke, exposure to secondhand smoke can lead to respiratory irritation and headaches. The chemicals in cigarette smoke can cause inflammation in the nasal passages and sinuses, leading to headaches. If possible, reducing exposure to secondhand smoke could help alleviate some of the headache symptoms.

Stress and anxiety are also common triggers for headaches. If your partner is experiencing stress related to their mental health condition or other life circumstances, this could manifest as tension headaches, particularly in the evening when the day's stressors may accumulate. Engaging in relaxation techniques, such as mindfulness, yoga, or deep-breathing exercises, could be beneficial in managing stress levels and potentially reducing headache frequency.

Moreover, hydration and nutrition should be considered. Dehydration can lead to headaches, and if your partner is not drinking enough water throughout the day or is consuming a diet lacking in essential nutrients, this could contribute to their symptoms. Encouraging regular hydration and a balanced diet rich in fruits, vegetables, and whole grains can support overall health and potentially reduce headache occurrences.

In summary, the evening headaches your partner is experiencing could be attributed to a combination of factors, including irregular sleep patterns, medication side effects, exposure to secondhand smoke, stress, and lifestyle choices. It is essential for your partner to consult with a healthcare professional who can conduct a thorough evaluation, including a review of their medications and lifestyle, to determine the most appropriate course of action. This may involve adjusting medications, implementing better sleep hygiene practices, reducing exposure to irritants, and exploring stress management techniques. By addressing these various aspects, it may be possible to alleviate the evening headaches and improve your partner's overall quality of life.

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