Morning headaches

Q I am 70 and healthy, but suffer from morning headaches. They are behind my right eye and last for up to two or three days. Paracetamol gives relief, but I would prefer not to use painkillers. My last eye test turned up no problems. - Michael Williams, Nottingham

A Morning headaches are generally a symptom of something else. They are linked with snoring (J Neurol, 1996; 243: 621-5) or sleeping with someone who snores (Health Care Women Int, 2000; 21: 81-90), teeth-grinding (J Oral Rehabil, 1997; 24: 581-7), limb-movement disorders and hypertension, and strongly associated with mood disorders such as depression and anxiety (Cephalalgia, 2002; 22: 333-9). But most doctors believe the main cause is obstructive sleep apnoea syndrome (J Neurol, 1996; 243: 621-5; Arch Intern Med, 1999; 159: 1765-8).

A comprehensive study of morning headaches, involving nearly 19,000 adult Europeans, found that 7.6 per cent (one in 13) of us wake up with a headache (Arch Intern Med, 2004; 164: 97-102). More women than men, mostly those aged 45-64 and more married than single people were morning-headache sufferers; there were also more who were unemployed and homemakers than workers and students.

Also, it was more common in those with a body mass index (BMI) below 20 (below the norm) or over 27 (obese), and among those suffering from musculoskeletal, heart or respiratory diseases, high blood pressure or thyroid disorders. Those who drank six or more glasses of alcohol a day had nearly twice the rate of morning headaches as abstainers. Likewise, rates were higher among those taking hypnotic, anti-anxiety, antidepressant or neuroleptic medications. There was no association with tobacco use.

Clearly, long-held beliefs that morning headaches are mostly related to sleep/breathing disorders are misleading. While these may be linked - for example, musculoskeletal pain can disturb sleep and, thus, lead to morning headaches - the list of causes is long.

Things that can influence morning headaches include:

* dehydration. Make sure you drink an adequate amount of water every day

* digestive problems, particularly eating foods to which you are allergic or sensitive

* bedding. If your pillow doesn’t support your head and neck properly, this could lead to spinal or musculoskeletal problems, resulting in headaches. The same applies to a worn-out mattress.