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1158 Morning Headache, Apnea and Early Morning Arousal
Abstract   Peer reviewed

1158 Morning Headache, Apnea and Early Morning Arousal

Aygun Asgarli, Linder Wendt, Elena Muro-Fuentes, Courtney Sullivan, Delora Denney, Andrew russo and Deema Fattal
Sleep (New York, N.Y.), Vol.49(Supplement_1), pp.A516-A516
05/01/2026
DOI: 10.1093/sleep/zsag091.1157

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Abstract

Introduction Morning headache (MH), a headache that occurs upon waking, affects ~10% of the population. Despite its prevalence, its cause(s) remain speculative. Previously, we found that in 383 Veterans MH was not associated with the presence of obstructive sleep apnea (OSA) or its severity, nor multiple other sleep parameters; sleep efficiency and total sleep time were non-significantly higher in those with MH. Therefore, we investigated MH with more detailed sleep parameters, including early morning arousal. Methods Participants aged 18–89, who visited the University of Iowa for a polysomnogram, and who consented to our study, completed a survey about headaches the morning after their polysomnogram. We collected sleep parameters from their polysomnogram. Results Of 100 enrolled participants, 89 did not have a headache at bedtime the night of their polysomnogram. Of those 89, 18 (20%) reported MH upon waking the next morning. There were no significant differences between those with MH (MH) and those without (non-MH) regarding the presence of OSA or OSA severity; lowest oxygen saturation; %REM sleep; presence of vivid dreams; presence of RSWA, WASO, PLMI, PLMAI, or SAI; or arousal past 4:00 AM. Moreover, 6% of MH and 21% of non-MH had prolonged arousal past 4:00 AM (p=0.2). Only 26 of 89 reported whether they woke up at night and went back to sleep; of those 26, 80% of MH and 100% of non-MH did. Sleep efficiency was non-significantly higher in MH vs non-MH (89% and 82%, respectively, p=0.12). A significant finding was that MH slept a bit longer than non-MH the night of the polysomnogram (median 6.4 vs 6.0 hours; p=0.03). Other significant findings were that 33% of MH and 6% of non-MH complained of teeth grinding that night (p=0.004), and 56% of MH and 24% of non-MH complained of teeth grinding at home (p=0.01). Conclusion • Consistent with our prior study, there were no positive associations between MH and OSA or OSA severity, nor multiple sleep parameters. Sleep efficiency was non-significantly higher in MH. • Novel parameters of early morning arousal were not associated with MH. • Teeth grinding and slightly longer sleep time were associated with MH. Support (if any)
 Headaches Sleep Apnea Efficiency

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