Nothing compares to the agony of trying to sleep with a headache. The pain itself can make you crave restful slumber (and the relief it may bring), making it difficult to sleep. You might be tempted to curl into a foetal position or pretzel your body into any position that will relieve the aching or throbbing. It turns out that the position you choose to sleep in when you have a headache can affect how easily you fall asleep and how you feel when you wake up.
When you have a headache, what is the best position to sleep in?
The best position to sleep in if you have a headache, according to Diana Shadbehr, DO, director of the Headache Clinic at Cedars-Sinai, is one that is both comfortable for you and aligns your neck and spine. For most people, this means sleeping on your back or side rather than on your stomach, which can cause overextension of the neck and back as you turn your head to the side to breathe. According to pulmonologist and sleep medicine specialist Raj Dasgupta, MD, this can cause neck strain, which can aggravate a headache.
Overall, Dr. Dasgupta emphasises the importance of spinal alignment in locating a sleep position that can help you fall asleep when you have a headache (while not exacerbating headache pain). “I know that when I’m in pain, all I want to do is curl up in a ball, but that’s not always the best position to be in,” he says.
Aim for a sleeping position on your back or side, with a pillow that conforms to the shape of your head and neck, so that both can remain in neutral alignment throughout the night. Remember that more isn’t always better in this situation; you might be tempted to stack pillows or use a super-thick pillow for what appears to be extra support, but both of these moves can overextend the neck in back or side sleeping positions.
Dr. Shadbehr also emphasises the importance of considering any other health conditions that may affect your sleep when deciding on the best sleep position for headache relief. For example, if you have obstructive sleep apnea or snore, you may find it difficult to breathe while sleeping on your back, making a side-sleeping position more ideal—for both breathing and neck positioning—when you have a headache.
The connection between sleep and headaches
Poor sleep can aggravate headaches and even increase the frequency with which they occur over time. However, the solution—in this case, getting more good-quality sleep—doesn’t usually come easily. “While a lack of sleep can lower the threshold for developing a headache and make people more susceptible to headaches, a headache can also make it difficult to stay and fall asleep,” explains Dr. Shadbehr.
Indeed, the link between headache pain and sleep problems may be especially pronounced in migraine sufferers. According to the American Migraine Foundation, migraine sufferers are two to eight times more likely than the general population to experience insomnia. Why is this so? According to research, the same neurotransmitters involved in migraine onset may also play a role in sleep patterns—and when they are out of whack, it may trigger both migraine and sleep issues. That makes it even more important for migraine sufferers to take afternoon naps if they’re losing nighttime sleep, according to Dr. Dasgupta.
Other types of headaches can even occur during sleep, disrupting your sleep and exacerbating the cycle. Hypnic headaches (chronic, dull headaches that appear after the age of 50) and cluster headaches, which cause intense pain in or around one eye or on one side of the head, are examples. According to Dr. Shadbehr, both of these “can classically occur during sleep, and the pain and associated symptoms can awaken people out of sleep.”
Other types of headaches that stem directly from nerve, muscle, or other issues in the neck or cervical spine, such as cervicogenic headaches and occipital neuralgia, can also be triggered or worsened by sleep positions or pillows that put pressure on the back of the head, she adds.
When you have a headache, is it safe to sleep?
In general, sleeping with a headache is completely safe, even if it feels difficult or uncomfortable.
However, because a headache can be a sign of a more serious health condition in rare cases, it’s important to consider the nature of your headache and any other symptoms you may be experiencing before attempting to sleep.
If your headache appears within 60 seconds, is extremely painful, and is accompanied by nausea or vomiting, it could be a thunderclap headache, indicating potential bleeding in the brain or another brain issue; in this case, you should not sleep and should seek emergency care.
Similarly, a sudden and severe headache that affects your vision and senses may indicate a stroke, while a headache accompanied by a fever, behavioural or mental changes, and a stiff neck may indicate meningitis, according to Dr. Shadbehr. In either case, you should forego sleep in order to receive immediate medical attention.
Tips for sleeping with a headache in general
In order to maximise your chances of getting good-quality sleep, it’s important to practise good sleep hygiene when you have a headache, in addition to choosing a sleep position that feels comfortable and keeps your spine and neck aligned. To begin, Dr. Dasgupta and Dr. Shadbehr recommend sleeping in a room that is dark, quiet, well-ventilated, and between 60 and 68 degrees Fahrenheit.
Any other suggestions? Try to do something relaxing, like listening to a meditation, to take your mind off the headache; take an over-the-counter medication (like ibuprofen), if your doctor has approved it; apply an ice pack to your head (or use an ice-therapy cap, if you have one), limit screen time, and avoid alcohol consumption.
When should you consult a doctor?
If you frequently have headaches that prevent you from getting enough restful sleep, you should see a doctor. “Ignoring poor sleep or headaches can lead to a cycle of chronic headaches and insomnia that becomes more difficult to treat the longer it goes untreated,” explains Dr. Shadbehr. A primary-care doctor or neurologist can diagnose the type of headaches you’re having and devise a treatment plan to reduce the severity and frequency of the attacks while also making it easier to sleep.
Erin Balsa is a highly skilled and knowledgeable health journalist with a passion for educating the public on important health and wellness topics. With extensive experience in both traditional and digital media, Erin has established herself as a trusted voice in the field.