Headaches, Migraines, and Neck or Shoulder Pain With Sleep Apnea

Reviewed by: HU Medical Review Board | Last reviewed: February 2023

Pain in the neck? Fear not, dear reader, for you do not suffer alone. More than half of people living on earth deal with chronic, or long-lasting, neck pain each year.1

But if you have sleep apnea, your symptoms may feel more burdensome. Obstructive sleep apnea (OSA) is the most common form of sleep apnea. It happens while you sleep: tissues in your throat relax and block the airway.1,2

Head and neck pains, including headaches and migraines, are frequently reported in people with sleep apnea. In fact, people with OSA report a greater severity or intensity in their headaches.3

Obstructive sleep apnea and comorbidities

A study of women aged 35 to 64 found that those with 2 or more comorbidities reported worse sleep quality. Comorbidities are health conditions that you have at the same time as another health condition. Sometimes comorbidities interact in ways that worsen one or more of the conditions. This may be true of OSA and:1,4

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  • Neck pain
  • Shoulder pain
  • Headaches

Obstructive sleep apnea and headaches

There is a well-documented link between sleep apnea and headaches. The link between OSA and migraines is especially strong. OSA is a known trigger of migraines. Most people with OSA do not have chronic migraines. But having chronic migraines may be a sign that you also have OSA.5

Headaches upon waking and tension headaches are more common than migraines among people with OSA. Of people with OSA:5

  • Almost one-third experience headaches upon waking up
  • About 15 percent experience tension headaches
  • About 8 percent experience migraines

Researchers have found that improving sleep quality can reduce the occurrence and intensity of chronic migraines. For people with OSA, this means using a continuous positive airway pressure (CPAP) machine to keep your airways open while you sleep.5

Does sleep posture play a role?

Maybe. A study looked at people aged 18 to 45 who reported neck pain while awake. The study found that they slept in positions that may cause or worsen their discomfort. Side sleeping in particular was linked to neck pain. This was especially true when the sleeper did not use support for their shoulders, pelvis, and spine while sleeping.6

While this study did not evaluate whether participants with neck pain had sleep apnea, it is still useful. It hints that people may be able to reduce their neck pain with better or supportive sleep positioning.6

People with sleep apnea often have trouble sleeping on their backs. This leads them to sleep on their sides, which can make breathing easier when you have apnea. But side sleeping is linked to shoulder pain, in addition to neck pain. To remedy this, side sleepers can support their spine by using a body pillow or a pillow placed between their knees while sleeping.7,8

What should you do?

If you experience neck pain, shoulder pain, headaches, or migraines along with chronic poor sleep, talk to your doctor.

Keep a journal of the kinds of head pains you experience:

  • Include the time of day or activity when you feel the pain (for example, upon waking up or late in the afternoon).
  • Try to describe the pain: Does it feel like a rubber band tightening around your head? Is your pain limited to your neck or one shoulder?
  • Note which positions you find yourself waking up in and which positions you fall asleep in.

Finally, if you have not been diagnosed with sleep apnea, ask your doctor if you should be tested for it. For some people, treating any underlying sleep apnea can also help reduce the frequency or intensity of head pains.