Frequent morning headaches are associated with increased risk for depression and anxiety disorders, according to an article in the January 12th issue of the Archives of Internal Medicine.

According to information given in the article, morning headache (headache on awakening) is traditionally associated with sleeps disorders such as chronic snoring and obstructive sleep apnea syndrome. The prevalence of frequent morning headache in the general population is not known, although one Swedish study estimated 5 percent.

In the current work, researchers investigated the prevalence of frequent morning headaches in the general population, as well as their relationship to sociodemographic characteristics, controlled substance use, and clinical, sleep, and mental disorders. A telephone questionnaire was used to survey 18,980 people (15 years or older) representative of the populations of the United Kingdom, Germany, Italy, Portugal, and Spain.

Overall, the prevalence of frequent morning headaches was 7.6 percent (1,442 respondents). Morning headaches were reported to occur "daily" by 1.3 percent of individuals, often by 4.4 percent, and sometimes by 1.9 percent. Rates were higher in women than in men (8.4 percent versus 6.7 percent) and in people aged between 45 and 64 years (about 9 percent). The most significant factors associated with frequent morning headaches were anxiety and depressive disorders.

Frequent morning headaches were also significantly associated with sleep-related breathing disorders, hypertension, musculoskeletal diseases, use of anxiolytic medication, and heavy alcohol consumption.

"Morning headache affects one individual in 13 in the general population," wrote the authors. "Chronic morning headaches are a good indicator of major depressive disorders and insomnia disorders. Contrary to what was previously suggested, however, they are not specific to sleep-related breathing disorder."