What to know about weekend headaches

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A weekend headache is a headache that may develop at the end of a busy or stressful week.

The United Kingdom’s National Health Service notes that weekend headaches are most likely due to an abrupt reduction in stress hormones triggering a rapid release of neurotransmitters. These neurotransmitters send out impulses that cause blood vessels to dilate and constrict, resulting in a headache.

According to the National Headache Foundation (NHF), people who have migraine may be particularly prone to migraine attacks at weekends, most likely due to oversleeping.

Migraine is a neurological condition that involves migraine attacks. A migraine is a moderate to severe throbbing or pulsating pain that typically occurs on one side of the head. According to the National Institute of Neurological Disorders and Stroke (NINDS), migraine most often occurs early in the morning. For some people, this can be at predictable times, such as on weekends following a stressful week at work.

Alongside a headache, other symptoms of migraine may include:

• nausea
• blurred vision
• increased sensitivity to light or sound
• confusion
• mood changes
• fatigue

Some people may experience a migraine with aura. An aura is a series of sensory disturbances that usually precede a migraine attack. Symptoms of a migraine aura may include:

• visual disturbances, such as seeing bright lights or geometric patterns
• atypical sensations, such as tingling or a feeling of touch on the skin
• speech or language difficulties

Below are some factors that may cause or contribute to migraine at the weekend or any other time:

Foods

According to the American Migraine Foundation (AMF), many people with migraine report that certain foods appear to trigger their migraine attacks. Common triggers include:

• foods rich in tyramine, such as:
  • cheese
  • kimchi
  • lemon
  • tofu
  • pickled beets
  • lemon
• foods rich in beta-phenylethylamine, such as:
  • chocolates
  • cocoa beans
  • eggs
  • natto
  • beans
  • herbs
• foods rich in nitrate, such as leafy greens and processed meats

Although many people consider the above foods common migraine triggers, scientists have not yet found any evidence to support these observations. Further high quality studies are necessary to determine whether such a link exists.

Sleep problems

The following sleep issues can increase the risk of weekend headaches:

• lying in at the weekend
• sleeping for more than 8 hours
• lack of sleep
• having a disturbed or irregular sleep pattern

The NHF recommends people try to maintain a regular sleep schedule throughout the week to help prevent weekend migraine.

Caffeine withdrawal

For people who drink a lot of coffee or other caffeinated beverages during the week, suddenly stopping caffeine consumption at the weekend can cause blood vessels to rapidly dilate. This can trigger a caffeine withdrawal headache (CWH). However, the dilation of blood vessels is a controversial topic in triggering migraine and headaches. More research is necessary to verify this.

The NHF recommends that people who consume large amounts of caffeine reduce their caffeine intake gradually to reduce the severity of CWH.

Weather changes

An older 2015 study found that even a slight decrease in barometric pressure was associated with a significant increase in migraine among people with migraine but not among those with tension-type headaches.

The researchers speculate that the decrease in barometric pressure may cause blood vessels in the brain to dilate, triggering the release of the neurochemical serotonin. Increased levels of serotonin in the blood then cause the cerebral blood vessels to constrict, triggering the aura phase of the migraine. A subsequent decrease in serotonin levels causes the cerebral blood vessels to rapidly dilate, prompting the headache phase of the migraine.

The researchers noted several other weather-related factors that may trigger migraine, including:

• hot or cold weather
• high wind
• bright sunlight

The treatment plan for weekend headaches may depend on several factors, including:

• the person’s age
• headache type
• headache severity
• other accompanying symptoms

A doctor may recommend one or more of the following treatments to help alleviate symptoms of weekend headaches:

Medications

A doctor may recommend over-the-counter (OTC) pain relief medications, such as acetaminophen or nonsteroidal anti-inflammatory drugs.

If a person experiences migraine episodes that do not respond to OTC pain relievers, a doctor may prescribe triptans, which are serotonin agonists. These medications work by constricting dilated blood vessels around the brain.

According to the AMF, doctors may also prescribe one or more of the following preventive medications for migraine:

• antihypertensive drugs, such as:
  • beta blockers
  • angiotensin receptor blockers
  • monoclonal antibodies
• antiseizure drugs, such as topiramate
• certain antidepressants, such as venlafaxine or amitriptyline
• calcitonin gene-related peptide receptor (CGRP) antagonists
• Botox (onabotulinumtoxinA)

Cognitive Behavioral Therapy (CBT)

CBT is a type of psychotherapy. As a migraine treatment, CBT can help people identify their triggers and modify any unhelpful thoughts, feelings, and behaviors associated with migraine.

A 2021 systematic review and meta-analysis found that CBT significantly reduced headache frequency and self-reported assessments of migraine-related disability. However, further randomized controlled trials investigating CBT for migraine are necessary to support these findings.

The following may help prevent weekend headaches:

• managing stress levels during the week
• maintaining a regular sleep schedule throughout the week and at weekends
• limiting alcohol and caffeine intake
• exercising regularly
• resting after strenuous activity

However, if a person experiences recurring episodes of weekend headaches, they should make an appointment with a doctor. The doctor will work to diagnose the cause and recommend an appropriate treatment plan.

Below are some common questions about weekend headaches.

Why do I only get headaches at the weekend?

There are several reasons a person may experience headaches exclusively at the weekend. These include:

• changes in routine
• a sudden reduction in stress levels
• sleep disruptions
• changes to diet
• increased alcohol consumption
• caffeine withdrawal

How do you get rid of a weekend headache?

A person may resolve a weekend headache by working with a doctor to identify the underlying triggers and begin any necessary treatments. Some treatments will help to alleviate the symptoms, while others may help prevent future headaches.

Why do I get headaches on lazy days?

If a person is experiencing headaches on lazy days, this may be due to a change in routine. People can aim to keep to a regular sleep schedule throughout the week and at weekends.

What if I have had the same headache for over a week?

According to the American Headache Society, people who experience frequent headaches may have a condition called chronic daily headache (CDH). To receive this diagnosis, a person must experience a headache on 15 or more days of the month.

If a person receives a diagnosis of CDH, a doctor will work to determine the cause and devise an appropriate treatment plan.

A weekend headache is one that typically occurs at the end of a busy or stressful week. The cause is generally a significant reduction in stress hormones, which causes constriction and dilation of the blood vessels inside the head.

Besides a rapid reduction in stress hormones, other factors that can cause or contribute to weekend headaches include changes in routine, increased alcohol consumption, and caffeine withdrawal.

Treatment options for weekend headaches depend on the underlying cause. They range from lifestyle changes and OTC pain medications to prescription pain relief and migraine preventives. A person can talk with a doctor about their individual treatment options.