Hangovers can last up to 72 hours after drinking, but most are shorter in duration. Certain inflammatory chemicals increase in the blood and affect various natural hormonal pathways. The stomach lining may become irritated, increasing nausea and the chance of bleeding. While not a disease we treat at the Johns Hopkins Headache Center, delayed alcohol-induced headaches are extremely common, disabling and costly to society. Many with migraine, and most with cluster headache, are sensitive to alcohol, even in small amounts. Substances such as sulfites, histamine, and tyramines are found in alcohol and may contribute to headaches as well.
Conflicting research about alcohol-related headaches
There has been some research into the effect alcohol has in increasing blood flow to certain parts of the brain, but whether this causes or relieves headache symptoms depends largely on the type of headache.
While headaches after drinking are usually not a cause for concern, there are some instances when you should seek medical attention. If your headaches are severe, persistent, or accompanied by other symptoms such as nausea, vomiting, or blurred vision, you should seek medical attention. In other words, the best treatment for a cocktail headache is actually preventing one in the first place. Before consuming a cocktail, ask yourself if it is worth developing a headache over and ruining your celebration or holiday. For a hangover headache, also called a delayed alcohol-induced headache, experts believe that nerve chemicals involved in central pain control, like serotonin, are likely responsible. If you have chronic headaches, identifying and avoiding your triggers can substantially improve your quality of life.
Many of these disturbances of the body’s natural physiology persist the next day, long after the alcohol is gone. Effects on hormones, blood chemistry, the sleep-wake cycle and inflammatory chemicals are also important in the thoroughly lousy feeling we have come to know as a hangover. Some of these effects are caused by ethanol itself, and others are from an even more toxic byproduct of its metabolism called acetaldehyde. This chemical builds up in the blood as the liver breaks down the alcohol into a form that can be eliminated from the body.
While the acute widening of blood vessels in the brain (called vasodilation) may explain the alcohol headache, this is likely not the mechanism for hangover headaches (when alcohol levels in the blood have declined to zero). Experts believe that nerve chemicals involved in central pain control, like serotonin, are likely responsible for an alcohol hangover headache, also called a delayed alcohol headache. Stress and poor sleep are frequently cited on lists of headache triggers.
Few and often only descriptive studies exist on this topic, with marked differences in the percentage of consumers perhaps depending on the country habits [19, 24, 26, 31–33] (Table 2). No differences between migraine and tension headache were reported [24, 26] (Table 1). Unfortunately for headache sufferers, acetaldehyde causes the body to produce histamines – a common trigger of migraines.We talk more about Asian flush related headaches in our article titled 5 Ways to Stop Asian Flush Headaches from Alcohol.
In conclusion, no significant association between alcohol consumption with migraine and tension headache was found in many studies [26, 28–30]. This work considered the alcoholic drinks and other triggering factors taken the day before onset of headache. Many studies in different countries show that alcohol is a headache trigger in high percentage of migraine subjects, both in the general population [15–17] and headache clinic population [18–22]. About one-third of the patients (mean 34%) report alcohol as a trigger (Fig. 1). However these are retrospective studies, and until recently only a prospective study based exclusively on the subjective patients information exists . Recent studies show that alcohol acts as a trigger at least occasionally in a percentage similar to that of the previous studies (37%), but as a frequent/consistent trigger in only 10% of the patients [22,24].
Alcohol can also cause headaches by causing your blood vessels to dilate. When blood vessels in your brain dilate, it can cause pain and discomfort. Lastly, drinking too much alcohol can cause a hangover, which is often characterized by headaches, nausea, and fatigue. It has been noted in some studies that in less than 30% of people, red wine triggers headache no matter the number of drinks consumed.
Of the 58 nonconsumer patients, 16 were abstainers but the others have consumed some type of alcoholic drinks during their life without the development of headache. In this study, six subjects of the consumer group identified white wine as a trigger, while two subjects reported red wine and two both the types of wine in the nonconsumer group (Table 3). Besides hangover headaches and alcohol headaches, alcohol has also been reported as a trigger in primary headaches, most notably migraine and cluster headaches, followed by tension headaches (although the evidence is not as robust). The means through which alcohol can activate these particular headaches is not well understood.
Beverages such as liquor, wine, and beer, contain a chemical called ethanol. There are a number of ways that ethanol may be triggering migraine episodes. First, ethanol is a direct vasodilator; in some individuals, vasodilation or the dilatation of blood vessels may cause migraine attacks. Second, ethanol is a natural diuretic; this leads to the excretion of salt, vitamins, and minerals from the body through the kidneys. Excess consumption of ethanol may produce dehydration and chemical imbalances in the body.
Curiously, in some countries, the percentages of alcohol or wine as migraine triggers were negligible, 6.1  and 1.4% , perhaps depending on the degree of alcohol habits. If you experience migraine headaches after drinking alcohol, it may be best to avoid alcohol. Talk with a doctor about ways to identify your migraine triggers and what to do if you develop these headaches. For people with migraine, alcohol can trigger an attack anywhere from 30 minutes to three hours after consumption, according to the American Migraine Foundation. This is the typical type of headache induced by alcohol, compared with delayed alcohol-induced headache (DAIH) that appears the next morning — also known as the hangover headache.
If you experience severe or persistent headaches, it is important to seek medical attention. At Nao Medical, we are here to help you stay healthy and prevent headaches caused by alcohol. Headaches are one of the most common physical symptoms of alcohol withdrawal. Headaches can initiate https://ecosoberhouse.com/article/alcohol-and-headaches-why-does-alcohol-cause-migraines/ only 6 hours after your last drink and may last anywhere between 3 days to over a year. A person’s alcohol withdrawal timeline depends on a number of factors, including the severity of alcohol dependence, the presence of other health problems, additional substance abuse, and others.
Some studies on the alcohol habits in migraine patients show a low percentage of drinkers in migraine patients. This was supposed to be due to previous experiences of alcohol as headache trigger, but one study does not agree . Certainly, if a less alcohol preference in migraine patients will be confirmed in large controlled studies, it merits a correlation with 5-HT system, which is involved in migraine pathogenesis in some way. In fact, an inverse relationship between density and metabolic functioning of regional brain 5-HT system and alcohol preference was repeatedly reported in animal studies [69–72]. Since alcohol can trigger migraine and tension headache attack, only a low percentage of headache patients should drink alcoholic beverages.
“The most common alcohol that triggers a migraine attack is red wine, followed by white wine, champagne and beer,” she says. Headaches after drinking can be a real pain, but there are things you can do to prevent them. By drinking plenty of water, pacing yourself, eating before and while you drink, avoiding mixing drinks, and taking pain relievers if necessary, you can reduce your risk of getting a headache after drinking.
However, the research suggests that alcohol may not be the only trigger and may also depend on other factors. This leads to excessive urination and dehydration, which may cause a headache after a small amount of alcohol. In a 2017 study, researchers found that people of East Asian ancestry drink less than members of other groups.