You may have read somewhere that one feature of sphenoid sinus headaches, or even those of general sinusitis, is that they tend to occur at night (while you’re still awake).

Or, if you have the headaches earlier in the day, they get worse as the evening wears on.

“There is no medical or structural reason to explain why a patient may have more sinus symptoms in the evening,” says Dr. Stacey Silvers, MD, of Madison ENT & Facial Plastic Surgery in NYC, who is board certified in otolaryngology; one of her specialties is sinus surgery.

“Some patients may be distracted by daytime activities which may find some relief only to find symptoms worsen when the distractions are gone.

“Ambulating helps move mucous and may also help relieve symptoms, and if sitting in one place at home for a while, the symptoms and pressure can build.”

This explains why, if you do some exercise in the midst of a sinus headache, the discomfort may subside or outright disappear, only to return once you stop exercise and assume a prolonged position before the TV or computer.

Dr. Silvers continues, “Position changes can worsen any type of headache.  With sinus headaches if there is a fluid level in the sinus, with a shift of that fluid based on head position, headaches can worsen or improve.

“Patients will often complain about bending their head forward and may have relief when lying flat.”

However, lying flat can worsen a sinusitis head pain, which is why when someone has sinusitis, they often have a headache in the morning upon awakening.

Hours of lying flat have caused a buildup in the sinus cavities.

Bear in mind that a tension or stress headache feels very similar to that caused by sinusitis, and can be indistinguishable as far as symptoms.

For example, both types of pain “move” with the patient. That is, if the patient jumps up and down, he can feel the pain jumping up and down in his head. If he leans over, the pain seems to lean over inside his skull as well.

A tension (stress) headache will be more noticeable when you lean forward or bend over to tie a shoe.

A tension headache will also be associated with a lot of stress; they don’t just happen, and they tend to develop gradually.

However, a person can be afflicted with both a stress and a sinusitis headache.

Stress discomforts do tend to build up as the day goes on, and may reach peak discomfort in the evening.

An NYC expert in ear, nose and throat care, Dr. Silvers has been named among America’s Top Physicians and Surgeons in facial plastic surgery and otolaryngology numerous times since 2003.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer. 


Top image,hutterstock/Andrey_Popov