An empty stomach and low blood sugar
After 8 to 12 hours without food, blood sugar can drop and stomach acid has nothing to act on. Some people feel shaky, light-headed and queasy until they eat. This is more common after an early or small evening meal, intense exercise the day before or alcohol.
A small bedtime snack and a light breakfast soon after waking often help. See foods for nausea.
Acid reflux and heartburn
Lying flat allows stomach acid to move up into the oesophagus and throat. On waking, this can cause nausea, a sour or bitter taste, burning in the chest, a hoarse voice, cough and throat clearing. Late, large, fatty or spicy meals, alcohol, coffee, chocolate and smoking make it worse.
Eating the last meal 3 hours before bed, raising the head of the bed and losing weight if needed reduce night-time reflux. See nausea after eating and does milk help heartburn.
Anxiety and stress
The gut and brain are closely connected. Stress hormones peak in the early morning, and worry about work, school or the day ahead can cause nausea, loss of appetite, a churning stomach and even retching. Morning nausea that improves on weekends or holidays often points to stress.
Breathing exercises, regular sleep, gentle exercise and talking therapies help. See morning anxiety and deep breathing for anxiety.
Pregnancy
Nausea and vomiting affect most pregnant people, often starting around week 6 and settling by weeks 16 to 20. Despite the name morning sickness, it can happen at any time of day. If there is a chance of pregnancy, a pregnancy test is a sensible first step.
Eating small, frequent, plain meals, cold foods, ginger and rest can help. Severe vomiting with inability to keep fluids down (hyperemesis gravidarum) needs medical care.
Other common causes
- Alcohol the night before, which irritates the stomach and causes dehydration.
- Postnasal drip from colds, allergies or sinusitis, swallowed overnight.
- Poor sleep, jet lag or shift work, which disturb the body clock and digestion.
- Sleep apnoea, with snoring, morning headaches and tiredness.
- Medicines and supplements, especially iron, antibiotics and some painkillers taken on an empty stomach.
- Dehydration and hot bedrooms.
- Migraine, gastritis, gallbladder problems and, rarely, other conditions.
What to eat and drink
- Keep plain crackers or a rice cake by the bed and eat a few before getting up.
- Sip water, ginger tea or peppermint tea slowly.
- Choose a light breakfast: toast, porridge, a banana, yoghurt or eggs.
- Eat small, regular meals during the day rather than large ones.
- Avoid strong coffee on an empty stomach, and very fatty or spicy foods if they trigger symptoms.
- Take supplements and medicines with food, unless told otherwise.
See also foods to eat when sick.
Changes to your routine
- Have the last main meal 2 to 3 hours before bed.
- Raise the head of the bed 10 to 20 cm if you have reflux.
- Limit alcohol, especially in the evening.
- Keep a regular sleep schedule.
- Get up slowly and get some fresh air.
- Keep a diary of symptoms, food, sleep and stress to identify patterns.
Morning nausea in children and teenagers
Children who feel sick most mornings before school may be anxious, skipping breakfast, not sleeping enough or have reflux or constipation. Recurrent morning nausea with headaches needs a medical review. Talking calmly about worries and keeping a regular breakfast and bedtime often help.
When to see a doctor
- Vomiting that will not stop or inability to keep fluids down.
- Blood or “coffee grounds” in vomit, or black stools.
- Unexplained weight loss or difficulty swallowing.
- Severe stomach pain, chest pain or yellow skin.
- Morning headaches that are getting worse, with vomiting.
- Nausea lasting more than a few weeks without a clear cause.
Key points to remember
- Morning nausea often comes from an empty stomach, reflux, anxiety or pregnancy.
- A small plain snack before getting up and sips of fluid often help.
- Avoid late heavy meals and alcohol, and raise the head of the bed for reflux.
- Persistent vomiting, weight loss or blood need medical review.
Questions about morning nausea
These answers are general information and do not replace an examination or individual medical advice.
Why do I feel sick every morning but I am not pregnant?
Common causes include an empty stomach, acid reflux, anxiety, poor sleep, alcohol and postnasal drip.
Can anxiety cause nausea in the morning?
Yes. Stress hormones peak in the morning and can cause nausea and loss of appetite.
What should I eat when I feel nauseous in the morning?
Plain foods such as crackers, toast, a banana or porridge, with small sips of water or ginger tea.
Can reflux cause nausea on waking?
Yes. Lying down allows acid to rise, causing nausea and a sour taste in the morning.
Is it normal to feel sick when you wake up?
Occasionally it is common. Frequent or persistent nausea should be checked.
Does drinking water help morning nausea?
Sipping water slowly can help, especially if you are dehydrated. Large amounts at once can worsen it.
Sources
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.