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Why do we wake up sore in the morning?

So you’ve just started your day and you’re already feeling sore? You’re probably wondering “what’s the deal with that, I haven’t even done anything yet”?! Read on to find out the top three reasons you might be sore in the morning, and our top 3 ways to address it!   

DOMS, DOMS DOMS, DOMS

The first major cause of morning aches is Delayed Onset Muscle Soreness, or DOMS. This is most likely if you completed a particular intense workout the day before or exercised more intensely than you’re used to. Congratulations, this is the best kind of “sore in the morning” to be. There are different theories as to what causes DOMS, but “eccentric overload” (the part of the rep where you slowly let the weight down) seems to be a big driver. 

But DOMS is usually self-limiting (goes away on its own). The rule of thumb for my patient’s is that an increase in soreness should last less than two days. If your workout left you sore for longer than that, you should consider lowering the intensity of your next workout and focus more on recovery. The best way to do that, is to ensure you’re getting enough protein to rebuild muscle tissue. Personally, I take 15 grams of Essential Amino Acids before and after a workout. That way I have everything I need to recover from my workout, in an easy to digest, bioavailable form. Making sure you have adequate protein / amino acids around your workouts, should help you recover faster, and experience less soreness. Once you have your nutrition dialed in, the next major piece of the recovery puzzle is how you sleep!  

Better Sleep posture for better

What position is best to wake up feeling refreshed? That’s a tremendous question. For better or worse, sleep posture can make a big difference in the way you feel when you wake up. In fact, in my experience there is nothing more powerful at improving heart rate variability (HRV) than optimizing sleep posture. For that reason, our next article will be a deep dive look at sleep posture! But if you want a head start on sleep posture, start thinking about how you can maintain the natural curves of your spine while you sleep!

Sore from bad breathing?

The last and perhaps most important cause of morning soreness is how you breath during the night. Thanks to Stranger Things Season 1 episode 3, we all know “Mouth Breathing” is not the way to go. If you want to learn more about how awesome nose breathing is, you can check out our breathing article here. Long story short, breathing through your nose helps you get oxygen where it needs to go. Mouth breathing on the other hand, leads to hypocapnia and causes low blood oxygen. This has some nasty side effects. Affecting everything from muscle soreness to increasing brain fog, increasing blood pressure, and even contributing to poor gut health.

Now Imagine you’re breathing through your mouth for 8 hours in a row. This amounts to 8 hours of intermittent hypoxia, which means 8 hours of not enough oxygen for your muscles. This not only hurts your recovery, but it also sets you up for tissue reperfusion injury in the morning! 

Reperfusion injury?

Reperfusion is the most interesting thing no one is talking about. It sounds complicated, but it’s basically when you have lowered blood oxygen levels for a while. And then when oxygen comes back to normal levels, you’re hit with a bunch of reactive oxygen species. Which is basically a wave of inflammation. This is what happens when someone has a heart attack. Their heart muscles temporarily have a lack of blood and oxygen to the heart, and when blood comes back, it causes a sudden spike in oxygen. And that cause a sudden spike in reactive oxygen species. The return of oxygen is just as bad, and sometimes worse, than the heart attack itself!

So, if you breath through your mouth all night long, then wake up and begin breathing normally, you too are being hit with a wave of oxidation and inflammation! Fortunately, a much smaller wave of inflammation than what would be seen after a heart attack, but still enough to hurt your recovery and leave you feeling needlessly sore in the morning!   

How would I know, I’m asleep?

When I ask people if they breathe through their noses while they sleep, they usually say “I don’t know, I’m usually asleep at the time”. This is a fair point. But here are 3 clues that you might be mouth breathing at night:

Snoring is one of the most common and serious signs of poor breathing at night. If you’re someone who snores and often wakes feeling sore, it is highly likely part of your morning soreness is related to your breathing though the night. Snoring is a form of sleep apnea and despite its depiction in cartoons and media, apnea should be taken very seriously.

Nocturia or waking multiple time in the night to urinate is another common symptom of those who breath poorly during the night. That is because poor breathing patterns and poor oxygenation do not allow your body to fully settle into restful sleep.

Waking with a dry mouth, is another tell-tale sign. Mouth breathing leads to greater dehydration and a dry mouth. This can lead to bad morning breath, contribute to the formation of cavities, and you guessed it, leave you feeling sore in the morning! 

Sore no more?

The most powerful thing you could do to improve your morning soreness would be to ensure you’re breathing through your nose the whole night!

Mouth tape, are you crazy?

If you haven’t heard of mouth tape for sleep, then what I’m about to say might sound crazy. But mouth tape is an elegant and simple solution to a serious problem. The technique involves placing a small piece of medical tape across your lips while you sleep. This ensures nasal breathing all night long and should provide significantly better breathing and tissue oxygenation. It also reduces soreness related to tissue reperfusion injuries in the morning.

Mouth tape was popularized after the release of books like Breath: The New Science of a Lost Art by James Nestor, and the The Oxygen Advantage by Patrick McKeown. And at first, I’ll admit, I was skeptical. But given the hype, I had to try it.  

My experience with mouth taping

At first, I was a little anxious about the prospect of taping my mouth shut all night. But after a trial mouth tape nap, I felt ready to try an entire night sleep with mouth tape on. 

Here’s what I noticed: my sleep latency (time to fall asleep), heart rate variability, and restfulness all improved significantly as measured by my Oura ring sleep tracker. And what’s more, after starting to use it regularly I no longer had to wake to use the bathroom at night! I felt consistently more rested, and less sore in the morning.

My current routine includes a small piece of 3m medical tape to ensure nose breathing and a Breathe Right nasal strip to super charge my nasal breathing all night long! And now I sleep great, wake feeling refreshed, and recover faster from my workouts.

Wrappin it up:

If you’re someone who’s tired of waking up sore, then I highly recommend the following: 1) dialing in your workouts and adding consider something like essential amino acids. 2) checking out our next article to learn more about sleep posture. And 3) breathing through your nose all night long! Things like mouth tape and nasal strips can tubro charge oxygen to your muscles all night long!

You can learn more about mouth tape from the Seattle Protocol here.

To those who chronically sleep poorly, I would highly recommend having a sleep study performed. C PAP and Bi PAP machines can greatly improve quality of sleep and quality of life.

The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician. Always seek the advice of your doctor or other qualified health provider regarding a medical condition.

-Written by Aaron Barnard Doctor of Physical Therapy

8/18/22