In most cases waking up with a headache is one of the cardinal signs of sleep apnea. Morning headaches, tension headaches, migraines, cluster headaches, and hypnic headaches have all been linked to sleep apnea and improved or disappeared with myofunctional therapy. Neck tension related to clenching and grinding also improves once proper head and oral position is achieved. Tethered oral tissue, tight tissue pulling on the muscles of the floor of the mouth can also be a cause of tension extending to the neck and shoulders and should be evaluated and treated.