Why Are My Hangovers So Bad? Age, Genes, Sleep and When to Worry

Your hangovers are probably not worse because you are older: in 51,645 Danish adults, a severe hangover after a binge was about seven times more likely in men aged 18 to 29 than in men over 60, with the same pattern in women.¹ What does make one worse is measurable: drinking more than you usually do, short sleep, smoking on the night, and genes, which account for roughly half of the variation. A two-day hangover is usually those stacked up; some symptoms are not a hangover at all. The wider guide is how to not be hungover.

Do hangovers get worse with age?

The largest study says the opposite. In the Danish study, the odds of a severe hangover after binge drinking were 6.8, 4.8, 3.0 and 2.0 for men aged 18 to 29, 30 to 39, 40 to 49 and 50 to 59 compared with men aged 60 and over; "For women, similar results were obtained", and usual intake and binge frequency did not explain it.¹ A survey of 761 adults aged 18 to 94 found the same decline after correcting for estimated blood alcohol (r = -0.327).²

So why do people in their forties report the reverse? In online forums the same explanations recur: drinking less often, so each occasion sits further above the usual level; more to do the next day; lighter sleep. Women often date the change to perimenopause, one to an undiagnosed thyroid problem; no study has tested either. The NHS does say palpitations "can be a sign you're going through the menopause" and lists an overactive thyroid among their causes: one for a GP.³ The next read is perimenopause and sleep.

How much is down to your genes?

About half. In 4,496 Australian twins, genetic factors accounted for 45% of the variation in hangover frequency in men and 40% in women, and 43% of the variation in being resistant to hangovers altogether.⁴ Heritability is a population figure; no gene test predicts your hangover. Roughly a fifth to a quarter of drinkers report none at a given dose (24.6% of 986 students at an estimated blood alcohol of 0.11%), for reasons not known.⁵

Does drinking more than usual matter more than how much?

Yes. The Alcohol Hangover Research Group concluded in 2020 that how drunk a person felt, not blood alcohol, is "the most important determinant of hangover severity", and that a hangover follows when an occasion "significantly exceeds" that person's normal drinking level.⁶ Someone who now drinks once a month can feel worse on the same four glasses than at 25. The NHS defines binge drinking as "drinking more than 8 units of alcohol in a single session for men, or more than 6 units in a single session for women".⁷

Why does a short night make it worse?

Because alcohol breaks up the second half of the night. In 93 young adults monitored by polysomnography after drinking to 0.11 g%, alcohol cut REM sleep and sleep efficiency, increased wakefulness, consolidated the first half of the night and fragmented the second.⁸ Among 578 students, those who slept under seven hours reported more severe hangovers than longer sleepers, who had drunk more.⁹ More on why alcohol wakes you up at 3am.

Does smoking on the night make a difference?

In the one diary study, yes. Among 113 American students logging drinking, smoking and symptoms daily for eight weeks, on days when estimated blood alcohol reached 110 mg/dl smoking "significantly increased the odds of hangover incidence and hangover severity" after controlling for drinks and sex.¹⁰ One self-report study.

Are women's hangovers worse?

Slightly, at the same blood alcohol. Among 2,446 students grouped by estimated peak blood alcohol, women scored higher for nausea and tiredness in the middle bands, but the differences "were of small magnitude, and therefore, have little clinical relevance".¹¹ The bigger effect is arithmetic: the same drinks give a smaller body a higher blood alcohol, and in the laboratory alcohol disrupted women's sleep more than men's.⁸ The gap was "significantly smaller or absent" in older groups.²

Can a hangover really last two or three days?

No peer-reviewed study has followed a hangover beyond the day after drinking. The first day is measured: of 727 drinkers' latest hangovers, 54.5% declined steadily from waking, 19.1% stayed flat and 21.8% rose then fell.¹² In hourly ratings, hangover-sensitive drinkers were worst at 09:30 and still symptomatic at 15:30.¹³

Day two and three are usually a stack: alcohol still clearing in the morning (how long alcohol stays in your system), a short broken night and the low mood of hangover anxiety. A week of drinking most evenings is a run of these mornings, not one long hangover. Symptoms that appear whenever you go without a drink are the NHS withdrawal signs quoted at the foot of this page.¹⁴

Is it alcohol intolerance?

Usually not, in the UK. The best-described intolerance is the inactive ALDH2*2 variant of the enzyme that clears acetaldehyde, common in East Asian populations and uncommon here, which causes facial flushing soon after drinking. Among 251 Japanese workers, carriers drank less yet reported hangovers at significantly lower intakes.¹⁵ A reaction within minutes of a drink is a reaction to the drink, not a hangover, and one for a GP; no test or product is suggested. More on what causes a hangover.

When is it more than a hangover?

A hangover begins as blood alcohol approaches zero.¹³ Someone still drunk and getting worse is a different situation.¹⁶

Symptoms of alcohol poisoning "may include: confusion; slurring words or being unable to speak; being unable to coordinate movement – for example, being unable to stand, walk, or pick things up; being sick; peeing or pooing yourself; pale or blue-tinged skin – on black or brown skin this may be easier to see inside the lips, on the gums and under the fingernails; slow or irregular breathing; having a seizure or fit; loss of consciousness."

"Call 999 if: you think someone has alcohol poisoning; you or someone else has had a seizure or fit; someone has lost consciousness; someone has stopped breathing." The do and do-not list is at nhs.uk/conditions/alcohol-poisoning.¹⁶

Next morning, three things are not a hangover. Palpitations that "do not go away" or come with "chest pain", "shortness of breath" or "feeling faint or fainting": "Call 999 or go to A&E"; if they have passed, "call 111".³ Vomiting: "Call 111 now if" you "keep being sick and cannot keep fluid down"; 999 if you "vomit blood or have vomit that looks like ground coffee".¹⁷ Hallucinations, severe tremors or a seizure once the drinking has ended: "Call 999".¹⁸

Frequently asked questions

How long does a terrible hangover last?

A day, as measured: worst at 09:30, lower at every hourly check, still present at 15:30;¹³ no study has followed one into a second day.

Why do I shake or sweat after drinking?

Shivering is among the 22 symptoms in the 2,446-student survey.¹¹ "A racing heartbeat, sweating and shaking (tremor)" are also NHS withdrawal symptoms, which "begin within 6 to 12 hours of your last drink";¹⁴ if they arrive whenever you go without a drink, see a GP.

Why do I get hangovers so easily now?

Usually because your usual intake has fallen, so the same night now sits far above it,⁶ and your sleep is shorter or lighter;⁹ smoking and inherited sensitivity do the rest.^{4, 10}

Is it normal to still feel hungover after two days?

Commonly described, never measured. Alcohol still clearing, two broken nights and low mood explain most of it; symptoms that return every time you go without a drink are dependence signs in NHS wording.¹⁴

Can a hangover affect your heart rate?

Palpitations after a heavy night are a recurring forum report; the NHS lists "alcohol, caffeine, nicotine and recreational drugs" and "lack of sleep" among common causes, "usually harmless", with a GP visit if "they keep coming back".³

If you are worried about your drinking

"Drinkline is the national alcohol helpline. If you're worried about your own or someone else's drinking, you can call this free helpline in complete confidence. Call 0300 123 1110 (weekdays 9am to 8pm, weekends 11am to 4pm)." "A good place to start is with a GP."¹⁸ In Scotland, NHS inform lists Drinkline Scotland on 0800 7314 314.¹⁹ "If you stop drinking or cut down, you may get withdrawal symptoms. This is a sign your body is dependent on alcohol." "It can be very dangerous to stop drinking suddenly if you're dependent on alcohol. If you get withdrawal symptoms, get medical help before you try to stop drinking."¹⁴ The NHS low-risk guidance (how many units are in a drink): "men and women are advised not to drink more than 14 units a week on a regular basis"; "spread your drinking over 3 or more days if you regularly drink as much as 14 units a week"; "try to have several drink-free days each week"; "It's called 'low risk' rather than 'safe' because there's no safe drinking level."⁷

Sources

1. Tolstrup JS et al. Does the severity of hangovers decline with age? Survey of the incidence of hangover in different age groups. Alcohol Clin Exp Res 2014. PubMed 24033827
2. Verster JC et al. Alcohol hangover across the lifespan: impact of sex and age. Alcohol Alcohol 2021. PubMed 33822860
3. NHS. Heart palpitations (reviewed 17 March 2026). nhs.uk/conditions/heart-palpitations
4. Slutske WS et al. Genetic influences on alcohol-related hangover. Addiction 2014. PubMed 25098862
5. van Schrojenstein Lantman M et al. Susceptibility to alcohol hangovers: not just a matter of being resilient. Alcohol Alcohol 2018. PubMed 29211818
6. Verster JC et al. Sensitivity to experiencing alcohol hangovers: reconsideration of the 0.11% blood alcohol concentration threshold for having a hangover. J Clin Med 2020. PubMed 31936502
7. NHS. The risks of drinking too much (reviewed 10 September 2026). nhs.uk/live-well/alcohol-advice/the-risks-of-drinking-too-much
8. Arnedt JT et al. Sleep following alcohol intoxication in healthy, young adults: effects of sex and family history of alcoholism. Alcohol Clin Exp Res 2011. PubMed 21323679
9. van Schrojenstein Lantman M et al. Total sleep time, alcohol consumption, and the duration and severity of alcohol hangover. Nat Sci Sleep 2017. PubMed 28721110
10. Jackson KM et al. Role of tobacco smoking in hangover symptoms among university students. J Stud Alcohol Drugs 2013. PubMed 23200149
11. van Lawick van Pabst AE et al. Sex differences in the presence and severity of alcohol hangover symptoms. J Clin Med 2019. PubMed 31213020
12. Verster JC et al. Differences in the temporal typology of alcohol hangover. Alcohol Clin Exp Res 2018. PubMed 29423958
13. Mackus M et al. Differences in next-day adverse effects and impact on mood of an evening of heavy alcohol consumption between hangover-sensitive drinkers and hangover-resistant drinkers. J Clin Med 2023. PubMed 36983093
14. NHS. Alcohol-use disorder (reviewed 24 April 2026). nhs.uk/conditions/alcohol-use-disorder
15. Yokoyama M et al. Hangover susceptibility in relation to aldehyde dehydrogenase-2 genotype, alcohol flushing, and mean corpuscular volume in Japanese workers. Alcohol Clin Exp Res 2005. PubMed 16046871
16. NHS. Alcohol poisoning (reviewed 4 June 2026). nhs.uk/conditions/alcohol-poisoning
17. NHS. Diarrhoea and vomiting (reviewed 21 December 2023). nhs.uk/conditions/diarrhoea-and-vomiting
18. NHS. Alcohol support (reviewed 17 August 2026). nhs.uk/live-well/alcohol-advice/alcohol-support
19. NHS inform. Alcohol support (updated 7 October 2026). nhsinform.scot/healthy-living/alcohol/alcohol-support