Hypnic Headache

What is a hypnic headache?

A hypnic headache is a rare type of headache that only develops while you’re sleeping. This type of nighttime headache is sometimes called an alarm clock headache because it may wake you up at the same time every night. A hypnic headache is different from other types of headaches, like migraines or cluster headaches, because those can occur at any time, not just at night.

The location of a hypnic headache is usually bilateral (it affects both sides of your head), and the pain can range from mild to severe. Hypnic headaches not only cause pain, but they can also interrupt your sleep. Sleep is very important for your physical, mental and emotional well-being, so treating these headaches is vital to getting you back on track.

How common are hypnic headaches?

Researchers don’t know the exact rate of hypnic headaches. Some older studies indicate the condition affects less than 2% of the population. But current data suggest that it affects less than 1% of the population.

What are the symptoms of hypnic headaches?

The main symptom of a hypnic headache is a dull or throbbing pain in your head that occurs while you’re sleeping. The pain can be mild to severe, but it’s enough to wake you up. You’ll experience a headache multiple times a week, typically at the same time each night, usually two to three hours after you’ve fallen asleep. You might have more than one hypnic headache each night.

A hypnic headache usually affects both sides of your head, but it can also affect just one side. It lasts at least 15 minutes and up to four hours. Most people experience hypnic headaches that last about 90 minutes.

Other hypnic headache symptoms may include:

• Nausea.
• Sensitivity to light or sounds.
• Runny nose or eyes.
• Droopy eyelids.

Hypnic headaches occur at least 10 times a month. Some people experience them at least every other day.

What causes hypnic headaches?

Researchers don’t know what exactly causes hypnic headaches, but some believe it could involve a part of your brain called the hypothalamus. Your hypothalamus is responsible for a wide range of bodily functions, including sleep cycles. Hypnic headaches often happen during REM (rapid eye movement) sleep. Some scientists think an area of your brain that’s responsible for processing pain gets activated by mistake during a hypnic headache.

Other researchers believe hypnic headaches may be associated with your body’s melatonin production. Melatonin is a hormone your body produces that makes you drowsy. Its production levels rise and fall throughout the day with your circadian rhythm. Because hypnic headaches happen at about the same time each night, some scientists believe there may be a disruption to your circadian rhythm.

What are the risk factors for hypnic headaches?

Hypnic headaches most commonly affect people older than 50, with the average age being 62. But the condition can affect anyone, including children. Hypnic headaches affect more women and people assigned female at birth (AFAB) than men and people assigned male at birth (AMAB). People AFAB are 1.5 to 2 times more likely to experience one of these headaches.

How are hypnic headaches diagnosed?

Hypnic headaches are a type of primary headache disorder, which means they can’t be attributed to another condition. Your healthcare provider will confirm that the headaches don’t stem from a secondary cause, like another medical condition. For instance, conditions like high blood pressure or sleep apnea may cause nighttime headaches. A medication you take or one you just stopped can also cause headaches.

Your provider will also confirm that the headaches only happen during sleep. They wouldn’t consider a cluster headache or a migraine headache to be a hypnic headache because they can also happen while you’re awake. In addition, the headaches must:

• Last from 15 minutes to four hours.
• Occur at least 10 times during a month.
• Occur for at least three months.

Your provider will ask you about any other symptoms and the history of your headaches. It may be helpful to keep a diary detailing your headaches. They’ll also perform a neurological examination.

Which tests will be done to diagnose hypnic headaches?

To help rule out the possibility of other health conditions, your healthcare provider may order tests, including:

• Polysomnogram (an overnight sleep study).
• Brain MRI.
• Computed tomography (CT) scan.

What is the treatment for a hypnic headache?

Caffeine is the main form of hypnic headache treatment. Healthcare providers recommend drinking a cup of coffee containing caffeine before you go to sleep. Evidence suggests that drinking one cup of coffee before bed won’t keep you awake. You can use this method to prevent hypnic headaches and treat them.

You may also try taking caffeine pills or pain relievers containing caffeine to relieve hypnic headaches. But regular use of these drugs can cause medication overuse headaches. Excessive use of medications can lead to this kind of rebound headache.

Another hypnic headache treatment option is the use of a medication called lithium carbonate. Research has shown it’s effective in preventing hypnic headaches in 1 out of every 3 people. Lithium carbonate can stop hypnic headaches, but you should use caution while taking it because it can cause adverse side effects.

Other medications that you may use for a hypnic headache include:

• Melatonin.
• Indomethacin.
• Topiramate.

Talk to your healthcare provider about the best option for you. You never want to start a treatment without talking to a provider first.

Can hypnic headaches be prevented?

Researchers don’t know the exact cause of hypnic headaches, so you can’t completely prevent them. You can try taking certain medications before you go to sleep to prevent the headaches from occurring.

What is the outlook (prognosis) of hypnic headaches?

Studies have shown that hypnic headaches went away randomly in about 17% of people over time. But for most people, the headaches are a long-term (chronic) condition that can last for years. Another study reported that 40% of people with hypnic headaches experienced relief with treatment.

When should I see my healthcare provider?

See a healthcare provider if you find yourself regularly waking up with a pounding headache in the middle of the night. They can help determine if you have hypnic headaches or another health condition. They’ll also recommend a treatment plan, and hopefully, you’ll be back to getting a good night’s sleep.

What questions should I ask my healthcare provider?

Questions you may want to ask your healthcare provider include:

• Do I have hypnic headaches or another kind of headache?
• Is another health condition causing my headaches?
• What can I do to relieve my headaches when they occur?
• What do you recommend I do to try to prevent them from happening?
• Are there any lifestyle changes I can make to prevent these headaches from occurring?