Hypnic Headache

  title={Hypnic Headache},
  author={Stefan Evers and Peter J. Goadsby},
  journal={Practical Neurology},
  pages={144 - 149}
INTRODUCTION Hypnic headache is a rare episodic headache syndrome first described by Raskin in 1988. It has also been called ‘clockwise headache’ or ‘alarm-clock headache’ (Newman et al. 1990). More than 80 similar cases have been reported and our recent systematic review of all published cases described the typical clinical picture and treatment options (Evers & Goadsby 2003). Characteristically, many times a month, a dull pain wakens the patient from sleep, it lasts for more than 15 min… 

Hypnic headache: an update

Sufficient evidence, mainly from polysomnographic studies, indicates that HH is a primary rapid eye movement (REM) sleep-related headache disorder of chronobiological origin and Lithium, melatonin, indomethacin and caffeine at bedtime are among the most effective therapeutic options.

Hypnic headache

The analysis shows that hypnic headache most probably is an entity among the idiopathic headache disorders unassociated with structural lesions and does not belong to the trigeminal-autonomic cephalalgias.

Hypnic headache in childhood: A literature review

Acoustic neuroma presenting as a hypnic headache

A 40-year-old woman with Acoustic neuroma that presented with 4 months of generalised, throbbing, nocturnal headaches that woke her from sleep is described, advocating for neuroimaging to exclude structural causes.

Other Primary Headache Disorders

Patients with primary headache disorders that are classified as “other primary headaches disorders” have presentations with unique diagnostic and management considerations, and an appreciation of the diagnoses will aid clinicians in providing safe and effective care for patients presenting with headache.

Ambulatory Blood Pressure Monitoring in Patient With Hypnic Headache: A Case Study

A case of hypnic headache is reported, in which the patient had elevated blood pressure during sleep and was diagnosed by ambulatory blood pressure monitoring (ABPM) and responded to therapy with beta-blocker.

European headache federation consensus on technical investigation for primary headache disorders

The consensus recommends brain MRI for the case of migraine with aura that persists on one side or in brainstem aura and brain MRI with detailed study of the pituitary area and cavernous sinus for all TACs.

First Austrian Case of Hypnic Headache: Serial Polysomnography and Blood Pressure Monitoring in Treatment With Indomethacin

According toICHD-II, subjects complaining of exclusively sleep-related dull headache can be diagnosed with hypnicheadache if at least two of the following are present: occurrence > 15 times per month; duration of pain for 15 min after waking; age at onset after50 years.

Remission of Hypnic Headache Associated with Idiopathic Cyclic Edema with the Use of Aminaphtone

A case of daily intermittent headaches in a patient with idiopathic cyclic edema who was prescribed aminaphtone which cured the headaches within two days after initiating treatment.



Episodic Hypnic Headache?

The review of the published cases suggests that hypnic headache tends to be a chronic unremitting disorder.

The Hypnic (“Alarm Clock”) Headache Syndrome

Hypnic headache syndrome is a rare, sleep-related, benign headache disorder that largely remains unchanged or attenuates over time, but frequency may vary in either direction.

Posterior Fossa Meningioma Presenting as Hypnic Headache

A patient who presented with otherwise typical hypnic headache accompanied by longstanding bilateral deafness and minimal imbalance was described, and magnetic resonance imaging showed evidence of a posterior fossa meningioma.

Hypnic Headache: Another Indomethacin‐Responsive Headache Syndrome?

Hypnic headache syndrome appears to represent yet another headache disorder in which there is sometimes an impressive response to indomethacin, and lithium has been reported to be an effective treatment, but the side effects of this medication are sometimes prohibitive.

Polysomnography in Hypnic Headache Syndrome

Three patients with long‐standing hypnic headache underwent overnight polysomnography and the results were quite variable, ranging from normal to marked sleep insufficiency.

Hypnic headache: a case report with polysomnography.

An additional case supports the view of a relationship between the hypnic headache syndrome and the REM sleep stage and Lithium therapy decreased the intensity and frequency of headache attacks.

Cefaleas hípnicas: cuatro casos clínicos

Although some patients did not fulfil the diagnostic criteria described by Dodick et al in a previous series of cases, the night-time presentation with no associated autonomic disorder and good response to lithium carbonate were in favour of the diagnosis of hypnic headaches.

A review of paroxysmal hemicranias, SUNCT syndrome and other short-lasting headaches with autonomic feature, including new cases.

It is suggested that the short-lasting primary headache syndromes are sufficiently well established for inclusion in the International Headache Society Classification system and that trigeminal-autonomic cephalalgias should be classified as a group together.

Hypnic Headache Syndrome

  • K. Ravishankar
  • Medicine
    Cephalalgia : an international journal of headache
  • 1998
A recently seen case that is of interest to the discussion of the overlap between trigeminal neuralgia and SlfNCT is described and a patient with short-lasting unilateral pain and autonomic symptoms should be best classified as SUNCT.

Do patients with obstructive sleep apnea wake up with headaches?

Awakening headaches are associated with OSA, and treatment of OSA with continuous positive airway pressure or uvulopalatopharyngoplasty can reduce these headaches.