Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentPrognosis and Coping

Table of ContentsView All

View All

Table of Contents

Symptoms

Causes

Diagnosis

Treatment

Prognosis and Coping

Also known as “alarm clock headache,” hypnic headache is a rare disorder in whichheadachesarise only while you’re sleeping. Varying in intensity, attacks of this condition disrupt sleep, last up to four hours after waking, and occur often: 10 or more times a month.

The diagnosis of hypnic headaches can be challenging, and treatment approaches vary. Caffeine at night is often tried, as are medications, such aslithiumand Tivorbex (indomethacin), among others.Read on to find out more about this disorder, including how it’s identified and managed, as well as what you can do to cope with it.

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Hypnic Headache Symptoms

As aprimary headache disorder, hypnic headaches arise independently of other health conditions. Several features define them, including:

Differences in SeverityTypically felt bilaterally (on both sides of the head)—though some experience it unilaterally (on only side)—the intensity of pain during hypnic headache attacks can vary significantly. Usually, pain is described as similar to atension headache, with dull or moderate pain.In about 20% of cases, the pain may be sharp, stabbing, and severe. More severe hypnic headaches can also causemigraine-like symptoms, such as nausea, vomiting, and sensitivity to light (photophobia) and sound (phonophobia).

Differences in Severity

Typically felt bilaterally (on both sides of the head)—though some experience it unilaterally (on only side)—the intensity of pain during hypnic headache attacks can vary significantly. Usually, pain is described as similar to atension headache, with dull or moderate pain.In about 20% of cases, the pain may be sharp, stabbing, and severe. More severe hypnic headaches can also causemigraine-like symptoms, such as nausea, vomiting, and sensitivity to light (photophobia) and sound (phonophobia).

Typically felt bilaterally (on both sides of the head)—though some experience it unilaterally (on only side)—the intensity of pain during hypnic headache attacks can vary significantly. Usually, pain is described as similar to atension headache, with dull or moderate pain.

In about 20% of cases, the pain may be sharp, stabbing, and severe. More severe hypnic headaches can also causemigraine-like symptoms, such as nausea, vomiting, and sensitivity to light (photophobia) and sound (phonophobia).

When attacks happen—something that occurs, on average, 21 times a month—people not only wake up, but become active, walking around, snacking, or bathing. Additional reported symptoms include:

Because it’s a rare condition, hypnic headache causes aren’t entirely understood. However, some researchers believe this type of headache may be a variant of migraines since it shares many of the same mechanisms. Since attacks only occur during sleep, this condition may be linked to disruptions of thecircadian rhythm(your natural sleep-wake cycle) due to disorders of thehypothalamusregion of the brain.

Since patients are generally over age 50, age-related degradation of this region is suspected. Several causes for hypnic headache have been proposed, such as:

Risk Factors

In general, hypnic headache is very rare, with an incidence estimated to be between 0.07 and 0.3% of the population.Several health factors have been linked to hypnic headaches, increasing the chances of attacks. Here’s a quick breakdown:

Diagnosing Hypnic Headache

Given how few people experience hypnic headaches—and the fact that its symptoms can vary significantly—identification of this condition can be challenging. The main goal of diagnosis is for neurologists or headache specialists to rule out other kinds of headaches, or other health issues that may be causing pain. This may entail a range of tests and assessments, including:

There’s no set therapy for hypnic headaches because they are so rare and poorly understood. Treatment approaches for hypnic headache include medications to manage symptoms after onset (abortive medications) as well as those that work to prevent attacks (preventive medications). In addition, some lifestyle changes have been reported to help as well as other nonpharmacologic medical treatments.

Abortive Medications

A number of abortive, or rescue, medications may be prescribed to take on hypnic headaches after they’ve set on. These include:

Preventive Medications

There is limited evidence that some drugs used for chronic migraine may help, such as:

Non-Pharmaceutical Approaches

There are several non-pharmaceutical approaches have been attempted, including:

Though the headaches, themselves, are benign and don’t cause damage to the brain, hypnic headaches can certainly be a burden. They can be unpredictable and disrupt sleep. The good news, however, is that this condition is usually responsive to treatment.

Some may struggle to live with chronic headache conditions, and they are associated withmood disorderssuch as anxiety and depression. Strategies that may help you cope include:

Tips for Coping with Headaches

Summary

Diagnosis involves ruling out other causes of nighttime headaches, which may entail imaging, blood pressure testing, and screening for sleep apnea.

Though there’s no set treatment, caffeine, certain analgesics, and triptans treat symptoms of hypnic headache, and lithium and indomethacin are most frequently prescribed as preventive medications.

A Word From Verywell

There’s no denying that hypnic headaches are disruptive and debilitating. It can be frustrating and difficult to have sleep disrupted and then wake up with pain. However, there are several treatment options, and they are generally successful in resolving this issue.

If you suspect you have hypnic headaches—or any kind of headache disorder—be proactive: Talk to your healthcare provider and get the help you need.

The Connection Between Migraines and Poor Sleep

9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.International Headache Society.4.9 hypnic headache. ICHD-3.American Migraine Foundation.Hypnic headache.George DeMaagd T.An introduction to hypnic headache.US Pharm.2021;46(1):17-20.Kesserwani H.Hypnic headache responds to topiramate: a case report and a review of mechanisms of action of therapeutic agents.Cureus. 2021;13(3):e13790. doi:10.7759/cureus.13790Holle D, Naegel S, Krebs S, et al.Hypothalamic gray matter volume loss in hypnic headache.Ann Neurol. 2011;69(3):533-539. doi:10.1002/ana.22188Headache Classification Committee of the International Headache Society (IHS).The International Classification of Headache Disorders, 3rd edition.Cephalalgia. 2018;38(1):1-211. doi:10.1177/0333102417738202Tariq N, Estemalik E, Vij B, et al.Long-term outcomes and clinical characteristics of hypnic headache syndrome: 40 patients series from a tertiary referral center.Headache. 2016;56(4):717-724. doi:10.1111/head.12796Dissanayake K, Wanniarachchi D, Ranawaka U.Case report of hypnic headache: a rare headache disorder with nocturnal symptoms.BMC Res Notes. 2017;10(1)American Psychological Association.Coping with chronic pain.

9 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.International Headache Society.4.9 hypnic headache. ICHD-3.American Migraine Foundation.Hypnic headache.George DeMaagd T.An introduction to hypnic headache.US Pharm.2021;46(1):17-20.Kesserwani H.Hypnic headache responds to topiramate: a case report and a review of mechanisms of action of therapeutic agents.Cureus. 2021;13(3):e13790. doi:10.7759/cureus.13790Holle D, Naegel S, Krebs S, et al.Hypothalamic gray matter volume loss in hypnic headache.Ann Neurol. 2011;69(3):533-539. doi:10.1002/ana.22188Headache Classification Committee of the International Headache Society (IHS).The International Classification of Headache Disorders, 3rd edition.Cephalalgia. 2018;38(1):1-211. doi:10.1177/0333102417738202Tariq N, Estemalik E, Vij B, et al.Long-term outcomes and clinical characteristics of hypnic headache syndrome: 40 patients series from a tertiary referral center.Headache. 2016;56(4):717-724. doi:10.1111/head.12796Dissanayake K, Wanniarachchi D, Ranawaka U.Case report of hypnic headache: a rare headache disorder with nocturnal symptoms.BMC Res Notes. 2017;10(1)American Psychological Association.Coping with chronic pain.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

International Headache Society.4.9 hypnic headache. ICHD-3.American Migraine Foundation.Hypnic headache.George DeMaagd T.An introduction to hypnic headache.US Pharm.2021;46(1):17-20.Kesserwani H.Hypnic headache responds to topiramate: a case report and a review of mechanisms of action of therapeutic agents.Cureus. 2021;13(3):e13790. doi:10.7759/cureus.13790Holle D, Naegel S, Krebs S, et al.Hypothalamic gray matter volume loss in hypnic headache.Ann Neurol. 2011;69(3):533-539. doi:10.1002/ana.22188Headache Classification Committee of the International Headache Society (IHS).The International Classification of Headache Disorders, 3rd edition.Cephalalgia. 2018;38(1):1-211. doi:10.1177/0333102417738202Tariq N, Estemalik E, Vij B, et al.Long-term outcomes and clinical characteristics of hypnic headache syndrome: 40 patients series from a tertiary referral center.Headache. 2016;56(4):717-724. doi:10.1111/head.12796Dissanayake K, Wanniarachchi D, Ranawaka U.Case report of hypnic headache: a rare headache disorder with nocturnal symptoms.BMC Res Notes. 2017;10(1)American Psychological Association.Coping with chronic pain.

International Headache Society.4.9 hypnic headache. ICHD-3.

American Migraine Foundation.Hypnic headache.

George DeMaagd T.An introduction to hypnic headache.US Pharm.2021;46(1):17-20.

Kesserwani H.Hypnic headache responds to topiramate: a case report and a review of mechanisms of action of therapeutic agents.Cureus. 2021;13(3):e13790. doi:10.7759/cureus.13790

Holle D, Naegel S, Krebs S, et al.Hypothalamic gray matter volume loss in hypnic headache.Ann Neurol. 2011;69(3):533-539. doi:10.1002/ana.22188

Headache Classification Committee of the International Headache Society (IHS).The International Classification of Headache Disorders, 3rd edition.Cephalalgia. 2018;38(1):1-211. doi:10.1177/0333102417738202

Tariq N, Estemalik E, Vij B, et al.Long-term outcomes and clinical characteristics of hypnic headache syndrome: 40 patients series from a tertiary referral center.Headache. 2016;56(4):717-724. doi:10.1111/head.12796

Dissanayake K, Wanniarachchi D, Ranawaka U.Case report of hypnic headache: a rare headache disorder with nocturnal symptoms.BMC Res Notes. 2017;10(1)

American Psychological Association.Coping with chronic pain.

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