Understanding Hypnic Headaches: Symptoms, Causes, and Treatment

Last updated: September 7th, 2023

What Is a Hypnic Headache?

A hypnic headache is a rare type of headache that only happens when you’re asleep, sometimes called “alarm clock” headaches. Known to rouse you from sleep with pain that lasts anywhere from 15 minutes to several hours, hypnic headaches are distinguishable from other sleep-related headaches in that they occur exclusively during sleep and are not linked to headaches at other times of the day. Most often occurring after age 50, hypnic headaches should not be confused with other types of headaches, including migraines and cluster headaches, which can also occur during sleep.

Symptoms of a Hypnic Headache

The core symptom of hypnic headaches is awakening from sleep with a headache that usually lasts between 15 minutes and three hours. Hypnic headaches tend to begin a few hours after a person falls asleep, usually between 2:00 and 4:00 am. Along with a headache, people may experience nausea, sensitivity to light, and dizziness. If a person experiences hypnic headaches more than once a week, they may have a condition called “periodic hypnic headaches”.

Other Types of Sleep-Related Headaches

Migraines, cluster headaches, and tension headaches can occur during sleep. Migraines are marked by a severe headache, visual disturbances, nausea, sensitivity to light and sound, fatigue, and pins and needles. Cluster headaches are characterized by severe pain on only one side of the head, along with watery eyes, restlessness, and a runny nose or congestion on the same side of the head as the pain. Tension headaches are marked by mild or moderate pain that’s often described as pressing or tightening around the head, along with potential muscle pain, jaw pain, and dyscognition.

Causes of a Hypnic Headache

While the primary cause of hypnic headaches is not known, some research suggests they result from changes in the natural pattern of brain wave activity during sleep. Alcohol consumption and sleep-disrupting medications can also play a role in the development of hypnic headaches, as can excessive napping and not getting enough sleep. Many people living with hypnic headaches report that the pain is worse when they wake up in the middle of an REM cycle.

How Are Hypnic Headaches Diagnosed?

If you regularly wake up during the night with a headache, your doctor may diagnose you with a hypnic headache. Diagnosis may involve a physical exam and tests like a CT scan or MRI to check for any underlying problems, as well as a thorough medical history to watch for any other potential causes of headaches during sleep.

How Are Hypnic Headaches Treated?

Depending on the severity and frequency of the headaches, treatment for hypnic headaches may involve medication or home remedies. Guidelines set by the National Institute for Health and Care Excellence (NICE) are used to diagnose and treat hypnic headaches. Medications such as amitriptyline, ergot derivatives, oxygen, and magnesium may be used to treat hypnic headaches. Home remedies for hypnic headaches may include getting at least seven to eight hours of sleep each night, avoiding alcohol and sports drinks before bedtime, limiting caffeine intake, and exercising exclusively during the day and avoiding it late in the evening.

When to See a Doctor

If your hypnic headaches fail to improve after trying the above treatments, or you’re unable to identify the source of your headache, talk to your doctor. Some diseases can be associated with sleep-related headaches, including temporal arteritis and the Encephalitis, so it’s best to talk to your doctor about any concerning symptoms.

Preventing Hypnic Headaches

The following lifestyle changes can help to prevent hypnic headaches: getting enough sleep, avoiding alcohol and sports drinks before bedtime, limiting caffeine intake, and exercising exclusively during the day and avoiding it late in the evening.

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