Headache After Sleeping

by Rab Nawaz M.

It remains a few hours. It is severe headache, unable to read any thing. Pressure goes to the head. I am suffering from it for the last 20 years. I keep taking Paracetamol and codeine with paracitamol. Still I do not get relief. I am recommended Amitriptyline 10mg. I am taking it for the last three years still the same pain, I am keep getting. Will you please recommend better drug than the above mention.


Hi Rab,

Part of you headache syndrome may be due to medication overuse also known as analgesic rebound headaches.

Amitriptyline is an excellent medication for chronic daily headache, but you are a bit under dosed. 10mg is a starting dose and most probably should be raised until you can get some relief.

You do not mention any testing that has been performed. A sleep study could rule out sleep apnea. The headache associated with sleep apnea is one that occurs after sleeping and lasts for a few hours.

There are several headache specialists in London, including a free clinic. I would highly suggest that you make an appointment to see a specialist in headaches, not just a neurologist.

Cases like yours are more common than you think, but effective treatment needs a true headache specialist.

Best of luck...
Mary Kay Betz MS RPA-C

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Headache While Sleeping

by jere
(new york)

Hi, I've had headaches for about a year (not a usual headache person). Been ok for a few months, was on amitryptyline until Oct.

This week headaches are back, waking me up at night and now I had tingling in both feet and fingers. Last visit with neurologist was June, follow-up is tomorrow. The only thing that subsided headaches last night all night was rubbing my shoulders and back but that didn't stop tingling.

Last year I had negative MRI, MRA, MRV and sed. test for arteritis. I wish someone could tell me what the cause is. What tests if any do you think my neurologist should ask for tomorrow? I'm not a big pill person so am hesitant to go down that road.
Thank you, I've written to you last year and was thankful for your response.


Hi Jere,

If you responded to Elavil before it might be worthwhile going back on it again for a short time. Rubbing the back and shoulders tells me it is coming from spasming in the back causing perhaps a cervicogenic headache.

Other anti-spasmotics such as tizanadine are also nice. This medication helps with spasm and tingling and it is out of your system in about 10 hours. So taken at bed time means no over sedation the next day.

The tingling could be a couple of things..headache patients are at higher risk for anxiety but other causes such as vitamin deficiencies can't be ignored. Both vitamin B12 deficiency and Vit D deficiency can worsen headaches. Lack of B12 in particular causes tingling in the hands and feet, so you might need some bloodwork.

I know you don't like to take medication but that is only part of the plan. Total headache care involves lifestyle changes, exercise and vitamin therapy. Consider also looking at your sleep patterns and making sure you have good back and neck support while sleeping as it makes an incredible difference in how good your sleep is.

Good luck tomorrow!
Mary Kay Betz MS RPA-C


My wife is 24 years, with massive headache, she suffer in tress , now this time she suffer massive headache in sleep at midnight, its comes suddenly , stay 15 mnt(s)approx and go automatically. I can't understand what should i do, plz help me..........


I sent you an email at the address you provided.

For anyone else who reads this, a new onset of a headache that is massive, no matter how it presents, needs to be taken seriously.

You should have your wife see her doctor as soone as possible to discuss having an MRI of the brain and an MRA which looks at the arteries. For more information please read about emergency headaches.

Good luck!
Mary Kay

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Sleepless in Seattle

by monera
(seattle, WA the US )

Headaches and sleeplessness

Headaches and sleeplessness

I have been having headaches most of my adult life and none of meds that I have taken have worked for me.


Hi Monera,

I am sorry to hear that you have been suffering for so long. I did a little research about headache centers in your area. Here is one that specializes in headache and is run by neurologists.

Swedish Headache Center looks to be a full service headache clinic with doctors, psychologists and various treatments. If you have been having headaches this long, perhaps you need to consider in patient treatment at a place like this where they can effectively monitor and treat your headaches.

Best of luck!

Mary Kay Betz, MS RPA-C
Physician Assistant

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Does the scenerio above sound like you? If not, or if you think you need more information please read about different types of headaches to find out which type of headache you are experiencing.

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