Hypnic Headache

Hypnic headache is a special type of headache that usually occurs in the elderly, and more often it occurs in women than men.

Most patients are over the age of 65 and may or may not have a past history of headaches. Usually the patients do not have a history of migraine, but they might.

This type of headache may be related to cluster headaches, in that they are tied to sleep cycles. Like paroxsysmal hemicrania, this is considered a subset of cluster headaches. Many times patients wake up with this different type of headache and like cluster headaches they are short lived, lasting from a few minutes to up to 3 hours. They may occur on both sides of the head, or only on one side.

Unlike the cluster headaches, there is no runny nose, no red eyes.

As always, a new onset of headache in the elderly may be due to other causes and should be worked up to rule out hypertension and the rare possibility of tumors in the brain. One thing we always consider in headaches in the elderly is temporal arteritis. Unlike hypnic headache, temporal arteries is 100% of the time on one side of the head and has blurry vision on that side (ipsilateral symptoms) and jaw tenderness.

Read more about types of emergency headaches.

Treatment of Hypnic Headache

If the pain is mild, many times people will respond to low doses of an anti-inflammatory such as ibuprofen or even over the counter Advil.

More severe cases are known to respond to a short course of lithium or indomethacin. Indomethacin is a stronger anti-inflammatory than ibuprofen but not as strong as a steroid. It can cause problems with the stomach so it is always a good idea to be on a medication such as Pepcid or Prilosec to protect the stomach while taking these medications.

At the present time, medications for cluster headaches are not used for these headaches mainly due to the age of the patient.