@benchi300 how are your headaches now? I hope you got some professional help. I was just wanting to update my reply since its about 1-2 years later. Indomethacin (us melatonin and no more nocturnal coffee) does still prevent the "hypnic" type headache about 92% of the time. I was encouraged to slowly dose of indomethacin from 75mg gradually to 25mg per night at the urging of my MD from Mayo and from Kaiser. If I take no indomethacin (which I do twice yearly to see if I still need it), I get a very sickly nocturnal headache (and awaken multiple times through the night) and the last awakening my headache is pounding and relentless. I have severe nausea and the pressure in my ears and behind my eyes is severe. I keep injectable Toradol to use for those episodes. After those episodes, I always have a low grade persistent headache and moderate nausea for about 5-6 days. I'm also more prone to migraine breakthrough after those "trial" withdrawal of Indomethacin.

As for the coffee at night, I no longer need to drink it. In the past, I always drank either medium or dark brew (various brands). I am now taking Ajovy for migraine prevention and it works about 26/30 days monthly. I took Emgality for several years for the nocturnal headaches (not migraines) and it seemed to be a bit more effective than Ajovy for me, but I had to pay for it as there were no CGRPs on the formulary at Kaiser when I first began preventative treatment with a CGRP. Ajovy is now on formulary and my copay is less than half the price I paid for Emgality.