Chronic severe nocturnal hypnic headaches

Posted by taterjoy @taterjoy, Aug 29, 2016

I am looking for anyone else who has been diagnosed and treated for chronic, severe nocturnal hypnic headaches. I have had them for about 12 years, and on treatment, but not optimal treatment. I am interested in hearing how others with this rare diagnosis are being told to treat them safely.

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Profile picture for taterjoy @taterjoy

I'm so glad she was able to fit you in due to a cancellation. How did your appointment go? Feel free to write to me privately. I will also send you my name privately in case you see her again. I had no time to reply this am. THank you for your kind thoughts for my Father in law. Every day we have him is precious. I hope you will be headache free for this exciting weekend, and I hope Dr. Sacco was able to help you today!!! I use to wait months for an appointment with her, LOL, and am glad she is still in practice 19-20 years later!!!

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Update. Saw Dr Sacco. Impressed by how long she spent with me. She doesn’t believe in getting hypnic headaches. Said they are clusters and that clusters can wake you up around the same time every night too. What I feel the next day is all part of it and resembles a non aura migraine she said. I don’t necessarily agree with that because my migraines are only ever on one temple and it’s almost my entire head that hurts during the day without an “episode”
She thinks I’m coming toward the tail end of the cluster since I haven’t had an episode in a week. I’m starting a new medicine when it’s ready: Verapamil 180mg 1 tablet at night. This is a preventative for the clusters. She is also putting me on a very high dose of prednisone even though I did a dose already a week ago. I hate prednisone but I know it helps. For the daytime headaches, she gave me nurtec and immitrex shots. I have a follow up in 3 weeks. The interesting thing she said was that she doesn’t think I need to waste my money on any scans. Doesn’t think this is a secondary headache meaning it’s due to an underlying illness or problem.

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Profile picture for allysonc99 @allysonc99

Also I’ll tell her you said hello but I don’t know your name other than you are an angel to me who is helping me!

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I'm so glad she was able to fit you in due to a cancellation. How did your appointment go? Feel free to write to me privately. I will also send you my name privately in case you see her again. I had no time to reply this am. THank you for your kind thoughts for my Father in law. Every day we have him is precious. I hope you will be headache free for this exciting weekend, and I hope Dr. Sacco was able to help you today!!! I use to wait months for an appointment with her, LOL, and am glad she is still in practice 19-20 years later!!!

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Profile picture for taterjoy @taterjoy

OH MY GOODNESS! THANK YOU for your amazing update. I am thrilled beyond measure that the coffee ketorolac combo has mitigated those horrendous unbearable hypnic/cluster headaches. I am so sorry I could not read this before. We moved my father in-law into hospice care Wednesday and have had challenges and been with him around the clock. Also was stricken with my usual "end of dose failure" of my CGRP injectable preventative, Ajovy (sickly daytime migraines) .

I am so so happy for you! Please ask your MD pronto--call them on Monday--ask whether or not you might need concomitant Protonix/pantoprozole to prevent GI bleeding (due to the Ketorolac and any day-time nonsteroidals you might be taking such as Motrin, naproxin, aspirin an many others). Ketorolac is only recommended for 5 days or fewer in a row. It, like Indomethacin/Indocin, can have serious side effects on the GI (gastric bleeding, ulcers and holes in stomach or intestine), kidney failure, heightened risk of heart attack, and others). Now that you feel better, the last thing you would want to do have uncontrolled GI bleeding or worse. Here is a link to more info: https://medlineplus.gov/druginfo/meds/a693001.html

Ketorolac, like Indomethacin (Indocin) also has a BLACK BOX Warning to to the risk of intestinal bleeding.

Please tell Dr. Sacco I said HELLO and appreciated her help back in 2005 and 2006. I hope and pray she can help you feel even better and treat your headaches more safely than daily Indocin. I wonder if she will recommend keeping Ketorolac in your regimen or trying an alternative. Please please keep me posted!! I hope you are well on your way to getting your life back!!!

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Also I’ll tell her you said hello but I don’t know your name other than you are an angel to me who is helping me!

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Profile picture for taterjoy @taterjoy

OH MY GOODNESS! THANK YOU for your amazing update. I am thrilled beyond measure that the coffee ketorolac combo has mitigated those horrendous unbearable hypnic/cluster headaches. I am so sorry I could not read this before. We moved my father in-law into hospice care Wednesday and have had challenges and been with him around the clock. Also was stricken with my usual "end of dose failure" of my CGRP injectable preventative, Ajovy (sickly daytime migraines) .

I am so so happy for you! Please ask your MD pronto--call them on Monday--ask whether or not you might need concomitant Protonix/pantoprozole to prevent GI bleeding (due to the Ketorolac and any day-time nonsteroidals you might be taking such as Motrin, naproxin, aspirin an many others). Ketorolac is only recommended for 5 days or fewer in a row. It, like Indomethacin/Indocin, can have serious side effects on the GI (gastric bleeding, ulcers and holes in stomach or intestine), kidney failure, heightened risk of heart attack, and others). Now that you feel better, the last thing you would want to do have uncontrolled GI bleeding or worse. Here is a link to more info: https://medlineplus.gov/druginfo/meds/a693001.html

Ketorolac, like Indomethacin (Indocin) also has a BLACK BOX Warning to to the risk of intestinal bleeding.

Please tell Dr. Sacco I said HELLO and appreciated her help back in 2005 and 2006. I hope and pray she can help you feel even better and treat your headaches more safely than daily Indocin. I wonder if she will recommend keeping Ketorolac in your regimen or trying an alternative. Please please keep me posted!! I hope you are well on your way to getting your life back!!!

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I was able to get an appt with Dr Sacco tomorrow as she had a cancellation!

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Profile picture for taterjoy @taterjoy

OH MY GOODNESS! THANK YOU for your amazing update. I am thrilled beyond measure that the coffee ketorolac combo has mitigated those horrendous unbearable hypnic/cluster headaches. I am so sorry I could not read this before. We moved my father in-law into hospice care Wednesday and have had challenges and been with him around the clock. Also was stricken with my usual "end of dose failure" of my CGRP injectable preventative, Ajovy (sickly daytime migraines) .

I am so so happy for you! Please ask your MD pronto--call them on Monday--ask whether or not you might need concomitant Protonix/pantoprozole to prevent GI bleeding (due to the Ketorolac and any day-time nonsteroidals you might be taking such as Motrin, naproxin, aspirin an many others). Ketorolac is only recommended for 5 days or fewer in a row. It, like Indomethacin/Indocin, can have serious side effects on the GI (gastric bleeding, ulcers and holes in stomach or intestine), kidney failure, heightened risk of heart attack, and others). Now that you feel better, the last thing you would want to do have uncontrolled GI bleeding or worse. Here is a link to more info: https://medlineplus.gov/druginfo/meds/a693001.html

Ketorolac, like Indomethacin (Indocin) also has a BLACK BOX Warning to to the risk of intestinal bleeding.

Please tell Dr. Sacco I said HELLO and appreciated her help back in 2005 and 2006. I hope and pray she can help you feel even better and treat your headaches more safely than daily Indocin. I wonder if she will recommend keeping Ketorolac in your regimen or trying an alternative. Please please keep me posted!! I hope you are well on your way to getting your life back!!!

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That had to be extremely rough with your father in law. I do hope peace for your family as you go through this hard time.
I tried no coffee 2 nights in a row. I didn’t have an episode either night. I still have bad headaches during the day and have to take 800 ibuprofen and even then, there is still pain. No nausea during the day. My daughter has a softball tournament for theee days we are traveling for on Friday. Since I can’t risk having an episode this weekend, I’ll be drinking coffee before bed as a precaution. I don’t know what all this means since I have gone about 6 days without an episode.
My MRI, MRV and MRB scans are scheduled for Thursday.
Good luck with it all and I’ll definitely be asking my Dr for help!
Thank you again for everything!

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Profile picture for allysonc99 @allysonc99

I’m 48, something I forgot to add earlier. I’ve tried a cup of coffee four nights in a row and no episodes. I’ve woken up with a headache, popped a Keroralic and was able to go back to sleep. Never turned into the excruciating throbbing like a cluster headache. I believe it’s a combo of hypnic turn into cluster headaches that awaken me at night. Still having severe headaches during the day at times but they are never the episode type of headache. I’m so sorry you had to go so long without a proper diagnosis. With your help, and being on this forum, I possibly self diagnosed myself in a few weeks. I’ll await for proper diagnosis but if I can prevent these with caffeine for now until I can get into the doctors recommended, then I’m forever thankful.

Jump to this post

OH MY GOODNESS! THANK YOU for your amazing update. I am thrilled beyond measure that the coffee ketorolac combo has mitigated those horrendous unbearable hypnic/cluster headaches. I am so sorry I could not read this before. We moved my father in-law into hospice care Wednesday and have had challenges and been with him around the clock. Also was stricken with my usual "end of dose failure" of my CGRP injectable preventative, Ajovy (sickly daytime migraines) .

I am so so happy for you! Please ask your MD pronto--call them on Monday--ask whether or not you might need concomitant Protonix/pantoprozole to prevent GI bleeding (due to the Ketorolac and any day-time nonsteroidals you might be taking such as Motrin, naproxin, aspirin an many others). Ketorolac is only recommended for 5 days or fewer in a row. It, like Indomethacin/Indocin, can have serious side effects on the GI (gastric bleeding, ulcers and holes in stomach or intestine), kidney failure, heightened risk of heart attack, and others). Now that you feel better, the last thing you would want to do have uncontrolled GI bleeding or worse. Here is a link to more info: https://medlineplus.gov/druginfo/meds/a693001.html

Ketorolac, like Indomethacin (Indocin) also has a BLACK BOX Warning to to the risk of intestinal bleeding.

Please tell Dr. Sacco I said HELLO and appreciated her help back in 2005 and 2006. I hope and pray she can help you feel even better and treat your headaches more safely than daily Indocin. I wonder if she will recommend keeping Ketorolac in your regimen or trying an alternative. Please please keep me posted!! I hope you are well on your way to getting your life back!!!

REPLY
Profile picture for taterjoy @taterjoy

I am so so glad you will see Dr. Sacco and are seeing an MD affiliated with Duke university. I am not aware of their headache MDs or research, but hope you will get the support you need. And if you are taking lots of NSAIDS (ketorolac--I take the injectable version acutely to avoid ER; and Advil) you might ask your MD about ways to prevent gastric bleeding. It's not fun and can be serious. I have had no more gastric crises since adding Pantoprozole to my regimen (since I am a chronic user of Indomethacin and occassional Ketorolac or Motrin). My amazing Mayo MD (Dr. Mark Whealy) does not like long term use of Indomethacin but it's the only NSAID that works for me. I hope and pray hope is on the horizon for you!!

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I’m 48, something I forgot to add earlier. I’ve tried a cup of coffee four nights in a row and no episodes. I’ve woken up with a headache, popped a Keroralic and was able to go back to sleep. Never turned into the excruciating throbbing like a cluster headache. I believe it’s a combo of hypnic turn into cluster headaches that awaken me at night. Still having severe headaches during the day at times but they are never the episode type of headache. I’m so sorry you had to go so long without a proper diagnosis. With your help, and being on this forum, I possibly self diagnosed myself in a few weeks. I’ll await for proper diagnosis but if I can prevent these with caffeine for now until I can get into the doctors recommended, then I’m forever thankful.

REPLY
Profile picture for taterjoy @taterjoy

I am so so glad you will see Dr. Sacco and are seeing an MD affiliated with Duke university. I am not aware of their headache MDs or research, but hope you will get the support you need. And if you are taking lots of NSAIDS (ketorolac--I take the injectable version acutely to avoid ER; and Advil) you might ask your MD about ways to prevent gastric bleeding. It's not fun and can be serious. I have had no more gastric crises since adding Pantoprozole to my regimen (since I am a chronic user of Indomethacin and occassional Ketorolac or Motrin). My amazing Mayo MD (Dr. Mark Whealy) does not like long term use of Indomethacin but it's the only NSAID that works for me. I hope and pray hope is on the horizon for you!!

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The neuro hasn’t prescribed injectable yet. I desperately need that. I’ll contact them tomorrow and hope they give it to me. The fear of sleep is very daunting. I have had a bad headache all day. The “episodes” of the extreme throbbing seems to be about 3 hours after I fall asleep I think. I think I also have a combo of clusters/hypnic/migraine. I want to get a hormone work up done as well since I’m in peri menopause. My mom suffered from clusters during perimenopause too. Thank you again for being a wealth of information!

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Profile picture for allysonc99 @allysonc99

Not sure how to message you privately. I’m new to this. I’ll try. Are you still suffering? This happens almost nightly and the residual is so bad the next day. I haven’t been able to function properly for two weeks.

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I Just sent you a private message. You can "click" on the persons @name (blue) and it will take you to a portal where you can send a private message. Very nice of Mayo to allow us to connect with other folks both in the group chat exchange center and privately.

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Profile picture for docb99 @docb99

I see that this topic goes back several years. I have posted in other threads about migraines. I’m 76 and have had headaches since my mid 30s. They have changed over the years but imitrex has always helped.
I recently developed morning headaches that occur while sleeping. I think they are hypnic but I’ve been told by the neurology NP I’ve seen at Emory that they are rebound headaches from imitrex.
I will be seeing Dr. Charles Gordon in Charlotte in October. He is an internist who specializes in migraines and was recommended.
Like many of you, I’ve been through many meds and many opinions about causes and cures. Unless you experience headaches you don’t understand them. I was told that Dr. Gordon understands. 🤞🏻🤞🏻🤞🏻

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I hope you will like Dr. Gordon and that he can help you. I am unaware of him as I moved to CA from NC in 2006. I wondered if your current MD ever prescribed something newer than Imitrex, any of the GCRPs? Some are taken by subcutaneous injections; other are oral or IV. They have helped my migraines (not the Hypnics) monumentally. If they are contraindicated for you I am sorry. They have changed my life--I am down from migrained daily (severe) to 4 per month, treatable at home with Frova and sometimes also Ketorolac injection. I believe that it was years of undertreated migraines that caused the Hypnics to occur and worsen over time to "every night." Preventing my migraines with the GCRPs has over time, finally had a impact on the severity of my nocturnal inflammatory headaches (reduction of severity; and I am using a smaller does of nightly Indomethacin now). I hope you can get answers and help in mitigating your migraines and your new night/morning headache. Please also keep us posted. What each of us learns could help us and also anyone reading these threads who is hesitant to share their health status publicly.

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