Chronic severe nocturnal hypnic headaches

@lwatson612 @jana15 I had migraines but am not really familiar with hypnic headaches, except for what I have read here. Are they similar enough to migraine that they use the same medication?
I really just wanted to comment, that when I was young no amount of caffeine kept me awake, but now I have to steer clear of it in the evening. I don't know if I am typical or if that's just me, but I think for people who are used to caffeine the effect is considerably less.
JK

Melatonin could be worth trying. I take melatonin. I started with 3 mg. but increased with guidance of a headache neurologist. I currently take 15 mg. Do not be concerned with taking a caffeine tablet. Caffeine prevents the headache in some people, also those of us with these night time headaches seem to be immune from the caffeine keeping us awake. The caffeine does not cause us to wake up. I currently take prescription Gapapentin as well as melatonin. It keeps things at a tolerable level of headache activity. Best of luck to your son.

Hi everyone, I noticed most of this discussion is from a year or more ago, but I stumbled across it while researching something that may help my son. It actually took a while for it to occur to me that it was odd that his headaches literally ONLY strike at night while he is sleeping. We have called them migraines, and I just assumed they only came at night. Now I see that they're called something else entirely. The reason I finally realized it was odd is that he started having them so frequently. He is only 17 though, and I understand the onset is always much older, so that is very odd. He first started having them about 2 years ago and then they stopped for a year, and now they are back with a vengeance. He had a MRI 2 years ago and everything checked out normal. His usually hit around 5:30 a.m., though one hit the other night at 1:30 a.m. He did have one after a nap the other day when he wasn't feeling well, but that's the only time that has happened. He has had them "come back" thru-out the day when medicine wears off, but they always strike between 4-5:30'ish. I've recently started giving him Excedrin or goody's powder, and those work better than anything else, though I'll also give him 2 advil if it's still hurting. I'm not comfortable putting him on any preventative prescription, he's still growing and there are just so many side effects. I do have migraines and take Trokendi XR (derivative of Topamax). He saw a chiropractor recently for 7 sessions and we felt like that was helping. They could tell his neck near the base of his head had some issues, the nerves on one side were essentially numb (I'm not using the technical words). He's an athlete and the chiropractor said as the season gets started, he will likely improve some as well, but the adjustments also should help. He said we could need some maintenance but he's hoping that helped. He's had 2 since we stopped. I read that melatonin can help? I also read that caffeine can help and I'm not sure how much would be ideal for a 17 year old, but for those of you using caffeine, I'd like to know if it impacts your sleep? I realize it may be worth it to avoid the headache, but I'd still like to know if it's keeping you awake or causing you to wake up? It seems he is at a very different stage of life than a lot of you, so he may be impacted by it very differently, but since he has to get up for school every morning, I hate to keep him up half the night with caffeine 🙂 I also think lack of sleep may give him a headache sometimes? I'm sure hormones plays into it as well. I'm so sorry that you all are suffering with this and discouraged that it's been so long for all of you...

Wow, after all these years actually finding a diagnosis for these headaches! Reading all these posts was a reflections of my life: I’m 68, female, had migraines since teen years, felt great for a couple of years during menopause then, wham, the nighttime headaches began. I tried everything the neurologist threw at me and some worked for a period of time, until they didn’t. Had scans, sleep studies. Finally relented to their recommendation of Botox about four years ago and am still on it (no longer receiving shoulder or neck injections which has created problems for me). Have also been on Topiramate about 6 yrs. Botox took over a year to kick in, then worked fantastically, not so great the past 18 months. Usually have pain five nights a week, but it’s NOT as bad as before and I sleep with an ice pack every night and put it over my eye/forehead at first indication of pain. Do I like subjecting my body to Botox poison? No, but I also don’t like hanging over a toilet throwing up in unbearable pain either. None of the pain meds worked and the older you get the less my doctors want to give them to you. Some of the new meds on the market remain untested with older women according to reseach I’ve done (which the doctors do Not tell you), and though my Neuro office was really pushing me towards it because their trial run was positive, they now have told me to wait. My very, very, unofficial observation has been that a lot of migraine sufferers have sensitive systems.
I’d like to get off both, shouldn’t be on Topiramate, never should have since I have osteopenia and now osteoporosis in areas. Tried weaning off Botox once and that was a mistake......

@lulu1962 @lisalucier - I started the Prednisone taper on 11 December. 42 tabs 10mg. I'll complete dosing on 22 December. Prior to starting the Prednisone I think the other meds had thrown off the timing of the headaches, so rather than waking me at a specific time, they were more random and not quite as severe, but was feeling generally achy along with a constant feeling of shakiness. I have tolerated Prednisone pretty well in the past, when taken for extreme cases of poison ivy and a lengthy battle with hives following a surgery. This round, after day 2, the headaches completely ceased and I've felt much better with the exception of the shakiness, a little fluid retention and elevated blood pressure. I expect the fluid retention and blood pressure will return to normal after I complete the dosage and, if true to form, I expect a week or 2 of feeling generally lousy while my body takes back over to produce cortisol. I'll keep you posted on what effect it has on the Hypnic Headaches. So far so good. @lulu1962, have you tried any caffeine or melatonin prior to sleeping yet? They worked more often than not for preventing the headache for me...at least while sleeping. Also, I've never taken Spironolactone. Prayers for us all to regain happy healthy lives.

@lulu1962 I took Spironolactone prior to my liver transplant along with another diuretic (I gained 35 pounds of fluid in 6 weeks). I had no problem from it and I was headache prone, but the headaches (migraines) ended with menopause, thankfully, so that is possibly why I didn’t have a problem. Interestingly, my migraines were almost all left sided also. Occasionally, when one was winding down, it would suddenly switch to the right side!
I can almost feel your pain, I hope you find some relief soon. That’s disappointing that the best migraine medications don’t help.
JK

Hi, @lulu1962 - I happen to take spirinolactone, but I don't experience nocturnal hypnic headaches (or other type of headache). Here is some information on the side effects of spirinolactone: https://www.mayoclinic.org/drugs-supplements/spironolactone-oral-route/precautions/drg-20071534.

Sounds like you are going to see the neurologist tomorrow, @lulu? Are you planning to discuss the possibility of hypnic headache?

@shaylala - you mentioned you'll be starting a round of prednisone. How do you typically do on that medication?

Hi @shaylala -I'm wondering how you are doing? Thank you for the response and our symptoms are definitely similar. Have you had any success with prednisone treatment? I meant to tell you I had a Dr. (mayo trained and Rheumatologist) who once treated me with IV steroids as I
was in the middle of a severe migraine attack. It is considered recue or breakthrough treatment and it worked, He had an infusion center and fortunately it was easily accessible. I do think there is a possible link in having adrenal fatigue (hypoadrenia) and hormone levels possibly affecting sleep hormones etc... I wonder if anyone in this group takes Spironolactone, (I'm on 100mg for Bioidentical HRT - fluid retention) Could there be any problem there? Also- i drink a lot of water daily. I don't drink coffee or tea or really anything other than water. I have a dry mouth related to RA and I even worry if I'm drinking too much wter?? I just wonder if migraine sufferers get in a cycle of adrenal stress from med side effects and lack of sleep, (poor sleep hygeine etc..) My gyno (hormone specialist) actually started me on a very low dose of prednisone years a go to see if it helped w inflamatory issues/migraines but it was too hard on my gut) I hope this treatment gives you some relief. It would be wonderful if it does. I know this time of year is tough on everyone- it makes eveything crazier as life and schedules ramp up. My prayer has become "please God-don't let me have a headache tonight". Blessings to all, Lulu💓

@lulu1962 - Glad you found this group too. I was just as frightened when these began about 4 months ago and mine is severe left side only as well. Worse than any migraine I ever experienced and nothing was helping the pain. I too, apply ice. Please try excedrin migraine rapid release as soon as you notice the pain or are awakened by it. No narcotic the doctors gave me helped and it blows me away that caffeine is more successful than even sumatriptan injections! I'm starting a round of Prednisone and will update on how that goes. I had a hysterectomy in 2007 and also have some degenerative discs and some herniated in both neck and low back but it doesn't seem to be related. I also have chronic sinus problems but control with Zyrtec, Flonaise and sometimes Afrin. The doctors told me the MRI did not show any problems with my sinuses that would explain the pain. Please stay in touch. It helps to know you're not alone. Maybe we can discover something we all share that could help explain this. You're in my prayers.

Hi - I have just found this group and am utterly relieved there is such a "syndrome"? As Hypnic Headaches. I have been suffering with these for the last year and a half on and off but they are becoming frequent and acute the last four months. I have been to my numerous specialists and healthcare providers and am furious not one professional has ever heard of this nor bothered to do further research. I have had an occipital nerve block and am scheduled for a cervical epidural at present. Seeing Neuro the 20th. I have told my Physiatrist about my symptoms and she ordered an MRI of my brain and brain stem, then another one of my cervical spine. Brain MRI was normal, cervical revealed a few minor disc issues, disc dehydration, minimal narrowing etc.. but not what would be casuing these headaches which are atypical. I have had migraines for past 20 years. Nothing like this and usually controlled w/ 50 mg Imitrex and Zofran. They are better. Had a forced hysterectomy at age 46 and and have been on hormone replacement therapy for last 10 years. I am astonished there are others suffering with these headaches. They typically hit between 2:00-3:00 am. The pain is always on the left side only and throbbing. Hurts to even touch area at C1/2 and surrounding soft tissues. Wakes me out of a dead sleep as I take 10 mg of ambien nightly to sleep (I have classic insomnia). The pain is so severe I thought maybe I was having an aneurism the first time it hit. I wake up and can hardly lift my head to get out of bed, I struggle to do this. My blood pressure is elevated from the pain and my heartrate goes very high. ( I normally have consistently low BP) I had a vasovagal response from the pain in recent episode. Which was scary. I immediatey try to get an ice pack and put it on my neck in bed and try to lay there until it is numbed away. This has worked in the past but it's beginning to be ineffective. A few times I have kept the ice pack in a small chest by bed. I have gotten to the point where I am scared to go to sleep sometimes because of the pain. I have only tried SPRYX nasal puff (toradol) for the pain, but its difficult to lean over and use accurately when in so much pain. I have been thinking it is something I do positionally/functionally while sleeping as I get in some strange postions and am restless sleeper, often uncomfortable and I also have RA. I have done years of manual therapy but just seems to flare things up at times and conditions seems chronic but now acute. I have also tried sleeping sitting up as position seems to be a possible factor??? It's making me crazy and lack of sleep isn't helping. I realize this is lengthy and too much info but I am so relieved I am not crazy and (sadly) there are others who have these symptoms with valuable information to share. Thank you so much for this group. I am going to read every post again as I think information is power! Grateful, Lulu