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 joannbar @joannbar

Yes - I am sure it’s the 65 mgs of caffeine in it that works - only one because with 2 - I can’t sleep.
Like I said they do make aspirin free Excedrin - and I use generic.
I am not a coffee drinker and tea is an inexact science as far as caffeine content. I am 71 and I think I am stuck with the condition for now.
I wish you luck - I know how miserable they make you feel.

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Has anyone tried ambian? I am going to try it , I know it’s for falling asleep but maybe it will keep me asleep.
I did use your suggestion of excedrin migraine before bed. 2 worked , until 1:00am . Then I was awake , no headache , but couldn’t go back to sleep. Also the nsaids constipate my system. Wish I could take sumatriptan every night. Thanks

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Profile picture for mlpults @mlpults

Thank you, I will try the excedrin ( migraine?). I also had all the diagnostic tests, cat scan , ct with dye. Neurologist is just guessing and throwing different drugs. I had to ask him to prescribe nurtec. I’m 70 , and it started at 61 after menopause.

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Yes - I am sure it’s the 65 mgs of caffeine in it that works - only one because with 2 - I can’t sleep.
Like I said they do make aspirin free Excedrin - and I use generic.
I am not a coffee drinker and tea is an inexact science as far as caffeine content. I am 71 and I think I am stuck with the condition for now.
I wish you luck - I know how miserable they make you feel.

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Profile picture for joannbar @joannbar

I self diagnosed myself with Hypnic headaches. Middle of the night Migraines started about 7 years ago in my mid 60s. I at first thought it must be sleep apnea but I passed my sleep test. I had a CT of my head and was seen by a Neurologist- all was normal. By the time I saw the Neurologist a few years ago, I was already treating myself with one Excedrin at bedtime. It works very well but if I forget to take it - I wake up 2-3 in the morning with the Migraine. Like other posts - I have to get out of bed and sit up - I, at that point take an Excedrin and the headache subsides. That is the only time I take abortive meds. The Neurologist suggested that I may have rebound headache, but since I only usually take the Excedrin as a preventative, I do not agree.
I think few doctors know and understand Hypnic headaches. They are terrible!
I also get Airplane headache - usually with a rapid descent in altitude - I usually just take a couple Aleve before descent which prevents. I also get an occasional mild regular migraine. The Neurologist did not think any of these were related. Other than the headaches, I am healthy, normal weight, very active and not on any meds.
Additionally- I usually take the Aspirin free Excedrin to avoid stomach issues.
I hope posts like these help more people and that there is more research into the problem

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Thank you, I will try the excedrin ( migraine?). I also had all the diagnostic tests, cat scan , ct with dye. Neurologist is just guessing and throwing different drugs. I had to ask him to prescribe nurtec. I’m 70 , and it started at 61 after menopause.

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I self diagnosed myself with Hypnic headaches. Middle of the night Migraines started about 7 years ago in my mid 60s. I at first thought it must be sleep apnea but I passed my sleep test. I had a CT of my head and was seen by a Neurologist- all was normal. By the time I saw the Neurologist a few years ago, I was already treating myself with one Excedrin at bedtime. It works very well but if I forget to take it - I wake up 2-3 in the morning with the Migraine. Like other posts - I have to get out of bed and sit up - I, at that point take an Excedrin and the headache subsides. That is the only time I take abortive meds. The Neurologist suggested that I may have rebound headache, but since I only usually take the Excedrin as a preventative, I do not agree.
I think few doctors know and understand Hypnic headaches. They are terrible!
I also get Airplane headache - usually with a rapid descent in altitude - I usually just take a couple Aleve before descent which prevents. I also get an occasional mild regular migraine. The Neurologist did not think any of these were related. Other than the headaches, I am healthy, normal weight, very active and not on any meds.
Additionally- I usually take the Aspirin free Excedrin to avoid stomach issues.
I hope posts like these help more people and that there is more research into the problem

REPLY
Profile picture for projfan @projfan

Interesting. I recently discovered that my migraines that start during the night seem to have been, at least in part, triggered by low glucose (hypoglycemia). I was wearing a continuous glucose monitor for another reason, and this pattern just popped out of the data. Not dangerously low, but potentially symptomatically low. So I started eating something with protein and fats before going to bed (an egg, a bit of turkey plus nuts, whatever). The monitor showed a consistently higher level of glucose during the night -- not a lot higher, but higher, and I'm down to less than half the morning migraines I had previously experienced. I'm a senior, too, and have had migraines my entire life. This particular pattern started a few years ago, and had been getting worse over time. That's actually compatible with avoiding simple carbs (desserts) in the evening. So maybe? Worth a shot.

The whole issue of trigger foods is a swamp -- just too custom to the individual and too many possibilities. It becomes a matter of creating your own elimination diet and obsessively keeping some kind of diary to track both the food and the headaches to look for correlations that might actually be causal. A time-of-day pattern is really helpful, because you can start with your evening foods.

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I have had hypnic headaches for at least 9 years. I have tried amatriptilene, topomax, norotriptilene, coffee,indomethcin, Qulipta ,melatonin and nurtex. Some didn’t work at all ,some worked sporadically, some made it worse. I average 15 to 18 nights per month. Last October and November I thought they were gone for good. Feel so blessed to wake up refreshed. But then they returned. I am so sick of feeling drugged when they do work and if they don’t the headaches intensify. A non drug fix for me is to stationary bike for 25 minutes in the middle of the night. The headache leaves but I am awake for the next hour or so. Occasionally I take sumatriptan, the only thing that takes it away other than the exercise. The headaches are on the right side and not severe .

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Profile picture for karenakr @karenakr

In my 50s I would wake up at 3am with a headache. It could escalate to a migraine very quickly if I thought it was mild and waited to do coffee. I had read that this happened to seniors. I figured out eventually that it was due to food eaten about 9pm. Usually, a dessert was the item. So, if I didn't eat gluten items, no headaches or migraines happened. With food industry ingredient changes of colorings, flavorings, and processing changes for many foods in last 20 yrs, more than gluten triggered my headaches and migraines. It now can happen during the day, or anytime. I avoid any trigger foods. Haven't had 3am incidents for years, as I never eat potential trigger foods past dinner. As a senior, something in me likely changed with my chemistry too.

Jump to this post

Interesting. I recently discovered that my migraines that start during the night seem to have been, at least in part, triggered by low glucose (hypoglycemia). I was wearing a continuous glucose monitor for another reason, and this pattern just popped out of the data. Not dangerously low, but potentially symptomatically low. So I started eating something with protein and fats before going to bed (an egg, a bit of turkey plus nuts, whatever). The monitor showed a consistently higher level of glucose during the night -- not a lot higher, but higher, and I'm down to less than half the morning migraines I had previously experienced. I'm a senior, too, and have had migraines my entire life. This particular pattern started a few years ago, and had been getting worse over time. That's actually compatible with avoiding simple carbs (desserts) in the evening. So maybe? Worth a shot.

The whole issue of trigger foods is a swamp -- just too custom to the individual and too many possibilities. It becomes a matter of creating your own elimination diet and obsessively keeping some kind of diary to track both the food and the headaches to look for correlations that might actually be causal. A time-of-day pattern is really helpful, because you can start with your evening foods.

REPLY

In my 50s I would wake up at 3am with a headache. It could escalate to a migraine very quickly if I thought it was mild and waited to do coffee. I had read that this happened to seniors. I figured out eventually that it was due to food eaten about 9pm. Usually, a dessert was the item. So, if I didn't eat gluten items, no headaches or migraines happened. With food industry ingredient changes of colorings, flavorings, and processing changes for many foods in last 20 yrs, more than gluten triggered my headaches and migraines. It now can happen during the day, or anytime. I avoid any trigger foods. Haven't had 3am incidents for years, as I never eat potential trigger foods past dinner. As a senior, something in me likely changed with my chemistry too.

REPLY
Profile picture for taterjoy @taterjoy

Hi Cheryl!

If you google "hypnic headaches" and read many of the summary articles by research physicians, you might see case reports of people not being able to lie down with them, since lying down can make the pain severe. That is my case also. Once awakened by them, I bolt out of bed and pace for hours upright. Before I used preventatives, I would become exhausted (usually about 3 hours of pacing, when no acute meds were helping). I would then sit on the floor with my back pushed tight (upright) against the wall. Sleeping on a propped wedge did not help me, but your idea of nearing standing while sleeping is amazing! and Clever!

I am so glad you are getting relief from caffeine. I met a Vietnam Veteran who had terrible headaches, and his only help was to drink coffee on and off all day. The VA system did not diagnose his headaches as hypnic, and offered little treatment; but he figured out that he felt better walking all day, rarely sitting or lying down. Very sad.

I do hope that caffeine continues to help prevent your headaches, and that your siblings will also get some much needed assessment and treatment options. The literature on migraines sadly relays that undertreated migraine can lead to stroke, and also to brain lesions. I do believe my own hypnic headaches stem from brain trauma due to under-treatment of migraines, for years. Every case may be different. I'm so hopeful that research on Hypnic headaches and Migraines will lead to more effective, well-tolerated treatments that are not terribly expensive.

Thank you for your well-wishes! I have not met another person that has hypnic headaches, and though we are not positive that yours are, it is really wonderful to connect with you and hear about your creative solutions to treatment! If I find other solutions, I will let you know. I am now taking a class in Qi Dong and finding it very relaxing--it's a bit like Tai Chi, but more about the breathing and healing component. Time will tell!

Taterjoy

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I have had them daily for 10 years as well. I am also hoping to get better treatment.

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Out of all of the chronic things I have going on the Hypnic Headaches are the worst. Not just waking every night with a headache it's not getting enough sleep. For 16 years I would wake and take 50 mg of Imitrex or 100 mg if really bad and go back to sleep. I did this every night. Last year after taking triptans for all those years I started breaking out in hives after taking just one triptan. It wasn't just Imitrex but all of them. I am so limited now in terms of taking something for the pain. I don't get regular migraines anymore except on very rare occasions. I am now on Gabapentin for extreme cervical nerve pain. I read that sometime that also helps with migraine but I only take 300 mg a day so either not enough or it doesn't work for Hypnic. I had to stop the Qulipta because of extreme hair loss and constipation but last night I took a 15 mg pill when I woke up and the headache was gone in a few minutes

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good advice on taking a glass of milk or something before drinking the coffee. I do have butalbital with codeine if my headache gets worse.

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