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 mollyquah @mollyquah

I have been getting nighttime headaches for about a year. They wake me up usually around 3am, then it's hard to go back to sleep, if not impossible. These headaches usually go away after i get up for the day, but sometimes turn into a migraine. It feels like they start at the left side of my neck and continue up to the left eye. There is pain to the touch on my neck and side of my head.

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I could’ve posted this exact thing today. I feel like I’ve been hit by a brick at night. It is always on my right side above and behind my ear. I also have spin off headaches afterwards. Either tension type headaches or facial pain. I also can get this particular headache if I nap. I tried melatonin but couldn’t sleep at all with it. What’s most likely to help? What have people had success with?

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I have been getting nighttime headaches for about a year. They wake me up usually around 3am, then it's hard to go back to sleep, if not impossible. These headaches usually go away after i get up for the day, but sometimes turn into a migraine. It feels like they start at the left side of my neck and continue up to the left eye. There is pain to the touch on my neck and side of my head.

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Profile picture for kathyb52 @kathyb52

I've found out now that, even though estrogen does relieve the headaches, I just can't tolerate the side effects - no matter how small a dose I take. I tried caffeine pills - up to 50 mg. per night. They did seem to relieve the headaches on 2-3 nights, but I had to keep upping the dose to have that happen after that - and I don't want to do that because it bothers my otherwise pretty good sleep - even with the headaches! So on to the next thing. I'm already on a very good diet, mostly chicken, some beef and sardines, and boatloads of cooked vegetables, with a few other additions. Been on it for almost 8 years and my health is actually wonderful - with the exception of these stupid headaches. About a month and a half ago, I started near infrared sauna therapy on a daily basis. Still too early to tell definitively, but the headaches seem to be receding. The sauna is supposed to eliminate toxic metals in my system - most of which have accumulated since before my diet change (aluminum, mercury, etc.) Hair analysis is wonderful for actually determining what's going on in that department. The sauna is starting to make me sweat some - which is the whole point. I have never been much of a "sweater", even in hot weather. I'm going to continue the daily saunas and see what develops! Maybe it will also help my somewhat mild brain fog. Have high hopes!! Will try to keep you posted.

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I'm so sorry the hormones continued to cause side effects, but glad you are investigating other routes to good health. Thank you for sharing your techniques! Your diet sounds very healthy! I've kept a good diet since my teens since I also have polycystic ovarian syndrome and had to keep my weight low. Headaches and autoimmune thyroid issues are my main issues, but I am feeling much better now that my migraines are much less frequent and severe due to the new CRGP inhibitors. I do practice Qi Gong, some pilates and daily walking for exercise, but could probably be doing more strength training. I hope you continue to feel better and better and that the diet and sauna will help keep your headaches at bay or at least minimal!

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Profile picture for taterjoy @taterjoy

I hope you are able to increase your doses to help stave off the nocturnal headaches. Are you able to drink coffee or take caffeine tablets? I wonder if those might help prevent your headaches. Also, have you seen a headache specialist? That your headaches are always on the same side could be that they are migraines, or possibly something else, even related to an anatomical issue. Please keep us posted and I hope you are able to tolerate the higher doses of hormones and are getting relief from the headaches.

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I've found out now that, even though estrogen does relieve the headaches, I just can't tolerate the side effects - no matter how small a dose I take. I tried caffeine pills - up to 50 mg. per night. They did seem to relieve the headaches on 2-3 nights, but I had to keep upping the dose to have that happen after that - and I don't want to do that because it bothers my otherwise pretty good sleep - even with the headaches! So on to the next thing. I'm already on a very good diet, mostly chicken, some beef and sardines, and boatloads of cooked vegetables, with a few other additions. Been on it for almost 8 years and my health is actually wonderful - with the exception of these stupid headaches. About a month and a half ago, I started near infrared sauna therapy on a daily basis. Still too early to tell definitively, but the headaches seem to be receding. The sauna is supposed to eliminate toxic metals in my system - most of which have accumulated since before my diet change (aluminum, mercury, etc.) Hair analysis is wonderful for actually determining what's going on in that department. The sauna is starting to make me sweat some - which is the whole point. I have never been much of a "sweater", even in hot weather. I'm going to continue the daily saunas and see what develops! Maybe it will also help my somewhat mild brain fog. Have high hopes!! Will try to keep you posted.

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Profile picture for kathyb52 @kathyb52

Hi, I've had nighttime headaches for at least 10 years now. They happen every night after I go to sleep. I usually wake up at varying times in the middle of the night with a right sided headache only. I think I clench my teeth now, so I got a custom nightguard. It doesn't seem to help, but at least it protects my teeth. I'm 70 years old and recently tried hormone therapy, estrogen, testosterone and progesterone. After a few days, I woke up with no headache!! However, at the recommended dose, I developed the beginnings of diverticulitis - so had to discontinue the hormones. I decided to start back on it again, but very low and slow - hoping that I can still relieve the headaches with a lower dose and not develop any more diverticulitis. I think I should be back up to the dose that relieved the headaches within a month or so. Like I said, low and slow - very frustrating - but hope it works in the long run. Will let you know.

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I hope you are able to increase your doses to help stave off the nocturnal headaches. Are you able to drink coffee or take caffeine tablets? I wonder if those might help prevent your headaches. Also, have you seen a headache specialist? That your headaches are always on the same side could be that they are migraines, or possibly something else, even related to an anatomical issue. Please keep us posted and I hope you are able to tolerate the higher doses of hormones and are getting relief from the headaches.

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Profile picture for johnrigsby1970 @johnrigsby1970

I wake up due to a sleep apnea which triggers an arrhythmia. Specifically, I can wake up calmly, know I am not breathing, no have any pain at that time, and choose consciously to take a breathe and the whole thing kicks off on that breath. This is called Cyclic Variation of Heart Rate, CVHR. CVHR requires two things, an apnea event and bradycardia , slow heart rate. At which point the blood flows to my head and I feel a throbbing at the base of my skull. Like two fingers pulsing up into my head. It starts out no pain and then quickly accelerates in severity. There are variations where I feel no pain or I feel a stead mild pain throughout but worst case is it elevates to the point I feel like they are about to pop. And then it spreads out like s sponge and dissipates. This can go on to my right temple where it does the same thing, a sharper more migraine like pain. If I were to get up right then I would be fine. If I go back to sleep I am likely to wake again and repeat it. It would get more severe and eventually cause a headache. IT can go on enough that it will happen even as I stand up and walk around. Melatonin 5mg set me off and had it happen starting at 10pm at night and go all night, but low dose of 1mg was fine, did not help with attack though, just with getting to sleep.

These attacks usually happen at around 630am. If I look at my heart rate using a fitbit Im in bradycardia around that time. I also have had vivid dreams every single night for a year. These things tend to happen during dreams.

I have spent a year at doctors. Pulminologist, rheumatologist ( to look for arteritis), neurologist, cardiologist, and now a second sleep study. None of these doctors had a clue. In the end I self diagnosed with CVHR mixed with Hypnic Headache. As it happens I also stopped drinking caffeine a year ago so these "headaches" spiked to happening every other night. So I took 100mg of caffeine at bed, 10pm, on an empty stomach. I havent hade an issue in two months, not even the throbbing which would indicate more pressure from the faster heart rate.

I have a kidney stone so a year ago I stopped drinking sodas and I dont drink coffee. I had these attacks before, its why Im on a cpap, but they just figured it was CO2 build up due to apnea. When I got off of caffeine the attacks started happening every other night. They usually happen around 5-6am. I dont know who decided to call these headaches, they are nothing like it. These are attacks.

For me, because mine are triggered from CVHR and CVHR requires a slow heart rate at night, I was also able to stop these attacks by working out so hard during the day that at 10pm at night I still had a heart rate off 95bpm. So it takes all night to slow down and I never have bradycardia. But this is not 100%. So far caffeine, liquid is best, at night before bed has been perfect. I am still with a sleep specialist so they can actually diagnose me. So far Ive had to figure it out.

Neurologist (not Mayo based) didnt have a clue and just randomly gave me Amnitryptoline. It didnt help. Well, I had one night where I had the attacks, felt the pulsing, and had zero pain along with it. But while the pain is a big deal, I worry more about the pressure and damage. The drug gave me severe side effects. He wouldnt try anytihng else and wanted me to go to a cardiologist who found no issue. HE just wanted to give me a drug, have me try it for three months (with the danger of these attakcs every other night) and follow up with an appointment (so he could get paid). Thats when I did one last google due to issues I had with hypnic flinches or ticks developing. Ticks have gone away now too.

IF caffeine does not work and if bradycardia is in the mix for you, try working out. I do not know if CVHR is always involved in hypnic headaches. If you are experiencing them, have you also looked at why you wake, is it an apnea. I also wonder if these things are rare because most people have caffeine of some form throughout the day and maybe more would have them if they didnt.

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Sorry I am seeing your posts for the first time, today. I have been out of state dude to family illness, and out of touch with internet mostly. I have never heard of CVHR and will certainly mention it to my MD next visit. The pulsing in my head during these headaches is so loud and so painful, I never though of a heart rate issue, but my normal is very low. It could be even lower at night. I will purchase a type of fitbit that monistors it and see! I was tested for Apnea but negative. Thank you for sharing your background. So glad you found some relief. Its a long road with rare illnesses! I hope that both your hypnic headaches and CVHR are staying under control. Please keep me posted, and I will do the same. My noctornal headaches are much less severe with the caffeine and now 50mg Indomethacin nightly, and 20 Melatonin. However, if my migraines before more frequent, it triggers my nocturnal headaches, too.

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Profile picture for CherylSD @cherylsd

Dear Taterjoy,

I am so sorry to read about your recent acute migraine. I have not had a headache that bad since the last time I had to take nitroglycerin! I'm glad you've recovered, but what an awful bout you must have had.

I wanted to add one piece of information about my headaches. About four years ago, I started sleeping in an almost upright position. Because the headaches would often go away IF I got up immediately upon waking with one, I thought perhaps I could forestall them by simply not lying down. Sitting up was not a perfect solution, but I feel it helped to some degree.

However, since learning about hypnic headaches, and taking caffeine at night, I have had only two headaches in thirteen days. This is a huge improvement. I have even been able to spend a larger portion of the night sleeping supine. I am taking more caffeine than what was recommended on the sites I read. (Either one strong cup of coffee plus 100 mg. caffeine tablet, or one 200 mg. tablet)

I have not yet made an appointment with a new neurologist, so this remains "my own diagnosis" at this point.
I'll let you know what I learn when I do meet with someone.
I hope you do not have another bad migraine attack for a long time!

Cheryl

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How are you doing now, Cheryl! Are you still drinking coffee and/or taking the caffeine supplements at night? And how are your siblings doing? I hope you are all doing well, and living well with fewer (if any) headaches.

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My neuro wants to try me on the GCRP injectables. I am 81 now and really don't get migraine during the day anymore except if I'm on the computer too much. I haven't heard anything about using them for Hypnic headaches. I have a feeling she is throwing things at me. The head neuro at UCSF headache clinic who gave me an hour consultation also suggested trying the herb Botswellia. I haven't tried that yet because I can't figure out a dose. She did want me to try Nurtec but Medicare doesn't cover it and $1000 is over my budget. If I do try the GCRP's is one better than the other? For some reason she said she wanted to try Emgality. Help!

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Profile picture for lwatson612 @lwatson612

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...

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Hi, this is a very timely post for me. I have had headaches almost every night for the last 10 years and have seen several doctors over the years. I'm 70 years old now, and just found out about hypnic headaches. I've never wanted to take any heavy duty headache medicine, but I've come to the end of my rope about the headaches. Two nights ago, I tried 25 mg. of a 200 mg. caffeine tablet. The first night I woke up at 4:00 without a headache; when I went back to sleep, however, I woke up at 7:00 with one. Last night, I took the same amount, at the same time (about 10:00 p.m.) and did ever get the usual headache! I know it's very soon to predict what may happen, but it's the first night I've been headache free for a long time, so YAY!! Anyway, the caffeine appears to have a lot of merit. I've read that 40-60 mg. per night is the usual dose for hypnic headache. Thought I would start out lower and raise it if I have to. Hope this post helps - even though it is early on!! Best of luck to you and your son with this debilitating problem. It appears to be hormonal because estrogen helped for a couple of days, but the side effects were too much for me. Will investigate further how caffeine helps hormonal problems.

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I wake up due to a sleep apnea which triggers an arrhythmia. Specifically, I can wake up calmly, know I am not breathing, no have any pain at that time, and choose consciously to take a breathe and the whole thing kicks off on that breath. This is called Cyclic Variation of Heart Rate, CVHR. CVHR requires two things, an apnea event and bradycardia , slow heart rate. At which point the blood flows to my head and I feel a throbbing at the base of my skull. Like two fingers pulsing up into my head. It starts out no pain and then quickly accelerates in severity. There are variations where I feel no pain or I feel a stead mild pain throughout but worst case is it elevates to the point I feel like they are about to pop. And then it spreads out like s sponge and dissipates. This can go on to my right temple where it does the same thing, a sharper more migraine like pain. If I were to get up right then I would be fine. If I go back to sleep I am likely to wake again and repeat it. It would get more severe and eventually cause a headache. IT can go on enough that it will happen even as I stand up and walk around. Melatonin 5mg set me off and had it happen starting at 10pm at night and go all night, but low dose of 1mg was fine, did not help with attack though, just with getting to sleep.

These attacks usually happen at around 630am. If I look at my heart rate using a fitbit Im in bradycardia around that time. I also have had vivid dreams every single night for a year. These things tend to happen during dreams.

I have spent a year at doctors. Pulminologist, rheumatologist ( to look for arteritis), neurologist, cardiologist, and now a second sleep study. None of these doctors had a clue. In the end I self diagnosed with CVHR mixed with Hypnic Headache. As it happens I also stopped drinking caffeine a year ago so these "headaches" spiked to happening every other night. So I took 100mg of caffeine at bed, 10pm, on an empty stomach. I havent hade an issue in two months, not even the throbbing which would indicate more pressure from the faster heart rate.

I have a kidney stone so a year ago I stopped drinking sodas and I dont drink coffee. I had these attacks before, its why Im on a cpap, but they just figured it was CO2 build up due to apnea. When I got off of caffeine the attacks started happening every other night. They usually happen around 5-6am. I dont know who decided to call these headaches, they are nothing like it. These are attacks.

For me, because mine are triggered from CVHR and CVHR requires a slow heart rate at night, I was also able to stop these attacks by working out so hard during the day that at 10pm at night I still had a heart rate off 95bpm. So it takes all night to slow down and I never have bradycardia. But this is not 100%. So far caffeine, liquid is best, at night before bed has been perfect. I am still with a sleep specialist so they can actually diagnose me. So far Ive had to figure it out.

Neurologist (not Mayo based) didnt have a clue and just randomly gave me Amnitryptoline. It didnt help. Well, I had one night where I had the attacks, felt the pulsing, and had zero pain along with it. But while the pain is a big deal, I worry more about the pressure and damage. The drug gave me severe side effects. He wouldnt try anytihng else and wanted me to go to a cardiologist who found no issue. HE just wanted to give me a drug, have me try it for three months (with the danger of these attakcs every other night) and follow up with an appointment (so he could get paid). Thats when I did one last google due to issues I had with hypnic flinches or ticks developing. Ticks have gone away now too.

IF caffeine does not work and if bradycardia is in the mix for you, try working out. I do not know if CVHR is always involved in hypnic headaches. If you are experiencing them, have you also looked at why you wake, is it an apnea. I also wonder if these things are rare because most people have caffeine of some form throughout the day and maybe more would have them if they didnt.

REPLY
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