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((more citations needed|date=January 2019))
((Infobox medical condition (new)
| name            = Hypnic headache
| synonyms        =
| image           =
| caption         =
| pronounce       =
| field           = [[Neurology]]
| symptoms        =
| complications   =
| onset           =
| duration        = 2 days - 1 week
| types           =
| causes          =
| risks           =
| diagnosis       =
| differential    =
| prevention      =
| treatment       =
| medication      =
| prognosis       =
| frequency       = 20%
| deaths          = 3K
))
'''Hypnic headaches''' are benign primary [[headache]]s that affect the elderly, with an average age of onset at 63 ± 11 years.<ref name=Evers03/>  They are moderate, throbbing, bilateral or unilateral headaches that wake the sufferer from sleep once or multiple times a night.<ref>((cite journal |vauthors=Gould JD, Silberstein SD |title=Unilateral hypnic headache: a case study |journal=Neurology |volume=49 |issue=6 |pages=1749–51 |date=December 1997 |pmid=9409389 |doi=10.1212/wnl.49.6.1749|s2cid=31682748 ))</ref>   They typically begin a few hours after sleep begins and can last from 15–180 min.<ref>((cite book |author=Goadsby, Peter J. |author2=Silberstein, Stephen D. |author3=Lipton, Richard B. |title=Headache in clinical practice |publisher=Martin Dunitz |location=London |year=2002 |isbn=978-1-901865-88-2 |url-access=registration |url=https://archive.org/details/headacheinclinic0000silb_s8h9 ))</ref>   There is normally no nausea, photophobia, phonophobia or autonomic symptoms associated with the headache.  They commonly occur at the same time every night possibly linking the headaches with circadian rhythm, but [[polysomnography]] has recently revealed that the onset of hypnic headaches may be associated with REM sleep.<ref name=Evers03>((cite journal |vauthors=Evers S, Goadsby PJ |title=Hypnic headache: clinical features, pathophysiology, and treatment |journal=Neurology |volume=60 |issue=6 |pages=905–9 |date=March 2003 |pmid=12654950 |doi=10.1212/01.wnl.0000046582.21771.9c|s2cid=20201772 ))</ref>

== Diagnosis ==
For diagnosis of hypnic headache syndrome, headaches should occur at least 15 times per month for at least one month. Included in the differential diagnosis of a new onset nighttime headaches in the elderly is drug withdrawal, [[temporal arteritis]], [[Sleep apnea]], oxygen desaturation, [[pheochromocytoma]], intracranial causes, primary and secondary neoplasms, [[communicating hydrocephalus]], [[subdural hematoma]], vascular lesions, [[migraines]], cluster headaches, chronic paroxysmal hemicrania, headaches due to bruxism,<ref name="Das15">((cite journal|last1=Das|first1=S|last2=Gupta|first2=R|last3=Dhyani|first3=M|last4=Goel|first4=D|year=2015|title=Headache secondary to sleep-related bruxism: A case with polysomnographic findings|journal=Journal of Neurosciences in Rural Practice|volume=6|issue=2|pages=248–251|doi=10.4103/0976-3147.150293|pmc=4387823|pmid=25883492|doi-access=free))</ref>  and hypnic headache.  All other causes must be ruled out before the diagnosis of hypnic headache can be made.

== Treatments ==
[[Lithium carbonate]] 200–600&nbsp;mg at bedtime is an effective treatment for most patients but for those that can not tolerate lithium, Verapamil, [[indomethacin]], [[melatonin]] or methysergide may be tried.<ref name="Evars05">((cite journal |last1=Evars |first1=Stefan |last2=Goadsby |first2=Peter |year=2005 |title=Review: Hypnic headache |journal=Practical Neurology. Review |volume=5 |pages=144–49 |url=http://pn.bmj.com/content/practneurol/5/3/144.full.pdf |access-date=12 January 2018|doi=10.1111/j.1474-7766.2005.00301.x |doi-access=free ))</ref> Two patients have also responded to flunarizine 5&nbsp;mg.  It has also been shown that 1–2 cups of coffee or 100–200&nbsp;mg of caffeine before bed can prevent hypnic headaches.

A recent review of 348 cases available in the literature has been recently published.<ref>((cite journal |last1=Silva-Néto |first1=Raimundo Pereira |last2=Santos |first2=Patrick Emanuell Mesquita Sousa |last3=Peres |first3=Mário Fernando Prieto |title=Hypnic headache: A review of 348 cases published from 1988 to 2018 |journal=Journal of the Neurological Sciences |date=June 2019 |volume=401 |pages=103–109 |doi=10.1016/j.jns.2019.04.028|pmid=31075680 |s2cid=128363038 ))</ref>

==References==
((reflist))
((refbegin))
* ((cite web |title=ICHD-II-Hypnic Headaches |website=ISH Classification |url=http://ihs-classification.org/en/02_klassifikation/02_teil1/04.05.00_other.html |access-date=2008-07-01 |archive-url=https://web.archive.org/web/20150926050629/http://ihs-classification.org/en/02_klassifikation/02_teil1/04.05.00_other.html |archive-date=2015-09-26 |url-status=dead ))
* ((cite book |author=Dalessio, Donald J. |author2=Wolff, Harold G. |author3=Silberstein, Stephen D. |author4=Lipton, Richard B. |title=Wolff's headache and other head pain |publisher=Oxford University Press |location=Oxford [Oxfordshire] |year=2001 |isbn=978-0-19-513518-3 ))
((refend))

== External links ==
((Medical resources
|  DiseasesDB     = 
|  ICD10          = G44.81
|  ICD9           = ((ICD9|339.81))
|  ICDO           = 
|  OMIM           = 
|  MedlinePlus    = 
|  eMedicineSubj  = 
|  eMedicineTopic = 
|  MeshID         =
))
((Headache))

[[Category:Headaches]]

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