Hypnic Headaches

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A hypnic headache is a rare type of headache that only happens when you’re asleep. Sometimes called “alarm clock” headaches, they are known to rouse you from sleep with pain that lasts anywhere from 15 minutes to several hours.

Several types of headaches, including migraines, can cause you to wake up with a headache. What sets hypnic headaches apart is that they occur exclusively during sleep and are not linked to headaches at other times of the day. We’ll discuss the main symptoms and causes of hypnic headaches, how they’re diagnosed and treated, and when it’s time to see a doctor. 

A hypnic headache is a unique and uncommon type of sleep-related headache. Hypnic headaches only occur during sleep and cause a person to wake up. Unlike other sleep-related headaches, hypnic headaches do not cause symptoms at other points during the day. 

Some types of headaches, such as migraine and tension headaches, are relatively common, but hypnic headaches are rare. While exact numbers are hard to pin down, researchers believe hypnic headaches affect less than two percent of people who experience headaches.

Another distinctive characteristic of hypnic headaches is that they primarily occur in older adults. Many other types of sleep-related headaches happen less frequently as a person gets older, but hypnic headaches almost always start after the age of 50. 

Hypnic headaches should not be confused with other types of headaches. This includes migraine and cluster headaches which can share some similar symptoms. Although migraine and cluster headaches can occur during sleep, they also happen during waking periods, while hypnic headaches only happen during sleep.

The core symptom of hypnic headaches is the frequent experience of being woken up from sleep with a headache. These headaches are usually accompanied by a dull or pounding pain that affects one or both sides of the head. 

Most people find themselves fully awake during a hypnic headache episode and are likely to get out of bed while the headache persists. On average, hypnic headaches last around two and a half hours. While episodes can be longer, usually they don’t last more than three hours, and some may be as short as 15 minutes. 

People with hypnic headaches have episodes that occur at least 10 days per month with many people experiencing episodes on 21 or more days each month.

Less often, people may have other symptoms in addition to the headache itself. These include symptoms sometimes seen in other types of headaches, such as:

• Nausea
• Sensitivity to light and sound
• Stuffy nose
• Watery eyes
• Drooping eyelids

Researchers can’t explain exactly what causes hypnic headaches, but they may be linked to problems in the regions of the brain that control sleep and pain processing.

Although the pounding pain from a headache can seem like it’s coming from inside the brain itself, brain tissue doesn’t actually have nerves that can signal pain. Instead, the pain from a headache comes from a special network of sensitive nerves that surround the brain. 

Headaches arise when this nerve network sets off a cascade of signals that lead to headache pain. These signals can also cause symptoms that can occur with certain types of headaches like sensitivity to light and sound, nausea, and diarrhea.

Based on the way hypnic headaches affect people, researchers believe that they occur as a result of changes to a part of the brain called the hypothalamus. This brain region has connections to the nerve network that causes pain and headaches, and it is also involved in how the brain manages sleep. 

A doctor can evaluate and diagnose a person with hypnic headaches based on their reported symptoms and medical history. Those who suspect they are experiencing hypnic headaches should consult with a neurologist who is board-certified in sleep medicine in order to receive the most accurate diagnosis.

To diagnose this condition, the pattern of headache episodes must match certain characteristics. Specifically, these headaches must: 

• Only occur during sleep
• Cause the person to wake up from sleep
• Happen 10 or more days every month for a minimum of three months
• Last 15 minutes or longer after waking up
• Not be caused by another type of headache or medical condition

Diagnosing hypnic headaches isn’t always straightforward. For example, although uncommon, some people with hypnic headaches have symptoms like stuffy nose, watery eyes, and restlessness. These symptoms often arise with other sleep-related headaches, which can make it challenging to determine if the episodes are hypnic headaches or another type of headache.

In most cases, though, the lack of daytime headaches is enough to differentiate hypnic headaches from migraines, cluster headaches, and other kinds of headaches that can happen during sleep.

To diagnose hypnic headaches, a doctor also has to make sure that there is no other obvious cause of headache episodes. Sometimes headaches are a sign of another health issue, including a sleep disorder like sleep apnea. As a result, a doctor may recommend other medical tests, like a home test for sleep apnea, to rule out other potential causes of recurring headaches.

When to Talk to Your Doctor

Talk with your doctor if you’re experiencing frequent headaches, no matter the time of day that they occur. Make sure to let your doctor know if your headache symptoms include:

• Two or more episodes per week 
• Severe and sudden onset of new headaches
• A change in the pattern of your headaches
• Appearance of new headaches if you’re over age 50
• Additional symptoms like nausea, fever, stiff neck, muscle weakness, convulsions, vision changes, or confusion

Talking with a doctor is a key step in getting appropriate care. Self-medicating with over-the-counter pain medications may seem effective, but it can sometimes trigger more headaches. A medical professional can help give you an accurate diagnosis, rule out more serious medical problems, and develop a tailored treatment plan.

You should also talk to your doctor if headaches are disrupting your sleep. Some signs that you aren’t getting enough quality sleep include:

• Daytime drowsiness 
• Falling asleep at inappropriate times 
• Trouble focusing 
• Frequent yawning 

Your doctor can help you understand your symptoms and determine whether you’re experiencing hypnic headaches, migraines, or a headache that is a symptom of another medical issue.

Rarely, headaches can be a sign of a serious condition that needs urgent medical attention. If a headache is severely painful and accompanied by blurred vision, nausea, vomiting, paralysis, or seizures, seek medical attention immediately.

Treatment for hypnic headaches usually involves taking medications or supplements. Because these headaches are rare, though, there is limited evidence from research studies about the optimal type of treatment. 

One of the first options that many doctors recommend is consuming a small dose of caffeine before bedtime. Caffeine may offer relief from hypnic headaches, and while caffeine typically has the potential to interfere with sleep, this appears to be less likely to occur in people with hypnic headaches. 

Other treatments that may be prescribed for hypnic headaches include different kinds of medications used to treat pain. In addition, doctors may recommend drugs that are primarily used for other physical or mental health conditions. However, these medications are generally prescribed with caution because of the potential for unwanted side effects.

Hypnic headaches tend to be a persistent health issue, but treatment can help many people successfully control their symptoms. While hypnic headaches can be a nuisance and disrupt sleep, they have not been associated with any known long-term health issues or complications.