Headaches every night between 3 and 6 am?

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    I get headaches every night (between 3 and 6 am).  They have gotten worse the past year but I have had them for about four years.  I have been to two neurologists and after trying Topamax, Imitrex, blood pressure pills, gabapentin, amitriptyline, nothing helps.  I usually drink a cup of tea upon the initial headache and that helps many times but the past week, I need to take an Excedrin and I am afraid of getting rebound headaches so I use this as a last resort.  However, I have been taking one every day this week and I try to avoid this but I am in PAIN.  I have had x-rays, MRI's, etc on my neck and brain but all seems to be ok there.  My quality of life is terrible now - bad nights and tired all day. Help. Donna.

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    Answer:

     

    Dear Donna;

     

    Are these headaches or Migraines? It does make a difference.

     

    That said, if these are Migraines, one would wonder what trigger you're encountering that is precipitating them. It could be something you eat, a fragrance in a product you use, or any number of things.

     

    Trigger identification and management is an important part of Migraine management and preventing Migraines. You may have some triggers that you can avoid, thus preventing Migraines brought on by those triggers. Do you know what any of your triggers are? When working to identify triggers one of the best tools is a good Migraine diary. You can read more about this and download a free diary workbook in our article Your Migraine and Headache Diary. Some of us have food triggers, some of us don’t. The best way to determine if you do is to do an elimination diet for a while. For more information and a workbook on this, see Managing Migraine - Migraine Trigger Foods.

     

    You're quite right to be cautious of the Excedrin. Taking Migraine abortive meds such as the triptans or ergotamines or any kind of pain med more than two or three days a week can make matters worse by causing medication overuse headache (MOH), aka rebound. See Medication Overuse Headache - When the Remedy Backfires for more information on this.

     

    There's also a rare form of headache that wakes people from sleep during the night, hypnic headache. You can read more about it in Hypnic Headache - The Basics.

     

    If your doctor isn’t able to help you, it may well be time to consult a Migraine and headache specialist. It’s important to note that neurologists aren’t necessarily Migraine and headache specialists. Take a look at the article Migraine and Headache Specialists - What's So Special? If you need help finding a Migraine specialist, check our listing of Patient Recommended Migraine and Headache Specialists.

     

    Good luck,
    John Claude Krusz and Teri Robert

     

     

    To review other questions from our Ask the Clinician Column,
     browse the Ask the Clinician archives.

     

    If you need help finding a  Migraine and headache specialist,
     visit our listing of Patient Recommended Specialists.

     

     

    About Ask the Clinician:

    Dr. Krusz is a recognized expert in the fields of headache and  Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and  Migraines. You can read more about Dr. Krusz or more about Teri Robert.

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    Last updated March 22, 2010.

Published On: March 22, 2010