Diagnosis of HH:
Before assigning a diagnosis of hypnic headache, imaging studies should be performed to rule out any organic issues.
Treatment of HH:
Lithium carbonate, 300 mg at bedtime, is frequently used to stop HH, but must be used with caution especially in the presence of renal disease, dehydration, or use of diuretics.
Bedtime doses of caffeine, flunarizine (a calcium channel blocker), and indomethacin have been shown effective in some cases.
Some case studies have shown daily preventive use of topiramate (Topamax) also to be effective in some cases.
Summary:
Hypnic headache is rare, and should be diagnosed only after any organic, physical causes have been ruled out. HH begins during sleep and wakes the suffer, then generally lasts 15 to 180 minutes. Lithium carbonate, caffeine, flunarizine, indomethacin, and Topamax have been successful in treating HH.
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Resources:
The International Headache Society. "International Classification of Headache Disorders, 2nd Edition." Cephalalgia, Volume 24 Issue s1. May, 2004. doi:10.1111/j.1468-2982.2003.00823.x
Silberstein, Stephen D.; Lipton, Richard B.; "Goadsby, Peter J. Headache in Clinical Practice, Second Edition." Martin Dunitz, Ltd. 2002.
© Teri Robert, 2009.
Last updated January 3, 2008.
