WHY DO I WAKE UP WITH HEADACHE?
Are you waking up with headaches? There are many types of headaches that can do this. One interesting but uncommon type of headache that does this is called hypnic headache. This headache has also been called “alarm clock” headache because it often wakes the person up at almost the same time every night. These recurrent attacks occur only during sleep, causing wakening. They typically occur on 10 or more days per month for more than 3 months. The headache lasts 15 minutes and up to 4 hours after waking. This headache usually begins after age 50, but can occur in younger ages too. The pain is typically mild to moderate, but can be severe occasionally. The pain usually occurs on both sides of the head. There is no restlessness during the headache. Hypnic headache is not associated with autonomic symptoms [lacrimation (runniness/tearing of the eye), conjunctival injection (redness of the eye), facial sweating or flushing (skin turning blushed), nasal congestion, rhinorrhea (runniness of nose), sense of ear fullness, eyelid edema (swelling), or partial Horner’s syndrome (miosis (pupil becomes small)) and/or ptosis (droopiness of the eye)].
These features described above are all opposed to cluster headache, which can be another cause of waking headaches (also often around the same time every night) focused on only 1 side, around the eye and temple, and is of a very severe form of pain (often called suicide headache). Cluster headache is also associated with many of the autonomic features noted above. Migraine commonly causes waking up with headaches for many patients as well. Other causes of wakeup headache can include rebound headache (medication overuse headache) from excess pain medications, including over the counter pain meds. This occurs because as the patient is sleeping, the overused medication is being eliminated from the body and the headache (typically migraine) is triggered. Caffeine withdrawal headache can sometimes be a cause of waking headache as well, for the same reasons as rebound headache.
Regardless of the possibilities above, any headache, including waking headaches, need to be discussed and evaluated by your doctor. Neuroimaging preferably with a brain MRI is recommended for waking headaches to exclude other causes such as brain tumor, etc., even if the risk is low.
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