Hypnic Headache

4.9. Hypnic headache


 Frequently recurring headache attacks developing only during sleep, causing wakening and lasting for up to 4 h, without characteristic associated symptoms and not attributed to other pathologies

Diagnostic criteria:

 A. Recurrent headache attacks fulfilling criteria B–E

 B. Developing only during sleep and causing wakening

 C. Occurring on ≥ 10 days per month for >3 months

 D. Lasting ≥ 15 min and for up to 4 h after waking

 E. No cranial autonomic symptoms or restlessness

 F. Not better accounted for by another ICHD-3 diagnosis

27.5 Brief General Information

HH was first described in 1988. It is a benign, recurrent headache disorder occurring exclusively during sleep, often starting during the same time of the night. The recurrence and the time-dependent manner are truly pathognomonic for this kind of headache. Commonly the headache is bilateral, mainly frontotemporal, or holocranial diffuse, with mild to moderate intensity. Concomitant symptoms are unusual. Patients usually suffer from 1 to 2 attacks per night lasting from 30 min to 3 h. Mean age of onset is 63 years with a female/male ratio of 2:1. Case series show an incidence of 0.1 % in outpatient headache centers. There is no known comorbidity with other idiopathic headaches or psychiatric diseases. Polysomnography studies show that attacks occurred during the initial REM sleep stage. Sleep quality is commonly normal, except decreased sleep efficiency and mildly decreased oxygen saturation down to 70 % in some patients. The exclusive relationship of HH with sleep, notably always during the same time of the night, and its tendency to occur in subjects older than 60 years imply a possible association with the changes of sleep physiology occurring in the elderly and the involvement of brain structures responsible for the endogenous circadian rhythm.
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Jul 4, 2016 | Posted by in HEAD AND NECK SURGERY | Comments Off on Hypnic Headache
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