First Italian Case of Hypnic Headache, with Literature Review and Discussion of Nosology

First Austrian Case of Hypnic Headache: Serial Polysomnography and Blood Pressure Monitoring in Treatment With Indomethacin

“…Indomethacin has been previously reported to be beneficial in the treatment of hypnic headache. In contrast to the patient presented here, pain was localized predominantly unilaterally in those responders (5, 10, 15, 27–30). During follow‐up ranging from 12 weeks (29) to 13 months (15), only three of nine patients remained hypnic headache‐free after discontinuation of treatment (5, 15, 29).…”

The Headaches That Awaken Us

“…Even so, a significant age range for onset of hypnic headache has been documented. Reports have included adults between the ages of 36 and 83 years and one child with onset at 9 years 5–8 . Certainly, the age of onset in this case (56 years) is entirely compatible with a diagnosis of hypnic headache.…”

“…Although 5 of the original 6 patients were men, the disorder appears to occur more commonly in women. Usually the headaches are short‐lasting (30 to 60 minutes), bilateral, and of moderate to severe intensity, but approximately one third of the cases described to date are unilateral 6,8–12 . In addition, the headaches may be severe in nature and last up to 4 hours.…”

Secondary “hypnic headache-

“…The mechanism by which nocturnal hypertensive peaks can cause headache is not clear. Interestingly, only nine of the cases published included 24 h blood pressure monitoring [14,15,18,25,35,39] despite the fact that 17 patients had previous history of arterial hypertension [12,13,17,18,24,25,31,39,40]. It should be noted that four patients attained headache relief with monotherapy with antihypertensives, such as atenolol and verapamil.…”

“…The therapies most frequently reported to be useful were lithium carbonate (33 patients), caffeine (12) and indomethacin (9). Interestingly, although 15 patients did not benefit from anti-hypertensive agents, such as propranolol/atenolol (14), verapamil (2) or clonidine (1) [10,14,15,18,29,30,35,37,38,44], two patients attained benefit from atenolol and two from verapamil, given as prophylactic monotherapy [13,17,36].…”