What are ‘Hypnic’ Headaches?

All my adult life I had migraines, until I became a Macrobiotic Nutritionist; cleaned up my lifestyle, diet and got rid of these headaches. But recently a client came to me with a peculiar headache: one that occurred every day (for the past 6 years); the headaches occurred on one side of her head onlyfor a particular duration ranging from 1 to 4 hours, usually at nights and usually at the same time every night, the intensity of the headache on a scale of 1 to 10 with 10 being the highest always averaged at a 5. For my client, it had started after the age of 50, post her menopause, and everything one tried had not worked; she’d somehow get immune to it: diet, tryptophan supplements and homeopathy. Somehow, they would get so bad, that she always need medication. An MRI revealed nothing was going on, and her doctor recommended coffee before sleeping at night (weird, as I always thought coffee made things worse). She was lately getting them in the late evenings, instead of in the middle of her sleep-cycle. 

It forced me to research some more, and then I came across this: ‘Hypnic’ headaches. More common in women than men, the ratio of men to women is 1:9. It is believed to be a disorder of the elderly, many people suffer with it for years before its diagnosed. Most people think it’s a migraine. It is not accompanied with nausea, watering eyes, blocked nose.

What is the cause?

There is not too much research out there on ‘hypnic’ headaches. However, the little research suggests that they are connected to the stages of sleep. Apart from the symptoms mentioned in the first paragraph, it is known that ‘genetic inheritance’ plays a part. Research says that the first association of a migraine and a variation in the gene for the type A2a adenosine receptor could be a link (adenosine is a nucleoside that occurs naturally in the cells of the body, it helps in cellular energy transfer, and in signalling various pathways and functions in the body). The pain that comes with this type of headache can be unilateral (occurring on one side) or bilateral (occurring on both sides), and since the headache occurs at night and disrupts sleep,it is called ‘alarm-clock’ headache; the pain can be a throbbing kind of pain. You could firsts rule out the following – 

  1. That you do not suffer from sleep apnea.
  2. If you have nocturnal high blood pressure.
  3. If you have nocturnal low blood sugar.
  4. Have an MRI to check if there is something else going on.
  5. You are not suffering from any withdrawals from medication (especially, pain medication).

Standards to diagnose a ‘hypnic headache’

  1. It is dull and constant or throbbing.
  2. Occurs during sleep and wakes up the person.
  3. Happens more than 15 times a month.
  4. Occurs after 50 years of age.
  5. No parallel symptoms (nausea, blocked sinuses, etc).
  6. Not attributed any other disorder.

Treating ‘hypnic headaches’

  1. Caffeine is recommended, while it could interfere with sleep; in some cases, it works as it did in my client’s case. Caffeine is a neurotoxic alkaloid naturally occurring in over 100 species of plants. Caffeine has the ability to disrupt neurochemical functioning of an insect’s nervous system. Plants manufacture caffeine to discourage insect browsing. Caffeine constricts blood vessels in the head and neck, and increases the release of excitatory neurochemicals, so increases the rate of nerve firing. This is why caffeine is stimulating. In the human brain, caffeine works by blocking adenosine receptors embedded in the surface membranes of nerve cells (neurons). A caffeine molecule fits into adenosine receptors without activating them, preventing binding to adenosine receptors, and blocking its action. This is how caffeine relieves this particular type of headache.
  2. Lithium is also recommended (but consult your doctor before starting).
  3. Melatonin also works with coffee as well.
  4. Ayurvedic remedies do help, once prakriti is analyzed. For this you need a good Ayurvedic doctor. 

Hoping you resolve it!

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