I am awakened by nighttime headaches. What should I do?

Answers from Jerry W. Swanson, M.D.

If you have nighttime headaches or headaches that awaken you from sleep, see your doctor for an accurate diagnosis. Treatment for nighttime headaches varies, depending on the type of headache and any underlying causes. Cluster headaches and migraines may have a nighttime onset.

Hypnic — or "alarm clock" — headaches, which begin only during sleep, usually awaken a person at the same time every night. It's also possible to have daytime naps interrupted by hypnic headaches. Hypnic headaches are rare and occur most commonly after age 50.

Possible treatments

The exact cause of hypnic headaches isn't known, but treatments that may provide relief for some individuals include:

  • Lithium (Lithobid) — a medication used to treat bipolar disorder
  • Indomethacin (Indocin) — a nonsteroidal anti-inflammatory medication
  • Melatonin — a hormone that helps control your natural sleep-wake cycle
  • Caffeine — taken as a tablet or beverage before bedtime

There are reports of small numbers of people whose headaches respond to other agents.

Feb. 05, 2014