Anyone else get "hypnic headaches"?

I’ve been plagued by middle-of-the-night headaches for about a dozen years. I wake up at 2 or 3 a.m. with quite a bad headache, and this happens about six times a month. Twice through the years it has achieved the level of an actual migraine. The headache fades slowly over the course of two hours or so, but I’m left feeling icky and out of it for the day.

I always assumed it was something to do with hormones (these started about the time I started menopause), or caffeine consumption. Well, I’m ten years into menopause, and I’ve cut way, way back on caffeine to spare my stomach. But the nighttime headaches still keep coming.

I googled up the symptoms and as far as I can tell, these are called “hypnic headaches”. I fit everything on the checklist of symptoms. I read that the first thing the headache doctor would suggest is drinking some caffeine just before bed. I tried that twice and both times it gave me bad nausea the next morning. The next line of defense would be all kinds of drugs, and I don’t like the idea of that. I take enough pills as it is.

Does anyone else get these? Mayo Clinic’s website says they’re rare.

I’ve never heard of them, but if they can be treated similarly to migraines, it wouldn’t be all kinds of drugs. It would be one drug, a preventative (and maybe an abortive, but that’s different). Anti-seizure meds are very commonly used for migraine prevention and do a pretty good job of cutting migraines down to about 50% for a lot of people.
There’s also a few brand new meds out that are once a month (self/at home) injections. I’ve been on one (Aimovig) for a year or two know and it seems to be at least as well as the Topamax.

If the headaches are reliably gone by morning, you probably don’t need an abortive, at least not one from the triptan family. IME, they leave you feeling pretty crappy for a while too, though it might not hurt to have some on hand just in case.

If you see a doctor on a regular basis, bring it up next time you see them, they may have some insight or experience with it.

No, not the middle of the night, but if I take a nap odds are 3 to 1 I’ll wake up with a headache. I don’t nap much.