II. Classification

  1. Brief Headache Syndrome

III. Precautions

  1. Headache that awakens a patient out of sleep is a Headache Red Flag
  2. Hypnic Headache is a diagnosis of exclusion
    1. First evaluate for Organic Headache (e.g. Intracranial Mass)

IV. Symptoms

  1. Headache onset during sleep (typically at least 1-2 hours after falling asleep)
  2. Moderate throbbing Headache
  3. No associated Nausea, Vomiting, photophobia or autonomic symptoms

V. Diagnosis (requires 2 of 3 criteria)

  1. Headache lasts more than 15 minutes after awakening (and typically <3 hours)
  2. Age over 50 years old
  3. Occurs more than 15 times per month

VI. Management

  1. Lithium
  2. Caffeine (100-200 mg) prior to bedtime may prevent Headache

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