Broadening the Spectrum of Hypnic Headache: A Retrospective Cohort Study

Authors

  • Filipa Dourado Sotero Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; Centro de Estudos Egas Moniz, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal https://orcid.org/0000-0002-5700-8834
  • Miguel Leal Rato Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; Centro de Estudos Egas Moniz, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal https://orcid.org/0000-0003-2233-0468
  • Isabel Pavão Martins Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; Centro de Estudos Egas Moniz, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal https://orcid.org/0000-0002-9611-7400

DOI:

https://doi.org/10.46531/sinapse/AO/240004/2024

Keywords:

Headache Disorders, Primary/ drug therapy, Sleep

Abstract

Introduction: Hypnic headache is a rare headache disorder that requires strictly sleep-related attacks. There is also an ill-defined group of patients with recurrent predominant sleep-related nocturnal headache with occasional awake attacks, that are excluded from that diagnosis. Our aim was to compare these different groups and to understand whether their differences justify a distinct diagnosis.
Methods: This is a retrospective cohort comparative study of patients with predominantly nocturnal (≥80% attacks) recurrent headache (PNRH) and hypnic headache (HH) attending to a tertiary Headache Clinic.
Results: Thirty-one patients (83.9% female) were included, of whom 13 had PNRH, and 18 had HH (13 had probable and 5 definitive). There were no significant differences between groups regarding demographics, pain characteristics, and response to treatment. Both had a high (71%) frequency of previous migraine attacks and 51.7% fulfilled criteria for medication-overuse headache.
Conclusion: Our data suggests that there is an overlap between predominantly nocturnal headache and exclusively nocturnal hypnic headache. Moreover, both may evolve from migraine. Although the pathophysiology of these disorders remains unknown, recurrent nocturnal headache may be another probable form of hypnic headache.

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Published

2024-11-07

How to Cite

1.
Dourado Sotero F, Leal Rato M, Pavão Martins I. Broadening the Spectrum of Hypnic Headache: A Retrospective Cohort Study. Sinapse [Internet]. 2024 Nov. 7 [cited 2025 Apr. 3];24(3):122-7. Available from: https://sinapse.pt/index.php/journal/article/view/122

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Original Articles