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4.5Hypnic headache G44.80  
Previously used terms Hypnic headache syndrome, "alarm clock" headache


Attacks of dull headache that always awaken the patient from asleep.

Diagnostic criteria:

  1. Dull headache fulfilling criteria B-D
  2. Develops only during sleep, and awakens patient
  3. At least two of the following characteristics:
    1. occurs >15 times per month
    2. lasts ≥15 minutes after waking
    3. first occurs after age of 50 years
  4. No autonomic symptoms and no more than one of nausea, photophobia or phonophobia
  5. Not attributed to another disorder1


  1. Intracranial disorders must be excluded. Distinction from one of the trigeminal autonomic cephalalgias is necessary for effective management.


The pain of hypnic headache is usually mild to moderate, but severe pain is reported by approximately 20% of patients. Pain is bilateral in about two-thirds of cases. The attack usually lasts from 15 to 180 minutes, but longer durations have been described.

Caffeine and lithium have been effective treatments in several reported cases.