Geriatric Headaches
Geriatric Headaches
Hypnic headache is a rare disorder that occurs in men and women from 40 to 79 years of age.60 The headache occurs only during sleep and awakens the sufferer at a consistent time. Nausea is infrequent, and autonomic symptoms are rare. The headache can be unilateral or bilateral, throbbing or nonthrobbing, and mild to severe in intensity. The headaches can last 15 minutes to 6 hours and can occur frequently, as often as nightly, for many years. Medications reported to be effective include caffeine (one or two cups of caffeinated coffee or a 40 to 60 mg caffeine tablet before bedtime), lithium carbonate (300 mg at bedtime), indomethacin, atenolol, melatonin, cyclobenzaprine, prednisone, and flunarizine (not available in the United States).
The diagnosis is one of exclusion. Secondary causes of nocturnal headaches that must be ruled out include drug withdrawal, temporal arteritis, sleep apnea, oxygen desaturation, pheochromocytoma, primary and secondary neoplasms, communicating hydrocephalus, subdural hematoma, and vascular lesions.61 Migraine, cluster, and chronic paroxysmal hemicrania are other primary headaches that can cause awakening from sleep. Migraine typically has associated symptoms and very uncommonly occurs only during sleep. Cluster headaches have autonomic symptoms and may occur during the day as well as during sleep. Chronic paroxysmal hemicrania occurs both during the day and at night, lasts for less than 30 minutes, and occurs 10 to 30 times a day.
Headache: Geriatric Headaches
In this article
- Late-Life Migraine Accompaniments
- Cerebrovascular Disease
- Head Trauma
- Temporal Arteritis
- Trigeminal Neuralgia
- Postherpetic Neuralgia
- Cardiac Ischemia
- Hypnic Headache
Hypnic Headache
Hypnic headache is a rare disorder that occurs in men and women from 40 to 79 years of age.60 The headache occurs only during sleep and awakens the sufferer at a consistent time. Nausea is infrequent, and autonomic symptoms are rare. The headache can be unilateral or bilateral, throbbing or nonthrobbing, and mild to severe in intensity. The headaches can last 15 minutes to 6 hours and can occur frequently, as often as nightly, for many years. Medications reported to be effective include caffeine (one or two cups of caffeinated coffee or a 40 to 60 mg caffeine tablet before bedtime), lithium carbonate (300 mg at bedtime), indomethacin, atenolol, melatonin, cyclobenzaprine, prednisone, and flunarizine (not available in the United States).
The diagnosis is one of exclusion. Secondary causes of nocturnal headaches that must be ruled out include drug withdrawal, temporal arteritis, sleep apnea, oxygen desaturation, pheochromocytoma, primary and secondary neoplasms, communicating hydrocephalus, subdural hematoma, and vascular lesions.61 Migraine, cluster, and chronic paroxysmal hemicrania are other primary headaches that can cause awakening from sleep. Migraine typically has associated symptoms and very uncommonly occurs only during sleep. Cluster headaches have autonomic symptoms and may occur during the day as well as during sleep. Chronic paroxysmal hemicrania occurs both during the day and at night, lasts for less than 30 minutes, and occurs 10 to 30 times a day.
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