Epidemiology and clinical features of hypnic headache: A systematic review and meta-analysis

Abstract

Background Hypnic headache is a neurological disorder characterized by recurrent headache attacks that occur exclusively during sleep, leading to awakening. Synthesizing the available epidemiological data might inform clinical decision-making. Methods We searched PubMed and Embase for observational studies on hypnic headache published between 1 May 2004, and 22 December 2022. Two investigators independently screened titles, abstracts, and full-text articles. We performed a random-effects meta-analysis with meta-regression to estimate the prevalence of hypnic headache and its clinical features based on epidemiologic data from population-based and clinic-based studies. Results Fourteen studies, one population-based and 13 clinic-based, met our eligibility criteria. The population-based study did not identify any people with hypnic headache. From 11 clinic-based studies, the pooled relative frequency of hypnic headache was 0.21% (95%CI, 0.13 to 0.35%; I2 = 87%) in adult patients evaluated for headache. The pooled mean age of onset was 60.5 years, with a slight female predisposition. Hypnic headache was typically bilateral (71%), pressing (73%), of moderate (38%) or severe (44%) pain intensity, and lasted about 115 minutes per attack. Conclusions Our data should be cautiously interpreted due to between-study heterogeneity. The identified clinical presentation of hypnic headache can guide clinical diagnosis, in addition to the International Classification of Headache Disorders.

A Possible Newly Defined and Treatable Secondary Cause of Early Morning Wake-Up Headaches in an Older Hypermobile Woman: Nutcracker Physiology with Spinal Epidural Venous Congestion

“…Cluster headache is easily recognized by its short headache duration, severe intensity, multiple attacks per day, and cranial autonomic associated symptoms with agitation. Hypnic or alarm clock headache appears to have a varied peak time incidence from 12:00 a.m. to 4:00 a.m., although the actual true timing of attacks in population studies is not well documented [9]. A recent meta-analysis noted that hypnic headache has an average age of onset of around 60 years with a small female predominance and is typified by bilateral head pain of moderate to severe intensity with a pressing quality and a duration of about 2 h [9].…”

“…Hypnic or alarm clock headache appears to have a varied peak time incidence from 12:00 a.m. to 4:00 a.m., although the actual true timing of attacks in population studies is not well documented [9]. A recent meta-analysis noted that hypnic headache has an average age of onset of around 60 years with a small female predominance and is typified by bilateral head pain of moderate to severe intensity with a pressing quality and a duration of about 2 h [9]. It is conceivable that some hypnic-like headaches are secondary to abdominal venous congestion syndromes,…”

Seltene primäre Kopfschmerzen

“…Der Kopfschmerz wird beschrieben als dumpfer, drückender Kopfschmerz von mäßiger Intensität, der beidseitig lokalisiert ist. Begleitsymptome wie Photophobie oder Phonophobie oder Übelkeit und Erbrechen fehlen meist [66,69].…”

“…In einer isländischen Prävalenzstudie mit 1398 Erwachsenen wurde die Prävalenz des Schlafkopfschmerzes auf 0,22% geschätzt [70]. In einer Metaanalyse aus 11 Studien wurde die Häufigkeit auf 0,21% aller Patienten mit Kopfschmerzen geschätzt [69]. Bei der Mehrzahl der Patienten halten die Schlafkopfschmerzen über viele Jahre an.…”