Headaches same time everyday

Understanding Cluster Headaches

Cluster headaches, which affect 500,000 or more Americans, get their name from their frequency. “In their most common form — episodic cluster headache — they occur in clusters. The person experiences headaches on a daily or near-daily basis, from once every other day to three or four times a day,” explains Ellen Drexler, MD, director of the Headache Center at Maimonides Medical Center in New York City.

Also known as histamine or noctural headaches, or red migraines, cluster headaches are more common in men than women, and usually affect people in their teens and middle years. Those who experience these headaches say they are severe and disabling, and describe their pain as burning, piercing, or throbbing. “The patient will characteristically pace around and feel agitated, as opposed to the person with a migraine, who gets relief by lying still,” says Dr. Drexler.

Timing Is Everything With Cluster Headaches

“The cluster headache period may last from a few weeks to a few months, and then they go away. The cluster periods often recur at the same time of year in subsequent years,” notes Drexler. These headaches may not come back for several months or even for several years.

During the headache period, they tend to occur at the same time every day. Cluster headaches have sometimes been referred to as “alarm clock headaches” because they often wake up a person in the early morning or after the first few hours of sound sleep.

“The cluster headache is very distinctive. It is always on the same side, usually centering on the eye. The pain is described as sharp or stabbing, and is of excruciating intensity, lasting from 15 minutes to 2 hours, and averaging 45 minutes,” says Drexler.

Other characteristics of cluster headaches include:

  • Pain that can radiate from the area around the eye to the forehead, temple, ear, or neck on that side of the body.
  • Headache pain that is accompanied by tearing and redness of the eye. The pupil of the eye may be constricted and the eyelid may droop, a condition called Horner’s syndrome.
  • The nose may be congested and the face may appear flushed on the side of the pain.

One saving grace is that, unlike migraine headaches, cluster headaches are rarely accompanied by nausea, vomiting, or light sensitivity.

Possible Causes of Cluster Headaches

“The cause of cluster headaches is not completely understood, but the hypothalamus appears to be involved in their development,” says Drexler. The hypothalamus is the part of the brain that controls sleeping and waking cycles.

Another theory is that cluster headaches are caused by a disorder of the internal carotid artery and the swelling of blood vessels inside the head. Sudden release of histamine and serotonin, substances released by the body that cause blood vessels to dilate, are also suspected.

What is known is that cluster headaches are not inherited and they are not related to other diseases. Cluster headaches may be more common in smokers, and some people with cluster headaches find they can be triggered by certain foods. Consumption of alcohol will immediately trigger a cluster headache during a cluster period, although at other times alcohol may not act as a trigger. A study published in the November 2011 issue of Headache: The Journal of Head and Face Pain, which cited data from a survey of over 1100 people with cluster headaches, found that beer was the most common type of alcohol trigger, followed by red wine and hard liquor.

Prevention and Treatment of Cluster Headaches

There is no known cure for cluster headaches, so treatment is aimed at prevention and relieving symptoms.

Lifestyle changes. If you get cluster headaches you should avoid:

  • Smoking
  • Alcohol
  • Any foods that seem to trigger your headaches
  • Stress
  • Changes in sleep patterns

Pain relief. Once a cluster of headaches has started, pain medications are not very effective because they take too long to work. “Cluster headaches are treated symptomatically with the same types of medications that are used for migraine,” explains Drexler. One example is Imitrex (sumatriptan), a migraine medication approved by the U.S. Food and Drug Administration for cluster headache and most effective as an injection or nasal spray.

Other treatments. At the onset of a headache, inhalation of 100 percent oxygen can be effective. Some people also get relief from the application of the topical anesthetic lidocaine inside the nose.

When cluster headaches occur, some people can reduce the number of headaches by using the steroid medication prednisone and the drug verapamil, which relaxes blood vessels. Your doctor may recommend other medications or combinations.

Then there is surgery. “Some patients with chronic cluster headache resistant to all medications have undergone a variety of surgical procedures with some success, most recently deep brain stimulation and occipital nerve stimulation with implanted electrical stimulators,” says Drexler.

Although in some rare cases cluster headaches become chronic and continue without periods of remission, most often they run their course and don’t last longer than a few weeks. These headaches are debilitating, but they are not life-threatening. If you have symptoms of cluster headaches, see your doctor to find the treatment that works best for you.

What to know about headaches at night

The sections below contain information about different types of headache that are likely to occur at night.

Share on PinterestA person with a hypnic headache may experience a throbbing pain.

Hypnic headaches are rare. According to the Migraine Trust, they occur most often in people over the age of 50, although they can also affect younger people. Hypnic headaches are more common in females than males.

Hypnic headaches only occur during sleep. If a person experiences nighttime headaches more than 10 times per month, they may have hypnic headaches. In some cases, hypnic headaches can occur if people sleep during the day.

Some people call hypnic headaches “the alarm clock headache,” because they cause people to wake up — often at the same time each night. In fact, people may find that a hypnic headache wakes them up between 1 a.m. and 3 a.m.

Symptoms of hypnic headache may include:

  • throbbing pain
  • pain on one or both sides of the head
  • pain that lasts anywhere between 15 minutes and 4 hours but usually lasts for around 30–60 minutes
  • increased sensitivity to light and sound
  • watery eyes or a blocked nose
  • nausea

Some people may have more than one hypnic headache per night.

Cluster headache

People who experience multiple headaches may have a cluster headache. These headache episodes, or clusters, can happen between one and eight times per day and last between 15 minutes and 3 hours. Cluster headaches are also one of the most painful types of headache.

Cluster headaches commonly occur at night and can cause people to wake up 1–2 hours after falling asleep.

Researchers are not sure what causes cluster headaches, but genetics may play a part. They usually occur in people who are over the age of 20. Males and people who smoke heavily are also more likely to experience cluster headaches.

Certain factors may also trigger cluster headaches, including:

  • alcohol intake
  • strong smells, such as paint fumes or solvents
  • exercise
  • overheating

Symptoms of cluster headaches can include:

  • severe stabbing pain on one side of the head, which can include the eye and temple area
  • red, watery eyes
  • runny nose
  • sweating on the side of the head where the headache is
  • restlessness and agitation
  • a headache that stops abruptly

Tension headache

Tension headaches can occur due to stress, tight muscles, or fatigue. People may experience tension headaches at night due to tension building up throughout the day.

Symptoms of a tension headache include:

  • a dull ache or squeezing sensation on both sides of the head
  • pain that feels like a tight band or vice around the head
  • aching muscles in the neck, shoulders, or back
  • tightness in the jaw
  • pain that lasts between 20 minutes and 2 hours

Migraine

Migraine can cause intense head pain and wake people up from sleeping.

According to the American Migraine Foundation, the most common time for people to experience a migraine is the early morning. This is because any pain medication they may be taking to treat the head pain will often stop working after 4–8 hours.

The National Sleep Foundation report that 50% of migraine episodes occur between the hours of 4 a.m. and 9 a.m.

Symptoms of migraine include:

  • moderate-to-severe pain
  • nausea
  • vomiting
  • increased sensitivity to light and sound
  • changes in vision, such as seeing flashing lights or zigzag patterns

Each migraine episode can last 4–72 hours.

Timing Headaches & Why Same-Time Every Day Headaches Are Common

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At times, headaches occur suddenly and without warning. However, other people experience headaches that occur at nearly the same time every day. Both cluster headaches and tension headaches can happen in this type of recurrent manner and really impact a person’s daily life.

Here is why some individuals experience cluster headaches and tension headaches around the same time every day and the types of things that may trigger this recurring pain. Read on to learn about what it means if you have headaches every day and what treatment options are available.

Daily Recurring Cluster Headaches

One of the characteristics of cluster headaches that distinguishes them from other types is that these headaches happen every day or near-daily. Some people experience cluster headaches every other day or three or four times in a single day as well.

They’ve actually been referred to as “alarm clock headaches” because of their timing regularity. The most common time that cluster headaches strike is in the early morning hours or within a few hours of falling asleep. Not only do cluster headaches tend to happen at the same time of day, but also at the same time of the year in subsequent years.

Daily Recurring Tension Headaches

Tension headaches are far more common than cluster headaches and also frequently occur at regular intervals throughout the day.

This type of headache tends to occur on a daily basis due to medication withdrawal. Individuals who rely on painkillers and take them at scheduled times may experience headaches when that medication begins to wear off. People with chronic tension-type headaches often have headaches daily or near-daily headaches for a period of several years.

Triggers for Recurring Headaches Every Day

Changes in sleep patterns can trigger headaches, so it’s important to keep a regular sleep schedule to prevent them as much as possible. Continued and ongoing stress is also a major contributing factor for headaches, so individuals must find healthy and effective ways to manage stress for headache prevention.

Smoking and alcohol are known triggers of cluster headaches, and many people have a habitual routine of when they have drinks and cigarettes during the day. By eliminating tobacco and alcohol from one’s life, those headache triggers are eliminated as well. Artificial lighting in the office, sun glare while commuting home from work, and a lack of physical activity can all be triggers for tension headaches that happen at regular times each day.

Everyday Relief for Daily Headache Sufferers

Since pain medications can be very addictive, it’s important to not solely rely on it for relief long-term and on a daily basis. Powerful pain relievers like Vanquish, for example, are recommended for use up to eight caplets in 24 hours. More than this dosage is not advised unless directed by a doctor.

For long-term headache pain management, it may be beneficial to try natural and alternative remedies to support the effects of medication. Acupuncture, massage, tai chi, and meditation may help to alleviate the stress and tension that causes headaches to happen at the same time every day. It may also be necessary to adjust one’s diet to include more headache-fighting foods, like cherries, spinach, and fish, into daily meals eaten at regular intervals.

Vanquish® is indicated for tension headaches. If you have a cluster headache, sinus headache, migraine headache or any other type of headache you may want to consult a doctor.

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DISCUSSION

The patient’s history and clinical examination is most likely consistent with hypnic headaches. As per the diagnostic criteria, the short duration of the headache for less than 15 to 30 min (compared to the usual attack duration of 10-180 min) which awakens the patient at the same time every night with no other autonomic symptoms is consistent with the diagnosis of hypnic headaches.1 There are no associated autonomic symptoms like unilateral tearing or any nasal congestion, as is seen with cluster headaches. Also the short duration of these headaches with no other associated symptoms of photophobia, phonophobia, nausea, vomiting does not fulfill the criteria of migraines. Migraines and cluster headaches generally have a predisposition to start in the REM period and sometimes in slow wave sleep.2,3 Absence of past medical history of headaches (with or without any associated autonomic symptoms) makes these headaches less likely to be migraines or cluster headaches.

Early morning headaches are seen in patients with space-occupying lesions, such as brain tumors or chronic subdural hematoma, or even in patients with obstructive sleep apnea. As the patient had a history of subdural hematoma in the past, this new pattern of headache justified further work-up with an MRI of the brain. However, his headaches were very time-specific and occurred at the same time every night for a short duration (hence these headaches are also known as “alarm clock headaches”).

“Exploding head syndrome” is a parasomnia in which patients experience a loud bang in their head, similar to a bomb exploding, which seems to originate from inside the head. This parasomnia mostly occurs at the onset of deep sleep and is not associated with any pain or swelling or any other physical trait, but sometimes is associated with bright light or shortness of breath.

Hypnic headaches are known to respond best to lithium. The mechanism of action of lithium is hypothesized to be related to increase in melatonin secretion. There are some case reports of topiramate being effective in resolving hypnic headaches.5 Other medications used to treat

hypnic headaches with equivocal response include indomethacin, flunarizine (not available in US), and caffeine. Indomethacin has been suggested to be helpful if the hypnic headaches are unilateral.4

What is This Everyday Headache All About?!

Understanding Everyday Headache

Imagine that your 15-year-old daughter comes to you crying one morning because she has awakened with a very bad headache. She is very nauseated and can’t stand even the lights in the kitchen. Her whole head is hurting worse than any pain she has ever had. She has to stay in bed all day and miss school. Even worse, the headache is just as bad the next day, and then the day after that. Her pediatrician tells you that she is having headache from stress. Your otolaryngologist can’t find anything wrong with her. She still has the same headache every day and only gets through each day by sleeping through them. Eventually, she gets to see a neurologist who tells her that she has migraine, even though she has never had any headaches before and no one else in the family has headaches. He prescribes all sorts of medications used to treat migraine, such as Sumatriptan and Topiramate and Divalproex, but they only make her sicker.

This is the typical pattern of a severe headache that usually affects young women between 11 and 30 years old. It is called New Daily Persistent Headache and no one knows what causes it. This headache is NOT psychological, NOT caused by stress, NOT a migraine or any other kind of headache you or your neurologist has probably ever heard about. It comes out of a clear blue sky and 80% of the time it continues without any relief for many years. About 1/5 of the patients spontaneously improve within the first 2 years. Luckily, many of the patients only have moderate daily headache 24/7, but about half have the pattern seen above. All have abrupt onset of daily headache, continuous from the day of onset and refractory to almost all medications.

The best management for this terrible headache disorder starts with the understanding that it is an organic, bonafide illness that can produce severe disability. Second is to have the disorder properly diagnosed so that medical providers take it seriously and provide appropriate care. Medical imaging studies may rule in a secondary, structural cause for the headache such as cerebral venous thrombosis. Trials of different preventive medication may help up in up to 40% of those afflicted. Unfortunately, many patients continue to suffer so that we must look to the future for research which could tell us the cause and cure of this unremitting curse.

Herbert Markley, MD, FAHS, Director, New England Regional Headache Center, Inc., Worcester, MA.

Acute Headache in Children

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Medically reviewed by Drugs.com. Last updated on Sep 24, 2019.

  • Care Notes

What is an acute headache?

An acute headache is pain or discomfort that starts suddenly and gets worse quickly. Your child may have an acute headache only when he or she feels stress or eats certain foods. Other acute headache pain can happen every day, and sometimes several times a day.

What are the most common types of acute headache?

  • Tension headache is the most common type of headache. These headaches typically occur in the late afternoon and go away by evening. The pain is usually mild or moderate. Your child may have problems tolerating bright light or loud noise. The pain is usually across the forehead or in the back of the head, often only on one side. These headaches may occur every day.
  • Migraine headaches cause moderate or severe pain. The headache generally lasts from 1 to 3 days and tends to come back. Pain is usually on only one side, but it may change sides. Migraines often occur in the temple, the back of the head, or behind the eye. The pain may throb or be sharp and steady.
  • A migraine with aura means your child sees or feels something before a migraine. He or she may see a small spot surrounded by bright zigzag lines. Other signs or symptoms may follow the aura.
  • Cluster headache pain is usually only on one side. It often causes severe pain, and can last for 30 minutes to 2 hours. These headaches may occur 1 or 2 times each day. These headaches occur more often at night, and may wake your child.

What causes an acute headache in children?

The cause of your child’s headache may not be known. The following conditions can trigger a headache:

  • Stress or tension, hours or even days after stressful events
  • Fatigue, a lack of sleep or changes in your child’s usual sleep pattern, or a nap during the day
  • In adolescents, menstruation or use of birth control pills
  • Food such as cured meats, artificial sweeteners, alcohol, dark chocolate, and MSG
  • Suddenly not having caffeine if your child usually has larger amounts
  • A medical problem, such as an infection, tooth pain, neck or sinus pain, thyroid problems, or a tumor
  • A head injury

How is the type of acute headache diagnosed and treated?

Your child’s healthcare provider will ask your child to rate the pain on a scale from 1 to 10. Have your child show the provider where he or she feels the pain. Tell the provider how often your child has headaches and how long they last. Have your child describe any other symptoms he or she has along with headaches, such as dizziness or blurred vision.

  • Medicines may be given to manage or prevent headaches. The medicine will depend on the type of acute headache your child has. Do not wait until the pain is severe before you give your child more medicine. Your child may be able to take over-the-counter pain medicines as needed. Examples include NSAIDs and acetaminophen. Ask your child’s healthcare provider which medicine is right for your child. Ask how much to give and when to give it. Follow directions. These medicines can cause stomach bleeding or kidney or liver damage if not taken correctly.
  • Biofeedback may be used to help your older child manage stress. Your child will learn how to change stress reactions. For example, your child will learn to slow his or her heart rate when he or she becomes upset.
  • Stress management may be used with other therapies to prevent headaches.

What can I do to manage my child’s symptoms?

  • Apply heat or ice on the headache area. Use a heat or ice pack. For an ice pack, you can also put crushed ice in a plastic bag. Cover the pack or bag with a towel before you apply it to your child’s skin. Ice and heat both help decrease pain, and heat also helps decrease muscle spasms. Apply heat for 20 to 30 minutes every 2 hours. Apply ice for 15 to 20 minutes every hour. Apply heat or ice for as long and for as many days as directed. You may alternate heat and ice.
  • Have your child relax his or her muscles. Have your child lie down in a comfortable position and close his or her eyes. Your child should relax muscles slowly, starting at the toes and working up the body.
  • Keep a record of your child’s headaches. Write down when the headaches start and stop. Include other symptoms and what your child was doing when the headache began. Record what your child ate or drank for 24 hours before the headache started. Describe the pain and where it hurts. Keep track of what you or your child did to treat the headache and if it worked.

What can I do to help my child prevent an acute headache?

  • Have your child avoid anything that triggers an acute headache. Examples include exposure to chemicals, going to high altitude, or not getting enough sleep. Help your child create a regular sleep routine. He or she should go to sleep at the same time and wake up at the same time each day. Do not allow your child to use electronic devices before bedtime. These may trigger a headache or prevent your child from sleeping well.
  • Do not let your adolescent smoke. Nicotine and other chemicals in cigarettes and cigars can trigger an acute headache or make it worse. Ask your adolescent’s healthcare provider for information if he or she currently smokes and needs help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before your adolescent uses these products.
  • Have your child exercise as directed. Exercise can reduce tension and help with headache pain. Your child should aim for 30 minutes of physical activity on most days of the week. Your healthcare provider can help you create an exercise plan.
  • Offer your child a variety of healthy foods. Healthy foods include fruits, vegetables, low-fat dairy products, lean meats, fish, whole grains, and cooked beans. Your healthcare provider or dietitian can help you create meals plans if your child needs to avoid foods that trigger headaches.

When should I seek immediate care?

  • Your child has severe pain.
  • Your child has numbness on one side of his or her face or body.
  • Your child has a headache that occurs after a blow to the head, a fall, or other trauma.
  • Your child has a headache and is forgetful or confused.

When should I contact my child’s healthcare provider?

  • Your child has a constant headache and is vomiting.
  • Your child has a headache each day that does not get better, even after treatment.
  • Your child’s headaches change, or new symptoms occur when your child has a headache.
  • You have questions or concerns about your child’s condition or care.

Care Agreement

You have the right to help plan your child’s care. Learn about your child’s health condition and how it may be treated. Discuss treatment options with your child’s healthcare providers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© Copyright IBM Corporation 2019 Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health

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