Hypnic headache
ICD-10 G44.81 is a billable code used to indicate a diagnosis of hypnic headache.
Hypnic headache is a rare primary headache disorder characterized by recurrent headaches that occur exclusively during sleep, typically awakening the patient from sleep. These headaches usually manifest as a dull, throbbing pain that can last from 15 minutes to several hours. The pain is often bilateral and may be accompanied by mild nausea or sensitivity to light. Hypnic headaches are most commonly seen in older adults, particularly those over the age of 50, and can occur several times a month. The exact pathophysiology remains unclear, but it is thought to involve dysregulation of the hypothalamic sleep-wake cycle. Triggers may include changes in sleep patterns, caffeine withdrawal, or certain medications. Preventive treatments often include the use of caffeine, lithium, or indomethacin, which have shown efficacy in reducing the frequency and severity of attacks. Accurate diagnosis is crucial, as hypnic headaches can be mistaken for other headache types, such as migraines or tension-type headaches, necessitating a thorough clinical evaluation.
Detailed headache history, including onset, duration, and associated symptoms; response to treatments; and exclusion of secondary causes.
Patients presenting with recurrent headaches that disrupt sleep, requiring differentiation from migraines or other headache types.
Neurologists should ensure comprehensive documentation to support the diagnosis and treatment plan, especially given the potential for misdiagnosis.
Sleep study results, patient sleep patterns, and any comorbid sleep disorders.
Patients with sleep disturbances presenting with headaches that occur during sleep.
Documentation should include the impact of sleep disorders on headache frequency and severity.
Used to evaluate sleep patterns in patients with hypnic headaches.
Document the indication for the sleep study and any relevant history.
Sleep specialists should ensure that the study results are correlated with headache patterns.
Common treatments include caffeine, indomethacin, and lithium. These medications have shown effectiveness in reducing the frequency and severity of hypnic headaches.
Hypnic headaches occur exclusively during sleep and typically awaken the patient, while migraines can occur at any time and are often associated with other symptoms like aura or severe nausea.