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1. MIGRAINE 2. TENSION-TYPE HEADACHE (TTH) 3. CLUSTER HEADACHE AND OTHER TRIGEMINAL AUTONOMIC CEPHALALGIAS 4. OTHER PRIMARY HEADACHES 4.2. Primary cough headache 4.3. Primary exertional headache 4.4. Primary headache associated with sexual activity 4.5. Hypnic headache 4.6. Primary thunderclap headache 4.7. Hemicrania continua 4.8. New daily-persistent headache (NDPH) Bibliography

IHS	Diagnosis	ICD-10
4.5	Hypnic headache	G44.80
Previously used terms	Hypnic headache syndrome, "alarm clock" headache

Description:

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

Diagnostic criteria:

Dull headache fulfilling criteria B-D
Develops only during sleep, and awakens patient
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
No autonomic symptoms and no more than one of nausea, photophobia or phonophobia
Not attributed to another disorder¹

Note:

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

Comment:

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.

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IHS vs. ICD-10

To facilitate headache diagnosis in daily practice, the classification provides the corresponding WHO ICD-10NA codes for each IHS code.

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The Classification Subcommittee prepares and revises the International Classification of Headache Disorders.

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