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Review
. 2025 Jul 28;15(8):1198.
doi: 10.3390/life15081198.

Nighttime Primary Headaches in Children: Beyond Hypnic Headache, a Comprehensive Review

Beatrice Baldo  1 , Ilaria Bonemazzi  1 , Antonella Morea  2 , Roberta Rossi  3 , Alessandro Ferretti  4 , Vittorio Sciruicchio  2 , Alessia Raffagnato  5 , Vincenzo Raieli  6 , Antonia Versace  3 , Irene Toldo  1
Affiliations
Review

Nighttime Primary Headaches in Children: Beyond Hypnic Headache, a Comprehensive Review

Beatrice Baldo et al. Life (Basel). .

Abstract

Many headaches at night arise due to primary headache disorders, which occur independently of other symptoms and are not caused by another medical condition. Primary headache disorders with nighttime attacks can include tension-type headaches, migraines, hypnic headaches, and cluster headaches. A hypnic headache is sometimes called an "alarm clock headache" because symptoms tend to arise at the same time of night. Apart from considering primary headaches, secondary causes of nighttime headaches should be considered and ruled out, in particular headaches secondary to intracranial hypertension, temporomandibular joint issues (like bruxism) and sleep apnea. Treatments vary based on headache type but often include a combination of medications and prevention strategies. This review article covers the basics of nighttime primary headaches in children, including pathophysiology, etiology, clinical features of the different forms and their treatment. It will also discuss the differences in headache features between children and adults.

Keywords: adolescents; children; cluster headache; hypnic headache; migraine; nocturnal awakenings; sleep.

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Conflict of interest statement

The authors declare no conflicts of interest.

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