![]() 1,2 Onset of hypnic headache is commonly after age 50 (reported average age of onset is 62, with a range of 30-84), and it is more common in woman. If this small but important group of nocturnal headache maladies had its own grand dame, it would be hypnic headache, an exclusively nighttime headache with alarm-clock-like precision of arrival (Box 1). But the doc told me to see a neurologist right away. I’m heading back to the hotel, maybe to get some more sleep. ![]() “No need to,” Michael replied, “They gave me something, a shot my pain is gone. Through her own pain and sleeping-pill fog, she offered to drive immediately to the hospital. Although he was normally an old-school stoic type, Michael cried from the torment curiously, only his right eye leaked. A panicky terror was spawned in subterranean brain regions Martin could not name. A shaft of blinding white-hot agony, emanating from his right eye and burrowing deep inside, crouched in some shadowy spot like a caged rabid animal. The pain that shook Martin like a rag doll from sleep, jolting him out of bed to pace his hotel room frantically 2 hours before calling Margaret, was like nothing he’d ever experienced. Now I’m okay, but you’re gonna’ think I’m crazy. “Listen, Honey,” Martin said, “I’m in the emergency room down in Huntsville. He knew, of course, that she’d be awake, most likely clutching an icepack to her head. On a Tuesday, around 2:30 am on an early spring day, Martin phoned Margaret. A few years younger than his girlfriend, Martin still worked part time selling insurance, a job that on occasion took him out of state. Next to Margaret, on most nights, lay Martin, her significant other, who she met (online, at her daughter’s prompting) a decade after her husband Will had passed. As she lay in the darkness and winced in misery, Margaret thought, “ Golden Years indeed”. She reached over to her nightstand, gulped some pills with water, and applied an ice pack to her aching head, all of which she readied each night as part of her dysfunctional bedtime routine. A deep dull ache sprang from behind her eyes and metastasized throughout her skull. Yet, as always, at 1:40 am-like clockwork these last 6 months-Margaret parted company with her dreams and gripped her head in pain. An eternal optimist after all these years, she would close her eyes and pray for her family, her friends, and for a painless repose. ![]() When she could scarcely set 1 foot in front of the other, Margaret would make her way into bed. ![]() Her hand busy worrying a set of beads, she’d pace the upstairs hallway in slippers, wearing out the shag rug-trying to tire herself out-willing the over-the-counter sleep aides she consumed in alarming quantities to finally kick in. In what she was constantly reminded by her children were her Golden Years, the retired and widowed school principal had developed what she knew was an entirely dysfunctional bedtime routine. Case Study: Presentation of Dreadful Nights ![]()
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