This guide is general information, not medical advice. Medicines and treatments must be prescribed or recommended for you by a doctor or pharmacist. We do not give doses here.
Related guides: Cluster headache.
What it is
Hypnic headache wakes people from sleep, often between 2am and 4am. The pain can be dull, throbbing or sharp, on one or both sides of the head. It is diagnosed when it happens on more than 10 days a month for 3 months or more, once other causes have been ruled out.
Diagnosis
A doctor will want to rule out other causes of night-time headache, such as sleep apnoea, blood pressure problems or medicines, and may arrange a scan. Migraine and cluster headache also need to be ruled out.
Treatment
A strong coffee or caffeine tablet at bedtime helps many people, and surprisingly rarely disturbs sleep. Lithium, indomethacin and topiramate are other options, though side effects can be a problem for older people. Topiramate must not be used in pregnancy.
When to get urgent help
Call 999 if you have
- a sudden, extremely bad headache that peaks within minutes
- weakness, numbness or a drooping face on one side, or slurred speech
- sudden loss of sight
- confusion, drowsiness or a seizure (fit)
- a high temperature with a stiff neck or a rash
- a headache after a head injury
Call NHS 111 if
- a new headache wakes you at night and is very severe
- you're over 50 with a new headache and also have scalp tenderness, jaw pain when chewing or changes to your sight (you need to be seen the same day)
See your GP if
- headaches regularly wake you up
- you're over 50 and have a new kind of headache
Work and your workspace
Migraine can count as a disability under the Equality Act 2010 (the Disability Discrimination Act in Northern Ireland) if it has a substantial, long-term effect on your everyday life. Conditions that come and go still count, and the law looks at how you would be without treatment. If it applies, your employer must make reasonable adjustments.
Adjustments that often help
- Flexible hours and working from home on bad days
- Regular short screen breaks
- A quiet, dark place to rest and take medicine
- Time off for appointments
- Flexibility over migraine-related absence
A migraine-friendly workspace
- A chair with good lumbar and neck support
- A desk big enough to put your screen at arm's length
- Screen raised so the top is at eye level
- A flicker-free monitor with an anti-glare or blue-light filter
- Lighting without flicker or glare, and blinds to control daylight
Access to Work can pay towards equipment and support. Acas and Citizens Advice give free advice on your rights.
How The Beyond Pain Foundation can help
If NHS waits are too long, or the help you need is not available to you on the NHS, we may be able to fund:
- A private specialist appointment for a faster diagnosis
- Support to stay in work if poor sleep is affecting your job
Every award depends on your situation and the funds we have that month. A letter from your doctor, a headache diary and a written quote all help your application.
Support and sources
The Migraine Trust
Information and support service
Information on every type of migraine, a free information and support service, and advice on treatment and work.
migrainetrust.orgNational Migraine Centre
Charity headache clinic
Specialist appointments in person and online, including routine appointments for a voluntary donation, plus free factsheets.
nationalmigrainecentre.org.ukNHS
Health information
Symptoms, treatment and when to get help with migraine and headache.
nhs.uk/conditions/migraineSources for this guide
Written in our own words from the sources above. Last reviewed: October 2026. Figures can differ between sources; where they do, we give the range.