What is Turtle Headache (Alarm Clock Headache)?
Turtle headache is a specific type of a larger group of headaches called hypnic headaches. This condition, which is quite rare, was first identified in the late 1980s. Hypnic headaches can either be a standalone issue or a sign of a more serious condition, such as cancer. It also goes by other names like “clock-wise” headache or “alarm clock” headache due to the way it behaves medically.
People with this condition typically experience a headache when they’re asleep, and it shows up at the same time every night. According to specific medical criteria, these attacks should happen at least 10 days a month for more than three months and last for 15 minutes to 4 hours after waking up. During these headaches, many patients report behaviors such as eating or reading.
But patients typically do not experience nervousness or symptoms related to the body’s automatic functions, something common to a type of headache known as cluster headaches. Most people report that the pain is moderate and can be on one or both sides of the head.
There might be a connection between migraines and hypnic headaches. However, most people have had their last migraine attack years before they started experiencing hypnic headaches. As mentioned earlier, the turtle headache is just a smaller part of hypnic headaches. Not much is known about this specific type of headache. However, it usually happens in the morning after waking up and going back to sleep, and it’s typically bilateral. It’s named the “turtle” headache because it occurs when a person pulls their head under the blankets, similar to how a turtle retracts into its shell.
What Causes Turtle Headache (Alarm Clock Headache)?
The exact cause of turtle headaches isn’t certain, but some suspect it’s due to changes in the size of an area in the brain called the “posterior hypothalamus.” This part of the brain operates a bit like a biological clock. There have been research studies exploring whether the size of the hypothalamus could help indicate if someone has chronic migraines. While these findings do not specifically relate to turtle or hypnic headaches, they could help build understanding of what causes these types of headaches.
One recent study found that there may be a connection between changes in the hypothalamus and the development of migraines. Another study compared hypnic headaches and cluster headaches. The results showed that with hypnic headaches there was a decrease, while with cluster headaches there was an increase in the size of the gray matter in the posterior hypothalamus.
As for turtle headaches, there’s still a lot that’s unknown about what causes them. In addition to changes in the hypothalamus, one theory suggests that hypoxia, or low oxygen levels, may play a role. Some studies indicate a possible link between hypoxia, migraines and cluster headaches, but the specific way this works isn’t well understood yet.
Risk Factors and Frequency for Turtle Headache (Alarm Clock Headache)
Hypnic headaches usually show up in people over 50, but there have been a few instances where patients as young as 8 have reported them. More women seem to get these headaches than men, with a ratio of about 3 to 2. It’s hard to know exactly how many people get hypnic headaches, as they are likely underdiagnosed. This is the same for a specific type of hypnic headache known as “turtle headaches,” which are so rare and little-known that many people who have them might not even be diagnosed.
- Hypnic headaches generally start in people over the age of 50.
- They can occur in people as young as 8, but this is very rare.
- Women are slightly more likely to get these headaches than men, with a ratio of about 3 to 2.
- We don’t know the exact numbers of people who get hypnic headaches or turtle headaches, since they’re often underdiagnosed.
- There are no known cases where hypnic headaches run in families, and we don’t know how common they are because many people are likely undiagnosed.
- Our understanding of these conditions is hampered by the fact that many patients never receive a proper diagnosis, leaving the true frequency of these headaches a mystery.
Signs and Symptoms of Turtle Headache (Alarm Clock Headache)
People suffering from this condition often explain that they frequently suffer from throbbing, sometimes dull, headaches during their sleep which awaken them. These headaches might happen more than ten times in a month and persist for over fifteen minutes when they disrupt the patient’s sleep. Some individuals might also experience additional symptoms similar to migraines, including nausea, vomiting, sensitivity to light (photophobia) and sound (phonophobia). Some might deal with symptoms like a runny nose (rhinorrhea) or tearing (lacrimation). In general, their physical exams turn out normal. However, it’s important to note that any irregularities found during the exams require further investigation to rule out serious conditions like brain tumors, which can also cause early morning headaches.
- Throbbing or dull headaches during sleep
- Headaches that awaken them from sleep
- Headaches happening more than ten times a month
- Headache episodes lasting more than fifteen minutes
- Symptoms similar to migraines such as nausea and vomiting
- Light and sound sensitivity (photophobia and phonophobia)
- Runny nose or tearing (rhinorrhea or lacrimation)
Testing for Turtle Headache (Alarm Clock Headache)
Diagnosing this type of headache is mostly based on the patient’s description of their symptoms. The headache typically strikes during sleep and wakes them up, often affecting middle-aged adults. It’s essential to make sure other types of headaches are not the cause of these night-time attacks. With what we call ‘turtle headaches’, there’s a consistent pattern: people wake up, try to go back to sleep, and to do so, they pull the blanket over their head.
To fully ensure the headaches are not due to a more serious problem, such as a growth in the brain, doctors might use imaging tests like CT scans or MRIs. However, laboratory tests such as blood work aren’t beneficial when investigating these types of headaches.
Treatment Options for Turtle Headache (Alarm Clock Headache)
The treatment approach for hypnic headaches (headaches that occur at night) is often based on individual experiences rather than concrete scientific evidence or studies. This is because there is a lack of extensive research on this topic. Several treatments have been attempted, including inhaling oxygen.
For many patients, the first line of treatment typically includes caffeine and a drug called indomethacin. Some people have found remedies such as melatonin and flunarizine helpful. If these treatments don’t work, lithium could be considered. However, it’s important to note that lithium has many potential side effects in both the short and long term, including feelings of sickness, shaking, and problems with the kidneys or liver.
What else can Turtle Headache (Alarm Clock Headache) be?
Turtle headaches, which are also known as hypnic headaches, can be difficult to diagnose because their symptoms may be similar to a variety of other conditions. These headaches often wake people up, like an alarm clock, which can make it even harder to figure out what’s really going on. Some possible misdiagnoses include:
- Migraines or cluster headaches
- Medication overuse headaches
- Conditions related to sleep issues, like sleep apnea
- Conditions related to blood pressure, like nocturnal hypertension or pheochromocytoma
- Conditions related to the brain, like temporal arteritis or intracranial mass
There’s also a unique, rare condition called exploding head syndrome that could be mistaken for turtle headaches. People with this condition feel like they hear a loud noise in their head that wakes them up, but they don’t actually feel any pain. These episodes usually happen when a person is shifting from being awake to falling asleep. As such, it’s crucial for medical practitioners to carefully assess and conduct the right tests to correctly diagnose the cause of these symptoms.
What to expect with Turtle Headache (Alarm Clock Headache)
Turtle and hypnic headaches can persist for many years. However, a significant number of people with these conditions report improvement after receiving treatment. A detailed review involved over 70 patients with hypnic headaches who were followed up for a period of six months to five years. The study discovered that 47% of these patients did not experience any alleviation of their headaches, 43% did see an improvement after receiving treatment, 7% had a relapse after initially improving, and 3% saw their condition improve on its own.
Unfortunately, no research has specifically examined the topic of turtle headaches.
Possible Complications When Diagnosed with Turtle Headache (Alarm Clock Headache)
Turtle headaches don’t usually lead to any major problems. Most people find that their symptoms get better after treatment. The impact of the headache on the individual’s daily life is minimal and can be managed effectively with proper treatment for the headache itself.
Preventing Turtle Headache (Alarm Clock Headache)
It’s advisable not to pull your blanket over your head while sleeping in bed. Implementing healthy sleep habits could possibly assist in preventing certain types of headaches. Additionally, regular exercise and maintaining proper oxygen levels in your body can play a pivotal role in promoting good health.
