In the past three years, I’ve solved a lot of health riddles. I’ve gotten leaner, cured my rosacea, discovered the root causes of my back pain and I almost never get colds anymore. However, one huge mystery remains and it has me stumped. For over 15 years, I will often wake up around 3 AM with a sinus headache. Not every day, but in patterns.
Because the patterns seemed to be erratic, it has been impossible for me to tell if a change that I initiate helps, doesn’t help, or partially helps. About 100 days ago, I started a headache journal. I was hoping that this exercise would shine a light on the guilty party to my headaches, but it has left me more confused.
I do not see a correlation between weather, pressure, pollen, coffee intake, chocolate, Neti pot use, or even the use of a few supplements. Note that this is not a Seattle thing. I had these headaches when I lived in San Diego, Northern Virginia, and Tampa Bay. My sister has them in Columbus. I’ve tried different pillows and different beds. I’ve eliminated wheat, alcohol, and most sugar. The headaches persist.
Photo by URBAN ARTefakte
My headaches wake me up at night. I have pressure around my eyes and nose. Whenever I lift my head off the pillow, the pressure decreases and my headache intensity declines. Caffeine helps. As a result, there have been many mornings in the past decade where I am sitting up drinking coffee or tea at 4 AM. It kills the headache, but then I’m unable to return to sleep.
Coffee and tea work so does patience and just having my head upright. Over-the-counter medication is pretty much worthless. I’ve had minor success with Mucinex-D, but then only for a limited amount of time and I can’t say for certain if it was the reason or something else.
Note that these feel nothing like the pain I feel when I cut way back on caffeine. These are completely different. A headache from caffeine withdrawal feels the same whether I am lying down or standing up. The headaches I am trying to prevent are far more intense when lying down.
I was positive my headache was sinus in nature until last week. Then I read about a study that said most people who believe they have sinus headaches don’t. From “Sinus Headache” May Be Migraine (2023: article offline):
A startling 97% of the participants, self-described sinus headache sufferers, actually had symptoms consistent with Migraine attacks as defined by the criteria of the International Headache Society.
My sinus headaches never lead to any mucus drainage or sickness. This may mean that I’m not suffering from sinus headaches. They may be migraines.
I’ve always discounted the idea that I suffer from migraines. Going through the Bellaire Neurology site, I made a list of the common elements for migraine headaches. They include:
- Lasting 4-72 hours.
- Throbbing pain often one-sided.
- Made worse by physical activity.
- Nausea or vomiting or photophobia (light sensitive) or phonophobia (sound sensitive).
- Speech difficulty.
- Runny nose or sinus stuffiness.
The only symptom that I have on that list is sinus stuffiness. None of the others apply. Not even close. This makes me think it may not be a migraine.
Cluster headaches are supposedly the most painful headaches and can even drive people to suicide. I do not believe I have cluster headaches, but I’m putting it on the list because I do have two of the symptoms.
- Often occur at night and they wake the sufferer.
- The headache is short in duration.
However, other symptoms do not match at all. It is said the pain feels like an ice pick pounding into your eye. Since I can’t measure the pain I’m feeling with someone else, I don’t know how severe my headaches are. They do vary in intensity and the majority are not the most severe. So I don’t think this is it, but it does share some similarities.
Then I read about hypnic headaches. From Hypnic Headaches – The Basics (2023: article offline):
Hypnic headache (HH) is a rare primary headache disorder (primary headache disorders are those that cannot be attributed to another condition.) It’s most identifying feature is that it only develops during sleep and wakes the sufferer.
It goes on to say that the pain lasts from 15 to 180 minutes and that caffeine helps. This type of headache, unlike migraines, has no nausea, photophobia, or phonophobia symptoms. So far it sounds like I found the answer. Then I got to this part of the diagnosis chart:
At least two of the following characteristics:
- occurs 15 or more times per month
- lasts 15 or more minutes after waking
- first occurs after age of 50 years
From my headache journal, you can see that these waking headaches occurred 40 times in 100 days. That is less than the threshold defined above. Also, if you just count those headaches where I define the intensity as a 3 or greater (out of 5), that number falls to just 21 times. Symptom #2 is mostly accurate, although I’ve had less severe headaches that went away minutes after sitting up. Symptom #3 is false, as these headaches started in my 20s.
I have no clue what type of headache I have. For all I know, there may be another type of headache that fits my condition. My current health insurance only protects me for catastrophic events, so seeking specialists is not an option. My headaches aren’t any worse today than they were 5 years ago. I am motivated by my success in solving other health riddles so that maybe I can figure out the root cause and solution for these headaches.
I am hoping to discover a non-pharmaceutical solution. I prefer to work from the premise that I am not broken, but may need to tweak something in my diet or environment. I’m going to cut my caffeine intake by 50% for a month to see if it has any effect. If you have any insights or ideas, please leave them in the comments. Thanks.
Follow-up: Hunting Headaches Take 2