Dados do Trabalho

Título

Hypnic headache and COVID-19 pandemic: Is it a coincidence?

RESUMO

Hypnic headache (HH) is characterized by attacks that occur only during sleep with wakening. Patients with HH complain of pain between fifteen minutes to four hours, bilateral, and varies from mild to moderate intensity. The pathophysiology is poorly understood, but circadian disruption can be involved. We describe a case of HH during the COVID-19 pandemic.
A 22-year-old patient from São Paulo complains of headaches exclusively during sleep (at night and napping), without autonomic symptoms, that started during the quarantine in the first wave of the COVID-19 pandemic in Brazil. The patient had significant circadian disruption during that period of life due to the pandemic. Neurological exams, magnetic resonance imaging, magnetic resonance angiography of the brain, and sleep studies were regular. He had three PCR tests negative for SARS-CoV-2 and no flu symptoms. Treatment with lithium carbonate 450mg at night led to the remission of the pain attacks.
Circadian rhythms interfere in many aspects of physiology and pathophysiology of many biological systems and headaches. The association between the sleep patterns caused by the restrictions during the COVID19 pandemic can influence the incidence of a few kinds of headaches such as HH. The disrupted sleep and circadian rhythm could be contributed to the beginning of HH. Indeed, the medication that adjusted the circadian cycle was effective.
This case highlights the possible impact of the COVID-19 pandemic and the lockdown on the incidence of HH and other headaches due to sleep and circadian disruption.

Palavras Chave

Hypnic headache; Sleep; Circadian Rhythm; COVID-19