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When it comes to headaches, the difference between rare type of head pain and more common conditions is a matter of night and day, if after otherwise normal day, expecting a for a restful night of sleep but suddenly awakened by a dull or throbbing headache, unilateral, in the middle of the night often at the same time, associated with nausea, runny nose (nasal congestion), droopy eyelids (ptosis) and light sensitivity. Its call Hypnic headache also known as alarm clock headache, different than other nocturnal headache by clinical manifestations, it is rare type of primary headache, more common in older people, most often people over 60 and more common in women than men. Polysomnographic (PSG) monitoring of 10 hypnic headache patients shows that the attacks arose directly from sleep and not related to the breathing abnormalities, and not associated with structural lesions and does not belong to the trigeminal-autonomic cephalagias. There is some evidence during REM sleep (rapid eye movement). The pathophysiology of hypnic headache not fully understood, however lateral hypothalamic neurons are most probably involved as hypnic headaches often happen during REM, for this reason is not really possible to prevent them from occurring. The diagnostic criteria includes as primary headache to rule out the secondary cause of headache , recurrent, occurring only during sleep and causing wake up, occurs more than 10 days per month for at least 3 months, and last about 15 minutes to 2 hours. Management of hypnic headache based on the clinical manifestations and because of rarity of hypnic headache are limited. Many patients reported drinking a cup of coffee containing caffeine before you go to sleep. Evidence suggests that drinking one cup of coffee before bed won’t keep you awake. You can use this method to prevent hypnic headaches and treat them. Other treatment options is of hypnic headache AKA alarm clock headache is melatonin as always occurs during REM sleep 3 to 5 mg melatonin reported to be 40% response in HH patients. If caffeine and melatonin treatment does not provide a significant response, a course of lithium should be tried, followed 3–4 months later by tapering, If headache recurs during tapering, a longer duration of therapy may be needed, as second-line approach. In conclusion Hypnic headache is a rare, idiopathic and characterized by exclusively sleep-related headache attacks in patients usually beyond the age of 60 years, cause of nocturnal head pain. It is described as alarm clock headache. The pathogenesis is not fully understood but a relationship with REM sleep has been postulated.