title: No Pattern Alteration in Single Nocturnal Melatonin Secretion in Patients With Hypnic Headache: A Case-Control Study.
abstract: OBJECTIVE
  To investigate headache-related serum melatonin levels and melatonin excretion rhythmicity in patients with hypnic headache (HH).
  
  
  BACKGROUND
  Strict sleep dependency of headache attacks is a pathognomonic feature of HH. Changes in melatonin levels, a marker for circadian rhythm, are assumed to play a pivotal role in the pathophysiology of HH.
  
  
  METHODS
  Serum melatonin levels were acquired in nine patients with HH and nine age- and gender-matched healthy controls over a 20-hour time period (12 pm, 4 pm, 7 pm, 10 pm, time of headache, and 8 am).
  
  
  RESULTS
  No significant changes of melatonin levels could be detected comparing HH patients and healthy controls. Melatonin excretion rhythmicity was not significantly altered in patients with HH (Mean melatonin level in ng/mL ± SD, patients vs controls at 12 pm: 21.5 ± 9.5 vs 13.6 ± 6.3 [P = .077], 4 pm: 18.4 ± 8.4 vs 14.0 ± 4.7 [P = .222], 7 pm: 19.4 ± 5.1 vs 15.1 ± 4.5 [P = .094], 10 pm: 59.5 ± 45.0 vs 29.4 ± 12.7 [P =.136], headache time: 96.9 ± 68.3 vs 49.1 ± 22.8 [P = .94], and 8 am: 31.6 ± 18.3 vs 26.7 ± 15.6 [P = .489]).
  
  
  CONCLUSIONS
  This study is not able to confirm a significant role of melatonin concentration changes in the pathophysiology of HH and vetoes that melatonin deficiency plays a major role in the pathophysiology of the disorder.
authors.affiliation: Department of Neurology and Headache Center, University of Duisburg-Essen, Essen, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Naegel
authors.affiliation: Department of Neurology and Headache Center, University of Duisburg-Essen, Essen, Germany.
authors.forename: Jana-Isabel
authors.initials: JI
authors.lastname: Huhn
authors.affiliation: Department of Neurology and Headache Center, University of Duisburg-Essen, Essen, Germany.|Migraine and Headache Clinic, Königstein, Germany.
authors.forename: Charly
authors.initials: C
authors.lastname: Gaul
authors.affiliation: Department of Neurology and Headache Center, University of Duisburg-Essen, Essen, Germany.
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Diener
authors.affiliation: Department of Neurology and Headache Center, University of Duisburg-Essen, Essen, Germany.|Asklepios Hospitals Schildautal, Center for Neurology, Seesen, Germany.
authors.forename: Mark
authors.initials: M
authors.lastname: Obermann
authors.affiliation: Department of Neurology and Headache Center, University of Duisburg-Essen, Essen, Germany.
authors.forename: Dagny
authors.initials: D
authors.lastname: Holle
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D016022:Case-Control Studies; D002940:Circadian Rhythm / Q000502:physiology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D051270:Headache Disorders, Primary / Q000097:blood*; D006801:Humans; D008297:Male; D008550:Melatonin / Q000097:blood*; D008875:Middle Aged
chemical_list: D008550:Melatonin
keywords: circadian rhythm; hypnic headache; melatonin excretion rhythmicity; sleep