Dear Dr. Gott: I recently read a letter from one of your readers who was having terrible headaches at night.

About a year ago, I began having bad night headaches. I started with my family doctor, who ordered X-rays and referred me to a local neuro-spine clinic.

I was under their care for three months, during which time I was given prescription pain medication, muscle relaxants and steroid injections into my scalp.

I also had CT scans and MRIs. I was told it was very important to make sure that there was nothing wrong with my head, such as a tumour or other growth. Nothing they did helped me at all, though.

I was then referred to a neurologist in a nearby town, and he immediately diagnosed my headaches as "hypnic".

Based on what he told me and what I learned from the Internet, these headaches happen most often to older females (I am 82), and they always occur at night.

There is no cure, and very little research has been done on them. There is hope, however, that they can be controlled. I am currently taking lithium, and my headaches have stopped.

I take only half a pill and need to have blood work every three months. I was warned of the side effects of this medication, but so far I have not had any.

I hope this helps your reader because she is correct when she says they are very painful.

Dear reader: According to the National Headache Foundation (www.headaches.org), hypnic headaches occur at a consistent time each night. Most sufferers experience them between 1 a.m. and 3 a.m. They generally last 15 minutes to three hours. They begin abruptly and resolve spontaneously.

The pain is described as being diffuse and throbbing and generally occurs in the front of the head, but some sufferers may have pain on the sides or entire head. The pain is rarely one sided. Most patients experience headaches four or more nights a week.

Despite poor tolerance by most patients, the most common treatment is lithium carbonate. Some may benefit from 40 to 60 milligrams of caffeine (or a cup of coffee) before bed or indomethacin (a nonsteroidal anti-inflammatory drug).

Dear Dr. Gott: I am writing in regards to your article about the teenage boy with near blackouts.

I was diagnosed with ophthalmic migraines and found that as soon as I felt the symptoms come on, I had to sit or lie down for about 15 minutes with my eyes closed to stop the blackness and minimise the headache. I hope you let him know that this could be the cause of his symptoms.

Dear reader: Ophthalmic or ocular migraines don't cause a headache. Rather, they are considered migraines because they involve the visual warnings signs (aura) that most migraine sufferers experience just before the pain of the migraine headache.

Based on the young man's symptoms of lightheadedness/dizziness and faintness (primarily upon standing), I don't believe this is his problem. I am, however, printing your letter for reader interest. Thank you for writing.

To provide related information, I am sending you a copy of my Health Report "Headaches." Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a check or money order for $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.