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August 27, 1982

Turtle Headaches

Author Affiliations

St Petersburg, Fla

JAMA. 1982;248(8):921. doi:10.1001/jama.1982.03330080011004

To the Editor.—  The question by Dr Wagshul (1982;247:1883) regarding a patient in whom early morning bilateral headaches develop only if he returns to sleep after awakening, and the excellent answer by Dr Donald Dalessio calls to mind another explanation for early morning headaches, as first reported in The Journal ten years ago as "turtle headache."1 Turtle headache occurs on awakening, characteristically in a patient who, desiring to return to sleep and finding the daylight a nuisance, pulls the bed covers over his head or retracts his head beneath the blankets. On awakening for the second time, he has bilateral, often generalized, headache, which is probably of the hypoxic type.2It is typical of turtle headache that it occurs only under the circumstances described by Dr Wagshul: Headache develops only if the patient returns to sleep after having awakened. Specific questioning might disclose the turtle habit. It has