New Daily Persistent Headache

Track the Headache That Never Goes Away

Daily severity scoring with personal baseline tracking. Automatic flare detection and trigger ranking. Lab tracking and doctor-ready reports that turn "my head always hurts" into actionable clinical data.

NDPH is rare, poorly understood, and notoriously treatment-resistant. Leo gives you the tools to track patterns, document treatment trials, and arm your neurologist with real data.

0.03-0.1%prevalence
24/7continuous headache
Day 1patients remember the exact onset

What Is New Daily Persistent Headache?

NDPH is a chronic daily headache disorder defined by its sudden, memorable onset. Unlike migraine or tension-type headache that gradually worsen over time, NDPH begins one day and simply never stops. Most patients can tell you the exact date their headache started.

The onset is often triggered by a viral illness (EBV, COVID, flu), a stressful life event, or surgery — though for some patients, no clear trigger is identified. The headache is present from the moment it begins and persists daily for months or years.

NDPH can present with migraine-like features (nausea, light and sound sensitivity, throbbing quality) or tension-type features (bilateral pressing/tightening, mild-to-moderate severity). Some patients experience both patterns on different days, making it one of the most challenging headache disorders to treat.

There are no FDA-approved treatments specifically for NDPH. Treatment is empirical — trial and error with medications borrowed from migraine and tension-type headache protocols. This makes meticulous tracking of what works and what doesn't absolutely essential.

NDPH Diagnostic Criteria (ICHD-3)

A

Persistent headache fulfilling criteria B and C

B

Distinct and clearly remembered onset, with pain becoming continuous and unremitting within 24 hours

C

Present for more than 3 months

D

Not better accounted for by another ICHD-3 diagnosis

Why Tracking Matters

With no standardized treatment protocol, NDPH management is entirely based on documenting your response to different medications and identifying your personal triggers. Your headache diary is your most powerful tool.

Your Complete NDPH Toolkit

Purpose-built tools for tracking a headache that's there every single day.

Daily Severity Logger

Core Feature

Track your baseline headache severity every day with a quick 1-10 pain scale. Record pain quality (throbbing, pressing, stabbing, bilateral), location, and accompanying symptoms. Over time, Leo builds your personal baseline so you and your neurologist can see exactly when flares happen and how far they deviate from your norm.

Daily 1-10 severity scoringPain quality descriptorsLocation trackingAccompanying symptom tagsPersonal baseline calculationFlare deviation tracking

Flare Detection & Tracking

When your headache severity spikes above your personal baseline, Leo automatically flags it as a flare. Track flare duration, peak severity, and what brought it back down. See flare frequency over time to show your doctor whether treatments are reducing the number and intensity of your bad days.

Auto-detect above-baseline spikesFlare duration trackingPeak severity recordingResolution trackingFlare frequency trendsTreatment response evidence

Trigger Tracking & Ranking

Tag the suspected triggers behind each daily entry — poor sleep, stress, weather change, dehydration, screen time, physical exertion, skipped meals, and more. Leo tallies how often each trigger shows up across your logs and ranks them, so you can focus on the factors that come up again and again — not just the ones you assume matter.

Tag triggers on every entryWeather change as a trigger tagSleep, stress & dehydration tagsScreen time & exertion tagsFrequency rankingRanked trigger list

Weather Sensitivity (Coming Soon)

Coming Soon

On the roadmap: automatic local weather data overlaid on your headache severity timeline — barometric pressure, temperature swings, and humidity. Many NDPH patients are weather-sensitive, and we want to help you prove it with data instead of anecdote. Today you can already log "weather change" as a trigger on any daily entry; the automatic data overlay is what's coming next.

Log weather change as a trigger (available today)Auto weather data overlay (coming soon)Pressure + severity timeline (coming soon)Temperature swing tracking (coming soon)Humidity correlation (coming soon)

Medication Effectiveness (Coming Soon)

Coming Soon

On the roadmap for the NDPH hub: rate how well each preventive or rescue medication worked, 0-10, alongside dose and duration. NDPH is notoriously treatment-resistant, so documenting exactly what you've tried and with what result is critical for treatment escalation. Today you can log medications and note them on your daily entries; per-medication effectiveness scoring inside the NDPH hub is coming next.

Medication logging (available today)Effectiveness rating 0-10 (coming soon)Dose and duration logging (coming soon)Treatment trial history (coming soon)

Doctor-Ready Reports

Generate clean PDF reports showing daily severity trends, flare frequency, your most common triggers, and lab results. Give your neurologist months of structured data in a format they can actually use — not a vague 'my head hurts every day.'

PDF export for appointmentsSeverity trend chartsFlare frequency summaryTrigger frequency reportLab resultsBaseline & deviation timeline

Lab Tracking

Track condition-relevant labs including CBC, CMP, inflammatory markers (CRP, ESR), thyroid panels, vitamin D, B12/folate, and iron studies. Set personal target ranges and visualize trends over time. Many NDPH workups involve ruling out secondary causes — Leo keeps all your lab data organized alongside your symptoms.

CBC, CMP, thyroid trackingInflammatory markers (CRP, ESR)Vitamin D & B12/folateIron studiesPersonal target rangesTrend visualization

NDPH Rarely Travels Alone

Leo tracks multiple conditions simultaneously with cross-condition correlation.

Migraine

In Leo

Up to 50% of NDPH patients have migraine-like features (nausea, photophobia, phonophobia). Some evolve from transformed migraine.

Fibromyalgia

In Leo

Chronic pain overlap with shared central sensitization mechanisms. Widespread pain and fatigue are common in both.

ME/CFS

In Leo

Post-viral onset pattern shared with many NDPH cases. Fatigue, brain fog, and post-exertional worsening overlap significantly.

Depression / Anxiety

In Leo

Living with a constant headache that doesn't respond to treatment takes a severe mental health toll. Bidirectional relationship.

POTS / Dysautonomia

In Leo

Autonomic dysfunction can co-occur. Orthostatic headache worsening and heart rate changes are common comorbidities.

TMJ Disorder

Jaw and facial pain can overlap with NDPH head pain. Clenching and grinding may worsen headache severity.

How Leo Compares for NDPH

Most headache apps are built for episodic migraine — not a headache that's there every day.

FeatureLeoMigraine AppsGeneric Trackers
Daily severity tracking
Baseline calculation
Automatic flare detection
Trigger tagging & ranking
Barometric pressure overlay (coming soon)
Medication effectiveness rating (coming soon)
Treatment trial documentation
Doctor-ready PDF reports
Multi-condition support
Apple Watch integration
Free — no premium paywall

Your Headache Diary Should Work as Hard as You Do.

Leo gives you the tools to track daily severity, detect flares, rank your triggers, and show your neurologist exactly what's happening — with data, not guesswork.

Free to download. No premium paywall for NDPH features.