Cluster headaches are excruciatingly painful, debilitating headaches that occur in clusters. They generally affect one side of the head and result in other symptoms that affect the same side of the face. They can awaken people in the hours after they go to sleep, often occur at the same time of day, and are experienced as either episodic or chronic.1 Cluster periods can last for weeks or up to a year, followed by periods of remission that can last a year or more.
Cluster headache treatment options
Once someone is diagnosed with cluster headache, an experienced healthcare provider will usually us a two-pronged approach to treatment: stopping the pain and preventing or reducing the frequency of future attacks. Unfortunately, there are few FDA-approved treatments, and most therapeutic options are considered experimental. These include injections, nasal sprays, oral medications, and inhaled 100% oxygen.
The direct cause of cluster headache is not well understood. Because of the pattern of head pain experienced by people with cluster, especially waking people up at night, it is thought that abnormalities in the biological clock controlled by the hypothalamus region of the brain could play a role.1
The oxygen option
100% oxygen is pure oxygen that is inhaled, delivered through a face mask. The treatment is quick, effective, and safe when used to address the pain of cluster headaches but has not been proven effective in treating traditional migraine.1,2 Inhaled oxygen therapy has been used to treat cluster headaches for more than 50 years.3 Cluster headaches require fast-acting treatment, and oxygen can resolve an attack in minutes.3 There are no side effects from using oxygen therapy.
How does oxygen therapy work?
Oxygen therapy can be administered at different flow rates, that are indicated as liters per minute.1,2 Low flow treatment is at 6-7 L/minute. It was found to be successful in 56%, 75% and 82% of patients reviewed in different studies in the literature. High-flow oxygen, delivered by mask at 12 L/min, was effective in eliminating pain in 78% of attacks.2
Hyperbaric oxygen therapy has been looked at in a few small studies and was effective for acute headache attacks but did not have a sustained preventive effect.
Oxygen is effective for cluster
Oxygen therapy acts quickly and has no side effects. It is available in a hospital or emergency department or for home use.1 It is an effective treatment for cluster headaches but not necessarily a convenient or cost-effective one. Access to oxygen is not always convenient because of the size of canisters and lack of portability. Oxygen is not always covered by health insurance and can be expensive.2
When oxygen therapy is prescribed your doctor will evaluate your lung capacity and rate of breathing to determine the recommended flow rate.3 Most oxygen tanks come with a regulator but there is also a mask specially designed for use in treating cluster headaches. Many people who suffer from cluster headaches find that they cannot sit still or lie down, they rock back and forth or pace. Experienced users of oxygen therapy who need to pace during an attack, may require a longer air-line; a 30-foot line is available to provide length for comfort.
There are support groups and not for profit organizations like ClusterBusters that can provide additional educational information on the use of oxygen therapy to treat cluster headaches.1
Torborg, L. Mayo Clinic Q and A: Oxygen treatment can relieve cluster headaches. Available at: https://www.ncbi.nlm.nih.gov/pubmed/24723673. Accessed 6.10.19.
Petersen AS, Barloese MC, Jensen RH. Oxygen treatment of cluster headache: a review. Available at: https://www.ncbi.nlm.nih.gov/pubmed/24723673. Accessed 6.9.19.
Wold, B. High Flow Oxygen for Treating Cluster Headaches. Available at: https://www.ncbi.nlm.nih.gov/pubmed/24723673. Accessed 6.10.19.