Tips for Plane Travel When You Have Cluster Headaches

Many people are afraid of flying. Most worry the plane will crash, and they won’t make it home. My fear is more specific. The rapid elevation change triggers a cluster headache when the plane takes off or lands. If I’m not prepared for the pain, it’s a horrific experience for me and my fellow passengers.

How have I managed cluster headache on a flight?

The first time air travel caused a cluster headache was when I visited my high school sweetheart in Honolulu, where he was stationed with the U.S. Army. The landing gear was still bouncing off the pavement when I felt the familiar twinge in my right temple and the base of my neck. Within minutes, the attack was full-blown. Luckily, I had a sumatriptan injection – though I probably traumatized the teen boy and his father next to me.

The same thing happened on my return flight and again a few years later when I flew to California. Cluster headaches come on so quickly and severely that there’s no time to run to the bathroom for vanity’s sake. I can't wait for the captain to turn off the seatbelt sign either. I have to use the injection right then and there, even if it means scaring the small children opposite my row.

After those experiences, I avoided flying. Instead, I took the train across the country so I could bring my oxygen tank with me. However, I couldn’t live in fear forever. I devised a plan based on advice from other “clusterheads,” or people with cluster headaches.

Tip #1

Take your preventative medication two hours before your flight. Triptans come in several forms: oral pill, nasal spray, or subcutaneous injection. The injections are my go-to abortive if I don’t have high-flow oxygen available. The oral and nasal options don’t work fast enough for cluster headaches, but a triptan pill can work as a preventative treatment. My headache specialist and a few fellow patients recommended I take one about two hours before my next flight. It worked like a charm! Now, I take one any time I travel if I’m in an episodic cluster headache cycle. I make sure I have injections wherever I go too.

Tip #2

Bring an energy drink. Energy drinks are a treatment “hack” for cluster headaches. Something about the caffeine and taurine combination can stop an attack if you chug it at the onset. I learned this trick at a Clusterbusters conference in 2014, and it has worked several times in a pinch. Five-hour energy is my preferred choice because I can drink it quickly. I wait until the attack starts, but others in the patient community drink an energy drink during takeoff.

Tip #3

Don’t plan for help – or oxygen. I’m fortunate sumatriptan injections work for me, but they cause rebound attacks, so I must use them sparingly. High-flow oxygen is the most effective treatment and least detrimental option for my health, but I can’t bring it on a plane. I learned the hard way that airline stewards are no help. While they have oxygen available, it’s reserved for life-threatening emergencies. Even if I could use the plane’s oxygen, the flow rate is too low to make a difference.

I’ve heard from countless clusterheads about their airplane woes. One friend recounted his honeymoon flight, during which he paced the aisle for over an hour while screaming in pain because he had no treatment available. There are many horror stories about flying with cluster headaches, but being prepared has saved me from hours of pain and embarrassment during air travel.