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cloud of oxygen coming from a facemask with tube leading to an oxygen tank.

My Experience with Oxygen Therapy

In early June 2014, I was sitting with my mom in my headache specialist‘s office, nervously wringing my hands while speaking to the headache nurse coordinator. I rarely got to see the specialist herself. The nurse – I’ll call her Connie – calmly took notes and gazed into her computer screen as I described my recently experienced Worst Headache Ever. She said, “Now you say when you went to the hospital the first time, you were put on oxygen?” I nodded. “How did it affect you?” I told her I had felt calmer afterward. “Were you having symptoms that aligned more with a cluster headache than a migraine?”

I responded that I didn’t think so other than the unbelievable severity of the pain. It had been just as long in duration, I hadn’t had several attacks over a short time period, I didn’t have an eye that had watered. What I did have was the worst pain I’d ever experienced and an inability to lie down and be still, which is more common for cluster sufferers than for someone with a migraine. I’d had to pace, rock, “take the beast for a walk”, as those with cluster headaches tend to describe their need to move during an attack.

Another treatment plan

Well, regardless, maybe using oxygen at home is something that could benefit you.” Connie said, and tapped on her keyboard. Sheets began ejecting from the printer. “8 to 9 liters per minute,” she explained, and handed me the prescription and several pages of information. She then outlined the new treatment plan which would be to first take an additional dose of my daily magnesium supplement and use 20 minutes of oxygen, then if pain still persisted, use a Sumatriptan injection (not a tablet). Using oral Sumatriptan was supposed to be a last resort. If those didn’t work or I got into a situation where pain continued to recur, I was to call their office and schedule IV infusions of DHE.

Trying it on for size

I was doubtful, but intrigued by the oxygen idea. John and I took the written prescription to a medical supply office the next day, and learned some of the vocabulary involved, most notably that the mask type is non-rebreather and that a large machine called a concentrator or regulator would also be required, as well as lengths of tubing and various other tools. I received several cylinders (tanks) of oxygen in a silver cart with wheels. When we were all together that evening, John and I showed the girls the oxygen mask and talked about what it was for, and I put it on for them so that it wouldn’t seem scary, and let them try it on too.

Trying on the mask for my daughters, so they could get used to it.

Trying on the mask for my daughters, so they could get used to it.

A brief history of oxygen treatment

According to the National Headache Foundation, oxygen treatment for headaches was first studied in 1939 when Mr. Charles Rhein of Linde Air Products reported to Dr. Francisco Alvarez at the Mayo Clinic that he had successfully treated severe headache patients with pure oxygen. In 1940 Dr. Alvarez released his own study of 100 patients with “migrainous” headaches who were treated with 100 percent oxygen through a nasal type mask and a flow of six to eight liters per minute, in which 80 percent of those were reported to be completely or significantly relieved. However, in the thirties and forties studies were much less rigorous, and there was nothing to distinguish migraine from cluster headaches. Recent work has been done almost exclusively on the effect of oxygen inhalation on cluster headaches, most significantly with Dr. Lee Kudrow, who found that 75 percent of the cluster headache patients he studied had their pain relieved by inhalation of oxygen, with increased success the earlier in the attack it is used.

Recent studies

As far as migraines, research is scarce. I did find a rather unhelpful collection of studies from 2008 originally published in the international journal The Cochrane Library, which evaluates research in all aspects of health care. Those studies only examined the effects of hyperbaric oxygen therapy on migraine, which would require a special chamber; normobaric therapy (the type we are discussing here) was only studied on cluster headaches. Obviously, hyperbaric chambers are not going to be available to most people.

Kerrie Smyres, another Migraine.com advocate, was able to send me a journal article she’d located when researching oxygen for migraine, from Cephalalgia in 2012. In this article, authors Jürgens, Schulte and May discuss a patient with typical migraine (no aura) and autonomic symptoms (runny nose, drooping and watering eye) who had mistakenly been diagnosed with cluster headache. She did receive relief from oxygen use; however, her pain would return after thirty minutes. The authors wondered about this “success” and the connection, perhaps, with her autonomic symptoms. Cluster headache sufferers often have these same symptoms. The authors conclude that there is clinically significant evidence that oxygen inhalation is more effective in migraine with cranial autonomic symptoms than that without, but that only cluster headaches seem to be completely relieved by oxygen therapy.

The downside of oxygen masks

As for me, whenever I felt a migraine coming on I would dutifully go take another dose of magnesium and go up to the bedroom, recline against pillows, put on the mask and turn on the oxygen. (And of course this was only possible due to the fact that I’d recently had to stop working.) The mask sometimes bugged me, putting pressure on my sensitive nose and leaving indents on my cheeks. I would struggle to relax, and breathe somewhere between deeply and normally while the big machine I’d been given vibrated noisily. The oxygen coming through the mask didn’t taste odd like I’d feared it might. However, only once or twice out of six months of use I was able to get up after the oxygen session and not need to take medication for the migraine that continued to progress.

I kept at it anyway, even bringing the machine and a small cylinder on vacation with me, but the honest truth is that it just didn’t work to abort a migraine or decrease pain. For a while I even tried using it daily as a prophylactic measure, but I stayed as chronic as ever. I believe it was probably somewhat beneficial in that it caused me to take a break, retreat, and breathe deeply, which would be a good idea for anyone at any time, really, but particularly when a migraine is coming on. Twenty minutes of relaxation while practicing some mindfulness or biofeedback is literally just what the doctor ordered, or what my pain psychologist ordered, anyway. However, the oxygen itself was probably superfluous.

All things considered…

In conclusion, it’s quite clear that oxygen inhalation is a very effective therapy for treating cluster headaches, but there is much less evidence to support its use for migraine. Dr. George Sands from the Beth Israel Medical Center in New York City states on the National Headache Foundation website that he sees some relief with oxygen inhalation in about half of his migraine patients. Side effects are rare, though Dr. Kudrow reported 25 percent of his cluster patients had rebound clusters after oxygen use. (I’m sorry, but really? What doesn’t cause rebound headaches?) Oxygen is not a commonly used treatment for migraine and it may be difficult to overcome the initial resistance from one’s doctor or insurance company; however it is also a natural, rather risk-free therapy without many of the worries most of us have when trying a new medication. I myself ended up retiring my oxygen inhalation accessories and returning my machine with the empty tanks by the end of that year. Would oxygen provide some relief for you? I have no idea, but there’s no harm in talking to your doctor if you feel it might be worth a try.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • jgargiulo
    2 years ago

    I glad to see oxygen therapy discussion for migraines. I do not have cluster headaches I have migraines with aura. Oxygen therapy helps me greatly. When aura begins for me I go put on my oxygen for 10-15 minutes at 10 and listen to music. All gone. If I don’t get there soon enough – on the rare occasion – then I might need to also take immitrex and lay down afterwards for a while.
    I heard about oxygen therapy in 2013 about an EMT had been using it successfully in my hometown.
    Biggest hurdle I’ve had is the insurance companies and the oxygen providers who only want to bill through the insurance companies not do self paid. Both need to get up to speed and cover the procedure for the migraine sufferers it helps – like me and let those who don’t need to run it through insurance to pay it directly.
    Four years and running and I can kill the migraines dead. What a relief.
    Good luck to you!

  • Siegfried
    2 years ago

    Thank you for sharing !

    I have just opened another post for experiences of migraine with oxygen therapy but I see your reply just now

    I am glad to see that there are more cases where oxygen works well and maybe there should go more research into it as it can help people who are now in a cycle of triptans, more migraines, more triptans etc…

    Here in Belgium its quite OK to get the oxygen. Once a neurologist confirms the diagnosis of CH (which I however have more or less) one is entitled to 4500 litres/month for free for the rest of his life.

    Thanks and good luck as well !

  • Siegfried
    2 years ago

    Thank you for sharing !

    I have just opened another post for experiences of migraine with oxygen therapy but I see your reply just now 🙂

    I am glad to see that there are more cases where oxygen works well and maybe there should go more research into it as it can help people who are now in a cycle of triptans, more migraines, more triptans etc…

    Here in Belgium its quite OK to get the oxygen. Once a neurologist confirms the diagnosis of CH (which I however have more or less) one is entitled to 4500 litres/month for free for the rest of his life.

    Thanks and good luck as well !

  • Siegfried
    2 years ago

    Hello,
    From Belgium here. With me the oxygen worked as well. I suffer from the “classical” migraine since my childhood. Typical nausea, can not stand light and have to stay in my bed in a dark room. A full attack typically takes 2 to 3 days if not aborted. Last years, I used Zomig to abort the attacks which has always worked very well. Only … I started to take a bit too much Zomig for my likings. Last years I also saw that a new type of headache was appearing within a migraine attack. The attacks where around 1 to 2 hours, a terrible, excruciating pain in the region around my eye, a running nose and the pain was so heavy that even if I felt so ill because of my migraine, I could not stay in my room and started to run around. When I had such an attack and when it went away, then the migraine went away as well.

    I went with this story to my neurologist and a bit to my surprise he diagnosed me with cluster headache (although I have the clear symptoms of migraine as well) and so I was entitled for oxygen treatment.

    Well I must say, to my big surprise, this treatment works 100 % successful. Whenever I start to feel the normal migraine come up (always at 4 am a slight glowing sensation in my ear) I go on the oxygen 15 min with 15 litres/min. It always works. In 15 min all the symptoms are gone and I am completely headache free for the rest of the day.

    I have now this oxygen for 3 months and my Zomig use has gone from 3-4 pills a month to zero. But I am still puzzled what I have. Is it now migraine or cluster headache or both ?

    Best Regards !

  • Elizabeth Roberts-Zibbel moderator author
    2 years ago

    Hello! I am SO glad oxygen therapy works for you! You’re the first person I’m aware of with migraine who has been able to give it uniquivocal praise. Hooray! Thanks for sharing your success with us.

    Warmly,
    elizabeth

  • Piglet
    3 years ago

    I tried the oxygen concentrator for a couple of months. The plastic bagging and tubing was smelly and I didn’t get any migraine relief but like you, it made me stop and relax. When my son was in hyperbarics for CRPS and when they found out about my migraines I got a trial session in the chamber. I had a migraine that day which did not change. I could not go full depth due to ear problems. But the next day I had my best day in years. i mean a normal day. Drove 9 hours too (it was my son’s last session and we went home). It was after this I got my migraine specialist to prescribe the concentrator for me which was partially covered. Hyperbarics has helped him and I think would help me too but at $250 per session and not covered by insurance, I doubt I will ever find out.

  • Elizabeth Roberts-Zibbel moderator author
    2 years ago

    Hi Piglet!

    Yes, exactly, about the hyperbaric chamber! That really seems like the way to go, if any of us could afford it. Sorry it took me so long to reply and I hope you’re doing well!
    Best,
    elizabeth

  • Lisa A
    3 years ago

    Was curious about oxygen therapy myself. Will ask my headache specialist. Thank you for sharing your experience. You are strong and mighty too! Best to you and hoping this new drug trial will be a positive result for you!!

  • Elizabeth Roberts-Zibbel moderator author
    2 years ago

    Lisa A, I’m so sorry it took me a long time to reply to this. Thank you for your kind words! The drug trial is ending soon. Not sure if I will get another one, or just wait for the CGRP meds to be approved, as they are supposed to be in 2018.
    All the best,
    elizabeth

  • Jani8
    3 years ago

    Hi Elizabeth,
    I did a sleep study test. While I didn’t have sleep apnea, I did breathe too shallowly when I was asleep. I was given a CPAP machine. I tried it for awhile, but couldn’t get used to the mask and headgear, so I stopped. Fast forward to September 2013. I was having a difficult time breathing so they gave me a new CPAP with a different kind of mask and I’ve been using it ever since. I have an interstitial lung disease that puts me at 38% lung capacity. That will never get better, but I have been stable for about 2 years. I have almost daily migraines for a long, long time. The oxygen doesn’t seem to prevent them as I usually wake up with a headache. I use the 3 liters setting. Do I need to have it higher?
    What does the Magnesium do for a migraine? I take 800 units a day.
    I had a daily migraine the first 7 months I was pregnant. It was miserable. While I love my daughter and can’t imagine life without her, that and the broken tailbone during delivery made Anna an only child.

  • Elizabeth Roberts-Zibbel moderator author
    3 years ago

    Hi Jani8,

    Using oxygen for sleep apnea is different than the high-flow oxygen used for headaches, so I would definitely stick with your doctor’s recommendation. Even at the 8-9 liters I was using, I wasn’t able to prevent migraines.

    Studies have shown that magnesium supplementation can help prevent migraine, and the recommended mg for that is 600, so you are already taking the right amount. I have never been able to tell how much it helps me but I keep taking it. Here is a bit of an explanation:
    https://migraine.com/migraine-treatment/natural-remedies/magnesium-for-migraine-headaches/

  • cathyn
    3 years ago

    Hi Elizabeth,
    I really enjoy your posts. I know you were part of a CGRP clinical trial. Are you no longer receiving the CGRP medication? I assume they wouldn’t prescribe a new therapy if you were.

  • Elizabeth Roberts-Zibbel moderator author
    3 years ago

    Hi Cathyn, Thank you so much! You’re right, I wouldn’t be trying any new therapies right now considering that I am still involved in the CGRP clinical trial. The oxygen was something my neurologist’s assistant prescribed a year or so before I began participating in the Amgen CGRP study; I am now on my second study with a different drug company. In this trial, I actually would be allowed to take a preventative medication, but other than my magnesium and B2 supplements I don’t take one anyway since I’ve tried nearly all of them with no success. Thanks again for your compliment about my writing and take care! <3

  • menopausalmigraineur
    3 years ago

    Hi Elizabeth, I’m a chronic migraine patient (daily for the last 24+ years disabled and out of a career since having my kids brought about a change in my body). I also have cluster headaches and it’s taken me 23 of those 24 years to get oxygen prescribed for them. And then it’s not covered by Medicare.
    But, one thing I have been trying is to use the oxygen when I’m out (I have a smaller bottle and canula) and decrease the impact of the smell of volatile chemicals in the air around me that bring on sudden debilitating pain. (I get syncope episodes when the pain gets too bad so I try to keep it down. Fainting in public is dangerous.)
    It has worked to a certain extent. That and a personal air purifier. But it is a great deal of hassle to cart around which makes it something I am hesitating about because it’s expensive as well to carry my own air supply just because I can’t breathe other people’s perfumes, colognes, hairsprays, body washes, dryer sheets, laundry detergent, cigarette residue, etc. It’s gotten awful to go into public.

  • Elizabeth Roberts-Zibbel moderator author
    3 years ago

    Hi MM – thank you for being here and commenting. I can empathize with the difficulty of getting treatments covered by Medicaid and Medicare (and private insurance) and with the inconvenience of oxygen, though I’m glad you’ve found a use for it in blocking out noxious scents. I am very sensitive to odors as well, but not nearly so much as you. I have never suddenly passed out from pain which sounds terrifying. Also, I wanted to tell you that my migraines became chronic during my first pregnancy. The attacks only continued increasing in severity and frequency and while I am extremely grateful for my second daughter, that pregnancy was a lucky accident as I was very sick and was afraid to be pregnant again. After her birth I went into early perimenopause and spent a lot of time in the hospital – almost every time I menstruated or ovulated. I had a hysterectomy in 2011. So it sounds like other than your syncope and cluster headaches we have a bit of similar history. I’m so sorry that you suffer so much. <3

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