Cluster Headaches

A cluster headache is a rare type of headache. Cluster headaches typically occur once or more daily at the same times each day for up to 12 weeks, until the "cluster period" is over.

Cluster headaches are more common in men and usually start very suddenly. The pain is usually located behind or around one eye and is very severe. The eye and nose on the same side as the pain may become red, swollen and runny. Cluster headaches also cause restlessness. These headaches can be frightening for the sufferer and the people around him or her.

A cluster headache can last a few minutes or several hours, but it usually lasts for 45 to 90 minutes. The most common times for cluster headaches seem to be between 1:00 a.m. and 2:00 a.m., 1:00 p.m. and 3:00 p.m. and around 9:00 p.m. Cluster periods usually last 4 to 8 weeks and may occur seasonally, such as in spring or fall. Then, no cluster headaches will occur for weeks, months or even years.

What causes cluster headaches?

Cluster headaches do not appear to be related to other illnesses or to diseases of the brain.

Some of the triggers of cluster headaches include:

How do I know if I have cluster headaches?

Your description of your headaches will help your doctor make the diagnosis. The time and pattern of attacks are important, so keep a diary of your pain. Family members or others who see you during a headache can also help by telling the doctor how you look and act. Don't be embarrassed to tell your doctor about your attempts to relieve the pain (such as banging your head against furniture). These attempts are common, and talking about them will help your doctor judge how severe the headaches are.

Your doctor will also give you a physical exam. Tests will probably not be needed to diagnose cluster headaches, but your doctor may order tests to rule out other illnesses.

Can I do anything to prevent headaches once a cluster period has started?

During a cluster period, it is important to keep to your usual routine, remain calm and avoid changing your sleep pattern. Once a cluster period has started, a change in sleep pattern, particularly taking an afternoon nap, seems to bring on the headaches.

Drinking alcohol will also bring on headaches during cluster periods. This happens very quickly -- before you finish the first drink. Alcohol should be completely avoided until the cluster period is over. Stress may bring on attacks, and the headaches may start when you are relaxing after a stressful time.

What treatments are available?

Several treatments are available for cluster headaches. It is important to work with your doctor to pick the right treatment for you, talk about side effects of different medicines and set up a schedule for taking the medicines your doctor prescribes.

At the start of a cluster headache, inhaling pure oxygen through a mask can help prevent the attack. Because the headaches come on so quickly however, this is not always practical.

Your doctor will probably prescribe 2 medicines. One medicine is taken regularly during the entire cluster period to reduce the number of headaches. In order for the medicine to work, the level of the drug in your blood must be high at the time your attacks usually start.

The second medicine is taken to relieve the pain as a cluster headache occurs. Attacks begin too quickly for you to reach medical help. You must be ready to take this medicine as soon as an attack begins. You may want to teach family members about your headaches and medicines so that they will be able to help you when you have an attack.

Medicines taken by mouth work too slowly to give relief for cluster headaches. For this reason, your doctor may prescribe a medicine that is taken by nasal spray, by injection (a "shot") or taken as a rectal suppository. Another treatment that works for some people is using a local anesthetic (numbing medicine) in the nose.

How can I manage a cluster headache period?

Although cluster headaches are very painful, with the right treatment most people cope very well. Preventive medicines work well to reduce the number of headaches during cluster periods. When a cluster headache does occur, medicines can greatly shorten the headache and reduce its severity. It is important that you work with your doctor to find the right treatment for you.