Cluster Headaches


Cluster headaches are recurrent headaches that take place over a specific period of time. During an episode, a person experiencing a cluster headache may experience one to three of these piercing headaches per day, although it is not unheard of to experience as many as eight of these headaches throughout the day.

Cluster periods can last anywhere between two weeks and three months. Many people experience them at the same time of the year each year. Many report the headaches go away completely for months, or even years, only to one day return out of the blue.

What is unique about cluster headaches is that they often wake sufferers from a deep sleep due to the pain of these headaches. This usually happens about one to two hours into the sleep cycle and is often much more painful than a daytime attack.

Cluster headaches most commonly occur in men under the age of 30. However, it is not unheard of for children to be diagnosed with this condition. Additionally, a growing number of women have been diagnosed with cluster headaches in recent years though men continue to be diagnosed as much as six times more often than women are.


Cluster headache symptoms and signs often come on rapidly and may vary slightly from person to person. They include:

  • Intense, continuous pain that begins in the area around the eye. This pain may radiate to other areas of the head and face, including the cheek, temple, neck, and sometimes shoulder area.
  • Pain is generally limited to one side of the head where the eye may become red and/or watery
  • Drooping eyelid on pain side
  • Constricted pupils
  • Sufferer becoming sweaty or pale in the face
  • Nose one the affected side becomes stuffy, blocked, or runny
  • Pain between 30 and 90 minutes, though they may last as little as 15 minutes or as much as three hours
  • Experience one to three headaches per day during the cluster period, though some people will experience more


Diagnostic criteria from IHS:

A. At least 5 attacks fulfilling criteria B-D
B. Severe or very severe unilateral orbital, supraorbital and/or temporal pain lasting 15-180 minutes if untreated
C. Headache is accompanied by at least one of the following:

  • Nasal congestion and/or rhinorrhoea
  • Eyelid oedema
  • Forehead and facial sweating
  • Miosis and/or ptosis
  • Sense of restlessness or agitation

D. Attacks have a frequency from one every other day to 8 per day
E. Not attributed to another disorder

A cluster headache diagnosis often involves a lengthy appointment with your doctor in which you discuss all your symptoms or during an actual episode or attack. MRIs and other tests or examinations are often used in the diagnosis process in an effort to rule out other potential causes of your headaches.


While there is no cure for cluster headaches, comprehensive treatment can help your symptoms. Treatment for pain relief during a cluster headache can include:

  • Oxygen: Pain relief can be achieved by breathing in 100% pure oxygen during a cluster headache. You will breathe through a plastic mask that is attached to an oxygen tank for about 15 minutes.
  • Triptans, such as sumatriptan (Imitrex)
  • Anti-inflammatory medicines such as prednisone
  • Injections of dihydroergotamine (DHE), which can stop cluster attacks within 5 minutes

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