Cluster Headaches

Information on cluster headaches and symptoms like drooping eyelids and sudden sharp eye pain.

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  1. What are Cluster Headaches?
  2. Diagnosing Cluster Headaches
  3. What Causes Cluster Headaches?
  4. Help for Cluster Headaches
  5. More Information on Cluster Headaches

What are Cluster Headaches?

Cluster headaches are excruciatingly, painful headaches that tend to occur in cycles or patterns. A bout of cluster headaches usually means that the individual will have one or more headaches per day for a period that may last between a week and many months. These headaches can last between 15 minutes and 3 hours, and they tend to occur at the same times of the day.

They have been nicknamed "alarm clock" headaches for their uncanny way of waking someone from a deep sleep at the same time each night. While the headaches may occur at any time of the day, they are more common between 1 and 2 a.m., 1 and 3 p.m., and at 9 p.m.

After this cycle of headache attacks subsides, there is usually period of reprieve when no headaches occur; however, if the pattern continues for a year without a break, the cluster headaches are said to be chronic.

Cluster headaches are far rarer than tension headaches or migraines, and the pain is also far worse. They usually come on suddenly without warning, and are typically unilateral (on one side of the head). The pain is often described as sharp, penetrating or burning.

Having cluster headaches may be incredibly debilitating and cause much distress. Many people fear going to sleep as they know an impending headache awaits them, and as a result, may get caught up in a bad cycle of sleep deprivation— which can worsen the condition and lead to feelings of depression. It is therefore important to learn as much as possible about your cluster headaches and take necessary steps to treat them.

Diagnosing Cluster Headaches

Your doctor will base the diagnosis on a physical examination as well as your reports of the severity and pattern of the headaches. Keeping a headache journal is also recommended, as this can be a useful diagnostic tool. In the journal it is important to keep track of the time and date of each headache, as well as the duration, pain severity and location of the pain.

Your doctor may also want to rule out any other underlying conditions and so a neurological examination and imaging tests such as a CT scan or MRI may be done.

Accompanying Symptoms

Other typical symptoms that often accompany the headaches include:

  • Restlessness
  • Stuffy nose, as the nasal passages often become inflamed
  • Flushing
  • Sweaty and pale skin
  • Swelling and redness of the eye on the side of the headache
  • Constricted pupils
  • Runny nose and eyes
  • Drooping eyelids
  • In some cases, migraine-like symptoms such as nausea and sound and light sensitivity may occur


What Causes Cluster Headaches?

Cluster headaches can be categorized as vascular headaches. This is a type of headache that occurs when the blood vessels dilate, which creates pressure on the trigeminal nerve. The underlying cause of this remains largely unknown.

Abnormal functioning of the hypothalamus has been implicated as a possible cause of cluster headaches. The hypothalamus is the area of the brain that controls the autonomic nervous system and regulates the biological clock. This theory explains why cluster headaches tend to be seasonal and occur at the same time each day. Neuro-imaging has also shown that there is increased activity in this part of the brain during a cluster headache.

Unlike migraine headaches, cluster headaches do not seem to be triggered by foods, hormonal changes or stress. They do however seem to be triggered by alcohol and cigarettes during active cycles and so they should be completely avoided during periods of attacks. Other possible triggers during active cycles may include certain medications, chocolate, heat, perfumes, and disruption of normal sleeping patterns.

Help for Cluster Headaches

Conventional Treatment

There is no known medical cure for cluster headaches; however, it is important not to become disheartened as there are a number of treatment options that can help reduce the frequency and duration of the headaches.

Treatment is often two-fold and includes immediate pain relievers and preventative medication. Because the attacks occur so suddenly, pain relievers are often ineffectual at relieving all the pain, but may help to stop the headache from reaching its peak.

Oxygen inhalation has been used as an abortive treatment with some success; however; the treatment needs to be immediate and it has little effect once the pain has reached its peak. Triptan drugs, such as sumatriptan and zolmitriptan may also be prescribed to reduce pain, and are often given in injection so that they enter the system quickly.

There are also a wide variety of preventative treatments which include the use of the calcium channel blocker verapamil, Steroids such as prednisolone, Methysergide, lithium and the anticonvulsant topiramate.

For chronic cluster headache sufferers who do not respond well to the medications or treatments, surgery may be an option. Surgery involves damaging the nerve pathways thought to be responsible for pain.

More Information on Cluster Headaches

Tips for Preventing and Treating Cluster Headaches
  • Stick to a healthy sleep schedule, even during active cycles. The more you can stick to your normal sleep patterns, the better. That also means avoiding afternoon naps, as these can quickly bring on an attack once in the cluster period.
  • Exercise regularly. Exercise has been shown to reduce attacks and some people also find that exercise during a cluster headache helps to relieve the pain.
  • Avoid the common triggers, especially alcohol and nicotine, as these two substances almost always trigger an attack during cluster periods.
  • Limit exposure to strong-smelling substances such as gasoline and oil-based paints and even perfumes, as these may trigger a cluster headache.
  • Be cautious of high altitudes during active periods, as the limited oxygen may bring on an attack.
  • Research your condition so that you can explore all your options and find the best treatment method to suit you.
  • Consider supplements such as magnesium and melatonin, as these seem to help many cluster headache sufferers.
  • Remain positive. While this is not always easy, keeping a positive attitude between attacks will help you get through them. If you start feeling depressed and helpless, then seek help and take the necessary steps towards emotional well-being.
  • Seek support from a psychologist, registered counselor or a support group. There are also online support groups available where valuable support, understanding and information may be found and shared.
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