What Are Cluster Headaches?
Cluster headaches are one of the most severe forms of primary headache. Unlike tension headaches or migraines, they occur in cyclical patterns or clusters, with periods of frequent attacks followed by remission periods, and are often called "suicide headaches" due to their extreme intensity.
Recognizing the Symptoms
Cluster headaches have very distinctive features:
- Excruciating pain around or behind one eye
- Pain that peaks within minutes and lasts 15 minutes to 3 hours
- Restlessness and agitation during an attack (unlike migraines, where sufferers prefer to lie still)
- Red or watering eye on the affected side
- Nasal congestion or runny nose on the affected side
- Drooping eyelid or constricted pupil
- Attacks often occur at the same time each day, frequently waking people from sleep
The Cluster Cycle
A cluster period typically lasts 6 to 12 weeks and often occurs seasonally - many sufferers experience attacks in spring or autumn. During a cluster period, attacks can happen one to eight times per day.
Episodic vs. Chronic
- Episodic cluster headaches: Clusters last weeks to months, with remission periods of at least three months
- Chronic cluster headaches: Attacks occur for more than a year without remission, or remission periods last less than three months
Who Gets Cluster Headaches?
Cluster headaches are just one of several types of headaches. They affect about 1 in 1,000 people and are:
- 3 to 4 times more common in men than women
- Most likely to begin between ages 20 and 40
- More common in smokers
- Sometimes run in families
Treatment Options
Acute Treatment
- High-flow oxygen therapy (100% oxygen at 12-15 L/min) - effective in about 78% of patients
- Sumatriptan injections - fast-acting relief
- Zolmitriptan nasal spray
Preventive Treatment
- Verapamil - the most commonly used preventive
- Lithium - for chronic cluster headaches
- Corticosteroids - short-term bridge therapy
- Galcanezumab (anti-CGRP) - recently approved for episodic cluster headache prevention
Tracking Your Clusters
Documenting the timing, duration, and severity of each attack is crucial for working with your neurologist. Using one of the best apps to track migraine symptoms can make this process much easier. Our migraine symptom tracker helps you log and spot patterns across all your symptoms. Tracking seasonal patterns and identifying the start of a cluster period early can help you begin preventive treatment sooner.
Start documenting your cluster patterns with the the Migraine Trail app, available free that helps you log attack timing, duration, and severity so you can track migraine triggers and share detailed reports with your neurologist.
