Cluster Headaches

Cluster headaches are a severe form of headache.  The headaches are sometimes called “alarm clock” headaches. This is because they tend to occur at the same time of day or night, and can occur for weeks to months. They also usually take place during the same time of year. The periods of time when the headaches occur are called “clusters.”  The headache periods, or clusters, can then go away completely for months or years.

Cluster headaches are not common. Men are more likely to get them. The exact cause of cluster headaches is not known.


The pain of cluster headaches can be very strong. It almost always occurs on one side of the head, and stays on that side during the period of attacks. When another period starts, the headaches can occur on the opposite side.

The pain is severe and constant, and does not throb. It happens in and around the eye on the affected side. This may cause watery eyes, drooping eyelids, or vision problems on the same side of the head as the headache. It often goes into the forehead, temple, and cheek as well. The pain may leave as quickly as it began. Or it may fade away slowly.


Your healthcare provider will check your medical history and give you a physical exam. In some cases, other tests may be done, such as blood tests or imaging tests.

Medication is the most common treatment for cluster headaches.

A drug called sumatriptan, may be given as an injection. This drug causes blood vessels in the brain to narrow, which helps relieve the pain.

A local anesthetic called lidocaine is sometimes used to treat a cluster headache that is already occurring. It is put inside the nose.

Some medications are given to prevent future headaches. One type is a medication called a calcium channel blocker, such as verapamil. These drugs relax blood vessels. Another medication is ergotamine tartrate. This medication is sometimes used with caffeine to help prevent cluster headaches that occur during the night time. Prednisone may also help prevent headaches.

If you get frequent breakthrough headaches, you may have oxygen therapy prescribed to use at home. Oxygen inhalation through a mask can be used at the beginning of an attack.

It’s also important to avoid things that can trigger a cluster headache. Common triggers include alcohol and tobacco. High altitudes and strenuous exercise are triggers, as well.

When cluster headaches don’t respond to any treatment, surgery may be an option. Ask your healthcare provider about the types of surgery that may help.

What We Have Learned

  1. Cluster headaches usually happen throughout the year. True or False?
    The answer is False. Cluster headaches typically occur at the same time of day or night and usually occur during the same time of year.

  2. Headache periods typically last 1 to 2 weeks. True or False?
    The answer is False.  Headache periods can last for months.

  3. Nothing can be done to prevent cluster headaches. True or False?
    The answer is False. There are medications that can prevent attacks, and common triggers can also be avoided.