Cluster Headache

Attacks of severe, unilateral, typically retro-orbital head pain that occurs in “clusters” around the same time of day/year. Attacks are often associated with eye tearing and last < 4 hours in duration. An individual can have multiple attacks per day during a cluster cycle.

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Cluster headache is an incredibly rare headache condition that affects 0.1% of the population. Studies have shown that 1st degree relatives of those with cluster headache are 18 times more likely to also suffer from cluster headache. Cluster headache occurs in “cycles” that can last, on average, anywhere from 2 weeks to 3 months (sometimes longer!). An individual can enter a cluster “cycle” at any time, but the most common time people enter their cluster “cycle” is surrounding the longest and the shortest days of the year. During a cluster “cycle,” an individual has cluster “attacks” that can last anywhere from 45-60 minutes on average – by definition, the attacks never last more than 4 hours. Likewise, during a cluster “cycle,” an individual can have, on average, 1-3 “attacks” per day (and sometimes more). Once a person exits their cluster “cycle,” they will not have anymore cluster headache “attacks” until they enter their next “cycle.” This could be anywhere from several months to several years later.

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The most common age of onset of cluster headache is around 30 years of age and men are three times more likely than women to suffer from cluster headache. Likewise, there is a high preponderance of cigarette smoking reported in people with cluster headache – some studies showing upwards of 88% of people diagnosed with cluster headache also partaking in cigarette smoking.

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Cluster headache attacks tend to cluster together around the same time of day AND the same time of the year for most individuals. It is thought that the hypothalamus (which is the body’s “circadian clock”) is involved in the generation of cluster headache. This involvement would explain the headaches occurring “like clockwork” around the same time of day and time of year. For example, a classic time for a cluster attack to occur is about 90-120 minutes after falling asleep. This correlates with the body’s first REM period of the night.

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