Cluster headache relieved with high flow oxygen

Kathleen Blanchard's picture

A new report shows that treating cluster headache with high flow oxygen. Results of the study compared high flow oxygen to placebo in 109 individuals with cluster headache that revealed 78 percent of patients were pain free or obtained some relief within fifteen minutes after receiving the oxygen therapy. Cluster headaches are cyclical, meaning they can be absent for long periods of time. They can last from one to twelve weeks, and follow an established pattern, such as seasonally.

Cluster headaches are characterized by pain that can be severe. The pain usually occurs on one side, and might be isolated in or around the eye, or extend to the head, face, shoulders or neck. Cluster headaches happen suddenly, and can be incapacitating. Tearing and drooping of the eyelid can occur.


The patients in the study either received air, or high flow oxygen delivered with a face mask at 12L/min, at the onset of four episodes of onset of headache symptoms. According to the study authors, “To our knowledge, this is the first adequately powered trial of high-flow oxygen compared with placebo, and it confirms clinical experience and current guidelines that inhaled oxygen can be used as an acute attack therapy for episodic and chronic cluster headache.”

The placebo group reported twenty percent reduction in cluster headache pain, compared to 78 percent of those given high flow oxygen. Therapy was delivered for fifteen minutes. No side effects were found from the high flow oxygen therapy treatment.

Cluster headaches are often treated with triptans, a class of drugs known as serotonin receptor agonists, used to treat migraines. An example is sumatriptin, marketed under the brand name Imitrex. Some patients cannot tolerate triptans because of side effects that include flushing, weakness, dizziness or drowsiness, High flow oxygen could prove to be an alternative treatment for relieving cluster headache, pending further studies.

JAMA. 2009;302[22]:2451-2457