High-flow oxygen inhalation therapy for cluster headaches

Examples

100% oxygen inhaled through a face mask

How It Works

Oxygen is given at a high flow rate of 6 to 7 liters a minute for 10 to 20 minutes at the start of a cluster headache.

It is not clear how inhaling oxygen relieves headache pain. It probably works by narrowing blood vessels, which leads to reduced pressure and inflammation associated with cluster headaches.

Why It Is Used

High-flow oxygen inhalation therapy is used to treat cluster headaches. If headache pain is not relieved within 20 minutes, oxygen therapy should be stopped.

High-flow oxygen therapy does not prevent a cluster headache—it only provides temporary relief of headache pain.

How Well It Works

Oxygen therapy relieves headache pain within 10 to 20 minutes in about 7 out of 10 people who use it immediately after a cluster headache starts.1

This therapy seems to work best for people who are under the age of 50 and who have occasional (episodic) cluster headaches. When oxygen therapy is started at the beginning of a cluster headache, it often stops the attack.2 You will need to repeat the procedure when the next headache begins.

Side Effects

High-flow oxygen inhalation therapy usually causes no side effects. But it may be difficult to sit still to receive oxygen therapy during a painful cluster headache.

What To Think About

The major drawback of this therapy is that you must have continuous access to an oxygen tank because you usually don't know when a cluster headache will occur. It may be inconvenient to keep oxygen on hand all the time. Ergotamine medicines may be easier to use when headaches occur at times when you are not at home.

If needed, oxygen can be combined with cluster headache medicines (such as sumatriptan) for the most effective treatment. Oxygen also may be combined with preventive medicines to reduce how often you get headaches.

Oxygen may increase the risk of fire if it is used near an open flame, and it cannot be safely stored or used if you are smoking or if you are near a flame of any kind (lit fireplace or gas stove).

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References

Citations

  1. Evans RW (2003). Headaches. In Saunders Manual of Neurologic Practice, pp. 25–32. Philadelphia: Saunders.
  2. Ekbom K, Hardebo JE (2002). Cluster headache: Aetiology, diagnosis, and management. Drugs, 62(1): 61–69.

Last Updated: April 11, 2008

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