Cluster headaches are also common in people who smoke
and drink alcohol frequently and a large proportion of the patients have sleep apnea.
During a cluster period, the sufferer is more
sensitive to the action of alcohol and nicotine, and minimal amounts of alcohol
can trigger the headaches. During headache-free periods, the patient can consume
alcohol without provoking a headache.
Smoking can also increase the severity of cluster headaches during a cluster period.
What are the symptoms of a cluster headache?
Cluster headaches generally reach their full force
within five or ten minutes after onset. The attacks are usually very similar,
varying only slightly from one attack to another.
Type of pain
The pain of cluster headache is one-sided, and during
a headache period, the pain remains on the same side. When a new headache period
starts, it rarely occurs on the opposite side.
Severity/intensity of pain
The pain of cluster headache is generally very intense
and severe and is often described as having a burning or piercing quality. It
may be throbbing or constant. The pain is so intense that most cluster headache
sufferers cannot sit still and will often pace during an attack.
Location of pain
The pain is located behind one eye or in the eye
region, without changing sides. It may radiate to the forehead, temple, nose,
cheek, or upper gum on the affected side.
The scalp may be tender, and the pulsing in the arteries often can be felt.
Duration of pain
The pain of a cluster headache can last anywhere from
a 15 minutes to three hours. In general, the headaches last for 30 to 90
minutes. The headache will disappear only to recur later that day. Typically, in
between attacks, people with cluster headaches are headache free but the pain
can sometimes linger.
Frequency of headaches
Most sufferers get one to three headaches per day
during a cluster period (the time when the headache sufferer is experiencing
daily attacks). They occur very regularly, generally at the same time each day,
and they often awaken the person at the same time during the night.
The cluster periods can last from two weeks to three
months and then disappear completely for months or years. The episodic cluster
headache sufferer has variable pain-free intervals between headache attacks.
Attacks appear to be linked to the circadian (or
"biological") clock. Most people with cluster headaches will develop cluster
periods at the same time each year -- either in the spring or fall or the winter or summer.