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Inhaled Oxygen Shown Effective for Cluster Headaches

by Teri Robert, Lead Expert

Cluster headaches are so painful that they've been called "suicide headaches." At this time, the only treatment that's FDA approved for the acute treatment of cluster headaches is subcutaneous sumatriptan (Imitrex injection).

For quite some time, cluster headache sufferers have been using inhaled oxygen and reporting that it often aborts a cluster headache. However, there has been little proof of this in medical literature, and getting a tank of oxygen has been difficult for many cluster sufferers. At times, this has been because their doctor didn't think it would work and didn't want to prescribe the oxygen. More frequently, however, it has been a matter of expense and insurance companies denying coverage.

Study results published in JAMA, the journal of the American Medical Association, have finally provided evidence that inhaled oxygen does work for some cluster headache sufferers.

Study Objective:
"To ascertain whether high-flow inhaled oxygen was superior to placebo in the acute treatment of cluster headache."1

Study Methods:

  • The study was double-blind, randomized, and placebo-controlled* trial

  • There were 109 adult participants, aged 18-70 years.
  • All participants were diagnosed with cluster headache as defined by the International Headache Society.
  • Participants treated four cluster headache episodes with high-flow inhaled oxygen or placebo (air in the tank), alternately.
  • Participants were randomized to the order in which they received the active treatment or placebo.
  • Participants were recruited and followed up between 2002 and 2007 at the National Hospital for Neurology and Neurosurgery in London, England.
  • High-flow oxygen at 100%, 12 L/min, or placebo was delivered by face mask, for 15 minutes at the start of an attack of cluster headache. This was done alternately for 4four attacks.
  • Participants could take rescue medications if they received no relief after 15 minutes of treatment.

Study Outcome Measures:

  • The primary endpoint of the study was for the participant to be pain free, or in the absence of a diary to have adequate relief, at 15 minutes.
  • Secondary endpoints measured included
    • Participant being pain-free at 30 minutes
    • reduction in pain up to 60 minutes
    • need for rescue medication 15 minutes after treatment
    • overall response to the treatment
    • overall functional disability
    • effect on associated symptoms
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