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How to deal with cluster headaches and the sleep cycle they disrupt
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How to deal with cluster headaches and the sleep cycle they disrupt

Cluster headaches typically last for three hours or less and may occur seven or eight times in a single day, disrupting the sleep cycle
Research shows that there is a negative impact of cluster headache on sleep, which may also manifest in sleep conditions like insomnia.

Cluster headaches are painful, one-sided headaches that cause intense pain in the eye sockets. They are rare but can last weeks, months or even years. Cluster headaches are more common in men over 30, while women are less likely to develop them. These headaches can occur 8-9 times per day and can last for weeks or months before remission. But, do cluster headaches affect sleep?

Happiest Heath in an article mentioned that cluster headaches are unpredictable and can occur on a regular basis. However, they can occur at the same time each day, typically at night, and are most common in spring and autumn. At first, scientists suspected that cluster headaches were caused by the hypothalamus, the brain’s timekeeper.

“The hypothalamus plays an important role in the timing of attacks, both in terms of time of day and time of day of year, “says, Dr Andrea Carmine Belin, a principal researcher at the Department of Neuroscience, Karolinska Institute, Sweden. Several imaging studies have shown that the hypothalamus is more active during cluster headache attacks.

Dealing with cluster headaches is difficult

39-year-old Neeraj Krishna, a senior writer from Kerala, experienced cluster headaches from 2014. He says that the pain was so intense that he had to roll on the ground and spend sleepless nights.

“My first cluster headache was not very frequent, but the attacks got worse and worse over the years, and I ended up in the hospital for a month three years ago,” he told Happiest health. He also sought multiple treatment options but couldn’t find the right doctor because cluster headaches are rare and at times, can be difficult to diagnose.

Sleep deprivation triggers cluster headache and vice-versa

Cluster headaches are diagnosed based on the individual’s experience of having severe, one-sided headaches, which can occur on daily basis lasting for weeks or months. These periods of headaches are followed by headache-free periods of several months. “The most common symptoms of cluster headaches are a stabbing sensation behind or around the eye sockets, severe headaches, a runny nose or stuffiness in the nose, and droopy eyelids,” explains Dr Sudhir Kumar, neurologist, Apollo Hospitals, Hyderabad.

The main causes of cluster headaches are sleep deprivation and sleep disorders such as sleep apnea. Shift workers in the IT industry, for example, may work on the night shift and sleep during the day, sometimes getting as little as 6-8 hours of rest. This disturbs their sleep patterns and quality, which can lead to cluster headaches.

Other factors that can cause cluster headaches include poor sleep, alcohol consumption or smoking, and even changing time zones due to temperature variations. Krishna’s sleep was affected by a series of pain attacks that occurred at any point in the day. He said, “I woke up several times during the night because of unbearable pain around the eyes and felt helpless because I couldn’t close my eyes because of the pain”.

While Krishna is yet to identify the reasons for this, he believes it could be due to his irregular sleep due to excessive screen time and irregular eating habits.

In an article published in the Journal of Headache and Pain shows that there is a negative impact of cluster headache on sleep, which may also manifest in sleep conditions like insomnia and prolonged sleep latency (time taken to fall asleep).

Misdiagnosis of cluster headache as migraine

Experts point out that cluster headaches and migraines are often mistakenly diagnosed as one another due to the similarities in the causes of both conditions. However, they emphasize that there are differences between the two neurological conditions. Cluster headaches typically last for three hours or less and may occur more than seven or eight times in a single day, whereas migraine headaches can last for up to four hours.

Additionally, the pain of a migraine attack is not as intense as that of a cluster headache, according to Dr Kumar. Similarly, Dr Srinivas Raju, consultant-neurologist, Manipal Hospital, Bangalore points out that migraine pain fluctuates throughout the day and those with migraine are sensitive to strong smells or light. However, cluster headaches are characterized by watery eyes and puffiness, as well as congestion in the nose, which is not common in migraine headaches.

Krishna also experienced a cluster headache with intense pain around the eyes, as well as feeling nauseous and puffiness.

Ways to deal with cluster headaches

Cluster headaches are a medical condition that cannot be cured. Krishna has been able to manage the pain of his headaches by utilizing oxygen therapy and adhering to healthy dietary habits. Additionally, experts and research studies suggest some effective methods for those living with cluster headaches to manage the condition:

  • Oxygen therapy
    Dr Kumar points out that individuals with cluster headaches may find relief through oxygen therapy, which involves the introduction of high flow oxygen into the bloodstream which contracts the cerebral vessels, this in turn reduces the pain of the attack.
    Research studies also showed that oxygen given at a rate of 6-15 litre per minute by a nonrebreather mask was observed to have reduced the pain in the individuals with cluster headaches.
  • Melatonin dose
    Taking melatonin supplements, which is a hormone that regulates sleep patterns, may help to reduce the occurrence of cluster headaches, says Dr Raju. Studies show that melatonin plays a major role in regulating the circadian rhythm and has been used to treat a few primary headache disorders, including migraine, cluster headaches.
  • Avoiding alcohol and smoking
    Cluster headaches cannot be prevented completely. However, experts say that certain triggering factors like alcohol intake and smoking may contribute or increase the risk of attacks. Hence, limiting alcohol consumption and abstaining from smoking may also be beneficial in managing the condition, adds Dr Raju.
  • Exercise regularly
    Regular exercise can help to improve blood circulation and improve sleep quality, thus reducing the likelihood of triggers and also reducing stress. Some studies have also shown that physical therapy interventions based on exercise seemed to have improved physical and psychological factors in individuals with cluster headaches.
  • Following a sleep hygiene
    Having a consistent sleep schedule and following a sleep hygiene can help in improving your circadian rhythm which may lead to fewer bouts of cluster headaches. Hence, it is advisable to follow a routine of sleeping and waking up at the same time every day.

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