The straight facts on cluster headaches

Cluster headaches are one of the most painful kinds of headaches. These monsters appear suddenly on one side of the face, often starting behind or around one eye and can last up to 90 minutes. They can occur many times per day for weeks, months, or even a year. Here is what you need to know about these debilitating headaches.

The pain is sharp and burning and it seems to only increase when lying down. Many people prefer to stand, walk around, or even exercise. The headaches often begin during the dream, or REM, sleep cycle, revving up the autonomic nervous system, which regulates blood pressure, heartbeat, and body temperature. As a result, you may sweat, have a stuffy nose, and tearing, red eyes. Many people try to forestall the headaches by staying awake, which compounds the problem by creating chronic fatigue, which can then spiral into depression.

Although many doctors believe that cluster headaches are related to migraines, what causes them is unclear. Some doctors think they may result from a burst of histamine (a chemical released during allergic reactions) or serotonin, a brain chemical that constricts blood vessels. The hypothalamus, the part of the brain that operates the body clock, may also be involved, which may explain why the headaches tend to occur at the same time each day. Triggers include heavy smoking, drinking, and drugs such as nitroglycerin, a heart medication.

The headaches are rare, striking less than one half of one percent of adults and five times more men than women, usually between ages 20 and 40. Fortunately, medication and prevention can help reduce both frequency and severity. Sumatriptan, a triptan medication, helps relieve at least 74 percent of acute cluster headaches within 15 minutes.

Your doctor can help you control both how often you get the headaches and the level of pain once they arrive.