High-Flow Oxygen Treats Cluster Headaches

Study Shows Oxygen Treatment Provides Pain Relief Without Side Effects

By Jennifer Warner
WebMD Health News

Reviewed By Louise Chang, MD

Dec. 8, 2009 -- A drug-free option for relief from painful cluster headaches may be just a breath away.

A large new study offers the best evidence to date backing the use of high-flow oxygen treatment for cluster headaches. Researchers found 78% of people who received oxygen treatment reported being pain-free or having adequate pain relief within 15 minutes of treatment.

Researchers say oxygen treatment for cluster headaches is already a part of accepted treatment guidelines, but its use has been limited by a lack of high-quality studies supporting its effectiveness.

Cluster headaches affect about 0.3% of the population and are characterized by bouts of excruciating pain, usually near the eye or temple on one side. The attacks can last from 15 minutes to three hours without treatment and may occur several times a day.

The most effective treatment for cluster headaches is injection with the triptan drug Imitrex, but use is limited due to potential side effects. Use of the drug is also not recommended in people with medical problems like coronary heart disease.

The study, published in The Journal of the American Medical Association, involved 76 adults with cluster headaches. The participants treated four cluster headache episodes alternately with either high-flow oxygen through a face mask for 15 minutes at the start of an attack or regular air through a face mask. Patients did not know which treatment they were receiving during each episode.

More than three-fourths of attacks among those who received oxygen treatment were pain-free or had adequate pain relief within 15 minutes of treatment compared with 20% of attacks treated with air. Oxygen treatment was also superior to the placebo air treatment for pain relief at 30 and 60 minutes after the start of the cluster headache attack.

Unlike with triptan drugs commonly used in cluster headache treatment, no adverse side effects were associated with the oxygen treatment.

"This work paves the way for further studies to optimize the administration of oxygen and its more widespread use as an acute attack treatment in cluster headache, offering an evidence-based alternative to those who cannot take triptan agents," write researcher Anna S. Cohen, PhD, of the National Hospital for Neurology and Neurosurgery in London, and colleagues.

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SOURCES: Cohen, A. The Journal of the American Medical Association, Dec. 9 2009; vol 302: pp 2451-2457.

News release, American Medical Association.

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