What Triggers Cluster Headaches?

It's common to hear and read about all sorts of migraine triggers. Cluster headaches, too, may have triggers or associations—although scientific research is very limited.

Similar to migraines, triggers of cluster headaches are individualized and pinpointing your precise ones can be challenging. And sometimes, triggers or associations are simply out of your control—for instance, you cannot change your DNA!

Let's review examples of cluster headache triggers and what you can do to avoid them (if possible):

• Alcohol and cigarette smoking
• High altitude
• Bright light (including sunlight)
• Physical activity
• Heat (hot weather, hot baths)
• Foods high in nitrites (such as bacon and preserved meats)
• Drinking coffee
• Nitroglycerin (a medication used to alleviate chest pain in those with heart disease)
• Cocaine
• History of head trauma
• Genetics (Autosomal Dominant Gene in some families*)
• Possibly severe emotional distress (one case study**)

Smoking may be the biggest trigger associated with cluster headaches. One study of 374 sufferers of cluster headaches (CH) found that approximately 79 percent of episodic CH patients smoked and approximately 88 percent of chronic CH patients smoked.

In this same study, alcohol abuse—more than 10 drinks per day—was reported in 16.2 percent of episodic and 26.8 percent of chronic CH patients. Coffee abuse—more than six cups a day—was reported in 6.9 percent of episodic and in 36.6 percent of chronic CH patients.  

Remember, associations don't mean that one habit, like smoking or drinking coffee, causes cluster headaches. It's a complicated interaction, and it's more likely that an interplay of multiple triggers, your genes, and your environment makes you prone to cluster attacks.

That being said, if you find that a particular trigger is linked to your cluster headaches, discuss it with your doctor. A habit change or lifestyle modification may be paramount in reducing your headaches.

Also, consider writing a headache diary recording your daily activities like:

• meals
• sleep hours
• any medications or supplements you take
• alcohol consumption
• smoking habits
• coffee drinking
• exercise regimen
• any change in your daily routine, like taking a vacation or attending a holiday dinner

Like migraines, cluster headaches are treated with an integrated approach, including preventive medications and lifestyle modifications. If you do suffer from cluster headaches, be sure to find a good neurologist or headache specialist to help you cope and manage your attacks. You are not alone. Seek guidance and remain proactive in your headache and overall health.