What Triggers Cluster Headaches?

What is triggering my cluster headache?. Jupiter Images/Getty Images

It's common to hear and read about all sorts of migraine triggers in the news and on the internet. Cluster headaches too may have triggers or associations — although the 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):

Potential Cluster Headache Triggers and Links:

  • Alcohol and cigarette smoking
  • High altitudes: Flying on planes or trekking mountains
  • 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% of episodic CH patients smoked and  approximately 88% of chronic CH patients smoked.

In this same study, alcohol abuse – more than 10 drinks per day – was reported in 16.2% of episodic and 26.8% of chronic CH patients. Coffee abuse – more than 6 cups a day – was reported in 6.9% of episodic and in 36.6% of chronic CH patients.  

What Should I Do?

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 — like smoking cessation — may be paramount in reducing your headaches.

Also, consider writing a headache diary or e-diary and 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. 

Take Home Message

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.

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Article Sources
  • Cluster Headache. (n.d.). PubMed Health. Retrieved Feb 10th 2015, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001790/.
  • Manzoni GC. Cluster headache and lifestyle: remarks on a population of 374 male patients. Cephalalgia. 1999 Mar;19(2):88-94.
  • Russell MB1, Andersson PG, Thomsen LL & Iselius L. Cluster headache is an autosomal dominantly inherited disorder in some families: a complex segregation analysis. J Med Genet. 1995 Dec;32(12):954-6.
  • Sandor PS, Irimia P, Jager HR, Goadsby PJ, & Kaube H. Onset of cluster headache triggered by emotional effect: a case report. J Neurol Neurosurg Psychiatry. 2006 Sep; 77(9): 1097–1099.
  • Weaver-Agostoni J. Cluster headache. Am Fam Physician. 2013;88:122-128.