Overview
A cluster headache is an uncommon type of headache. It causes severe pain on one side of the face, often around the eye, along with tearing, a red eye, a droopy eyelid, or a stuffy nose on the same side.
Attacks often strike 2 to 3 hours after falling asleep and tend to happen at the same time each day. They come in cluster periods that can last weeks to months, separated by pain-free periods of at least a month. Some people have chronic cluster headaches that go on for a year or more.
Symptoms
Pain starts suddenly and is often described as burning, sharp, or stabbing.
- Headache on one side of the head, very severe
- Pain behind or around one eye
- Watery eye or droopy eyelid on the same side
- Red eye or stuffy, runny nose on the same side
- Restlessness or pacing during attacks
Less common
- Swelling around the eye
- Attacks several times a day
How it usually goes
- 5 to 10 minutes: Pain reaches its worst.
- 30 minutes to 2 hours: Strongest pain lasts this long.
- Weeks to months: Daily attacks in a cluster period, then pain-free for at least a month.
When to get medical care
Causes
Doctors don't know exactly what causes cluster headaches. A part of the brain called the hypothalamus may play a part. Alcohol, smoking, high altitude, bright light, heat, exercise, nitrite foods, and some medicines can trigger attacks.
Does it spread or run in families?
- It isn't contagious. You can't catch it from someone else.
Who is more likely to get it
- Being male
- Smoking
- Alcohol during a cluster period
Diagnosis
A healthcare professional can usually diagnose it from your symptoms and an exam. Tests may be done to rule out other causes.
Questions you may be asked
- Where the pain is and how bad it is
- How long attacks last and what time they start
- Eye or nose symptoms on the same side
- Restlessness during attacks
- Alcohol and smoking
The exam
They'll check your eyes, nerves, and reflexes. During an attack, the eyelid may droop and the pupil may look small.
Tests
Tests may include:
- Brain MRI or CT scan: To rule out other causes of headache.
Treatment
Treatment doesn't cure cluster headaches but can stop attacks and help prevent them.
Self-care
- Avoid alcohol during a cluster period
- Don't smoke
- Keep a headache diary of when attacks start, how long they last, and what stops them
- Keep a regular sleep schedule
- Avoid other triggers, like heat, bright light, and nitrite foods (bacon, preserved meats)
Medicines
Cluster headache treatment needs a prescription.
| Medicine | Helps with | Good to know |
|---|---|---|
| Oxygen | Stops many attacks quickly, with few side effects | Needs a prescription and equipment. Keep away from flames and smoking. |
| Triptans | Stops an attack fast | Not for people with some heart or blood vessel problems. Limits on how often you can use them. |
| Preventive medicines | Fewer attacks during a cluster period | Your doctor will taper them off when the cluster ends. |
Over-the-counter pain relievers usually don't help because the pain peaks before they work.
Regular pain pills usually don't work because they act too slowly. Your doctor may prescribe oxygen to use at home, fast-acting triptans, and medicine to prevent attacks during a cluster period. A nerve stimulator is an option if nothing else works.
How it compares
| Cluster headache | Migraine | Tension headache | Trigeminal neuralgia | |
|---|---|---|---|---|
| Pain | Very severe, around one eye | Throbbing, often one side | Tight band, both sides | Electric shocks in the face |
| Eye and nose | Tearing, droopy lid, stuffy nose | Light sensitivity | None | None |
Prevention
You may lower the number of attacks:
- Avoid alcohol during cluster periods
- Don't smoke
- Keep regular sleep times
- Take preventive medicine if prescribed
Which doctor treats this
- Start with your primary care provider (family doctor or internist).
- They may send you to a neurologist (brain and nerve doctor).
Living with it
- Keep a simple diary of symptoms, triggers, and medicines to bring to visits.
- Bring a list of your medicines and questions to each visit.
- Stay active in ways that feel good to you.
- Get enough sleep and manage stress.
- Long-term illness can affect mood. Tell your doctor if you feel down or anxious.
Back to school, work, or sports
- Most people can keep working or going to school.
- Ask about changes that help, like extra breaks or a flexible schedule. Workers may be covered by the ADA. Students may get a 504 plan.
Children, pregnancy, and older adults
- Pregnancy: Oxygen may be an option. Talk with your doctor about safe treatments.
- Older adults: Triptans may not be safe with heart problems; oxygen may be an option.
Pregnancy and breastfeeding
- If you're pregnant or planning to be, tell your prenatal provider about this condition.
- Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
- Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
- Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.
For caregivers
- Go to visits when you can and take notes.
- Keep a list of medicines, allergies, and doctors in one place.
- Learn the warning signs that need fast care.
- Take breaks and ask for help. Caregivers need care too.
Outlook
Cluster headaches can come and go for years. Treatment can stop attacks and make cluster periods easier.
Getting ready for your visit
A headache diary is very helpful.
What to bring
- Dates, times, and length of attacks
- Eye and nose symptoms
- Alcohol, smoking, and other triggers
- Medicines you've tried
Questions to ask
- Is this a cluster headache?
- Can I get oxygen at home?
- Which medicine should I use during an attack?
- How can I prevent attacks?
Research studies
Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.
Sources
Last updated 2026-11-12.