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Patients with cluster headaches are usually taught to recognize the warning signs that a head pain may be a CH and to take immediate precautions. They are taught to take a quick pain-free breath (PFB) as a way to determine if an attack is starting. They should try to move in a way that avoids the pain. If a person has difficulty doing that, they should take a PFB, try to identify the symptoms and go back to bed to wait for the pain to pass.
In most cases, cluster headaches occur more often at night than during the day, and more often in the spring and fall. Headaches also often occur at the same time every day. The headaches usually last approximately 30 minutes, but can last as long as two hours and uncommonly longer. The pain of a cluster headache is deep, agonizing, usually non-throbbing and affects only one side of the head (unilateral). The area of the head or face involved is always the same from day to day, but occasionally switches to the other side before a cluster ends entirely. The cluster can switch sides with the next onset of attacks. The pain usually occurs in the eye socket area (orbit) and spreads to affect the face, temple and/or forehead. Often the headache is tolerated better by moving, pacing, rocking or even banging their head and usually not by remaining still. They may be irritable and aggressive. When the headache passes, affected individuals may fall into a deep sleep only to be awakened again by another headache. This may continue several times a day, sometimes for weeks or months. Some affected individuals may be unable to continue a normal work schedule. It is important to note that both drinking alcohol and smoking can act as triggers and can bring on attacks in persons who suffer from CH.
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