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The improved efficacy of oxygen therapy in aborting CH is based on lowering the partial pressure of arterial CO2 (PaCO2) through hyperventilation either with 100% oxygen or with room air for at least 30 seconds followed by a lung full of 100% oxygen that's held for 30 seconds. Breathing 100% oxygen at 7 to 9 liters/minute will actually make cluster headache worse if the user is animated by the CH pain. The extra physical activity coupled with a restricted level of lung ventilation causes PaCO2 to rise and systemic pH to drop (more acidic). This stimulates vasodilation further aggravating CH. Blowing off CO2 faster than the body generates it through normal metabolism by intentionally hyperventilating drives the cardiovascular system into respiratory alkalosis... (Remember the Andromeda Strain)? During respiratory alkalosis several things happen. As the PaCO2 levels drop, the blood becomes less acid so pH rises. This drop in PaCO2 and elevated pH are sensed by chemical receptors in the Aortic and Carotid bodies and the brain stem. They in turn signal the breathing center to slow the rate of respiration, the heart to beat slower and the circulatory system's arteries and capillaries to constrict. This response is part of what's called pH homeostasis, a feedback control mechanism the body uses that tries to maintain optimum levels of PaCO2 and PaO2. However as we are intentionally hyperventilating, this increases the vasoconstriction. The elevated pH (more alkaline) also causes blood hemoglobin to have a greater affinity for oxygen so each molecule of hemoglobin becomes capable of attracting and holding more molecules of oxygen... up to 12% more oxygen than during normal respiration. This results in a super-oxygenated flow of blood to the brain. When the increased level of vasoconstriction caused by a low PaCO2 and elevated pH is coupled with super-oxygenated blood flow, we experience rapid and reliable CH aborts. Bottom line... If you want fast and reliable CH aborts, ya gotta be huffing and puffing like a big bad wolf trying to blow down the pig's houses of straw and sticks... It's hard work... but well worth the extra effort. One word of caution. Do not hold the lungful of 100% oxygen longer than 30 seconds. The reason for this is simple. Our bodies are running like a car's engine producing exhaust... in our case, CO2. Although there's sufficient oxygen in the lungful of 100% oxygen to hold your breath for over a minute... the level of CO2 or PaCO2 starts climbing as soon as you stop hyperventilating and hold your breath. If you hold your breath for more than 30 seconds, the level of CO2 rises above normal and this triggers vasodilation... In the scheme of Good and Bad things... That's Bad for CHers as vasodilation increases CH pain and prolongs the abort process. Take care, V/R, Batch

Batch, Thanks for the information very informative. I just checked how long it takes for my O2 bag to fill using 8 Lpm. It takes 11 seconds. The huffing method works for me but it takes much longer. Is 11 seconds of holding the O2 in dangerous to me? I do not want to be giving bad advice.

I've been using a large bag since Ben Khan first developed the clustermasx back in 2002/3 i also have my optimask set up in the clustermasx configuration, Bens original intent was the bag out the front using a mouthpiece so that the user then had both hands free to do injections etc , the photo shows how to configure it zany