Why does oxygen work?

[CHsince99]

High-flow oxygen works in 10 minutes for me every time.  But why?  What is it doing?

1.  By constricting blood vessels, does it reduce the pain signal sent to the brain?

2.  By constricting dilated blood vessels, does the oxygen relieve pressure on the irritated nerve?

3.  By causing a different mix of neurotransmitters, does it calm the activity of the irritated nerve?

4.  Something else?

 

[CHfather]

Here's something from 2019: https://pmc.ncbi.nlm.nih.gov/articles/PMC7802413/

 

      "As previously mentioned, it is still unclear why oxygen exhibits such good efficacy in the treatment of CH. The vasoconstrictive theory was prevalent in the early 20^th century until Wolff et al. found that ergotamine constricted external carotid arteries and simultaneously relieved migrainous headaches.20 Therefore, they proposed that headache is caused by vasodilation rather than vasoconstriction. The study was published in 1938 and overturned the past theory.20 In 1961, Horton7 proposed that histamine cephalalgia was caused by the vasodilatation of extracranial vessels, and that oxygen was a vasoconstriction factor. If the vasoconstrictive effect of oxygen exists, oxygen therapy should be effective for both migraine and CH. However, the oxygen treatment is only effective for CH. In the 1980s, some studies reported a decrease of cerebrospinal flui in patients after breathing 100% oxygen as compared to breathing room air.21 Since then, animal model studies have demonstrated the protective, anti-inflammatory role of hyperoxia in microcirculatory inflammation. In 2006, Schuh-Hofer et al.11 demonstrated that hyperoxia can inhibit dural plasma protein extravasation in rats. Recent studies have suggested that CH is associated with some brain structures, including the trigeminovascular system, the cranial autonomic system, and the hypothalamus. The activation of the trigeminovascular system is thought to play an important role in the pathophysiology of CH. Goadsby and Edvinsson22 attempted to demonstrate the associations between hyperoxia and neuropeptides, and the results indicated that a significant reduction of calcitonin gene related peptide concentration in the jugular vein after oxygen treatment occurred, which suggests a possible effect of hyperoxia on trigeminal afferents. However, animal experiments have shown that oxygen does not directly act on trigeminal afferents, but appears to play a key role at the parasympathetic pathways.23 At present, studies assume that oxygen may act as a terminating factor in CH attacks. More research is needed to clarify the specific mechanisms of oxygen treatment for CH.

Table 1.

The history of oxygen used for cluster headache

Study	Year	Findings
Alvarez et al.15	1940	First use of oxygen for headache at a flow rate between 6 and 8 L/min.
Horton16	1952	First description of oxygen used for histamine cephalalgia.
Horton17	1955	Oxygen treatment in 1176 patients with histamine cephalalgia.
Horton7	1961	He raised the vasoconstrictive effect of oxygen in histamine cephalalgia.
Kudrow et al.18	1981	First systematic study on oxygen used for cluster headache.
Fogan et al.12	1985	Crossover study found that oxygen was more effective than room air.
Cohen et al.19	2009	Oxygen at 12 L/min, as well as at 7 L/min, was effective.

Open in a new tab

Figure 1.

Open in a new tab

The possible mechanism of oxygen in cluster headache.

Note: TCC: Trigeminal cervical complex.

 

[CHsince99]

Hmm.  That makes me think it's option 4.  Maybe oxygen works because it hyperoxia (too much oxygen) reduce adenosine levels.  (See below study.)  

https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2020.00097/full

[andrew zappara]

when the blood vessels become inflammed and dialated they put pressure on the trigeminal nerve which then sends pain signals through the nerves in your face so pure medical oxygen reduces the inflamed blood vessels and return them back to normal and once they are no longer pressing on the trigeminal nerve the pain goes away quiet quickly.since i have started using cbd oil which is a powerful inflamitory i dont even use oxygen theropy any more they have compltely stopped

[CHsince99]

Thanks, Andrew.  Would you please give me a recommendation on the CBD oil to try?  

[andrew zappara]

in Australia its called humacology i get drug tested alot with my job so had one with 0THC,270mgCBD,60mgCGB,10mgCBN oil

[jon019]

...if you are subject to drug testing it is wise to be EXTREMELY careful with CBD in any form. it is NOT FDA regulated and packaging labelling is notoriously incorrect in this area. 

...not to say ineffective...i know not....just go in eyes wide open. even strictly regulated N/A beer has 0.5% alcohol in it...i would be surprised if many/most CBD products don't contain some amount of THC...

Edited January 11 by jon019