Oxygen as an acute treatment for cluster headaches
We encounter many cluster patients that come to us stating that they had tried oxygen and it didn’t work for them in the past. When we work with them, they almost always are able to make it the most effective acute treatment they have. Once its working for them, their tanks and set ups are the most valued asset.
There are several long used oxygen protocols that are prescribed by doctors when they write a prescription. One of the oldest protocols calls for a flow rate of 7-10 LPM with a non-rebreather mask, for 15 minutes.
Some doctors continue to use this out of date protocol. If they continue to work with the patient and increase the flow rates they are able to sometimes come to a rate that is successful. Unfortunately, the problem with this protocol is that many patients start and end with trying 7 LPM (Liters per minute) and think that 02 doesn’t work for them. They then go years or a lifetime never giving 02 a chance again.
We at Clusterbusters recommend prescriptions be written for a minimum of 12-15LPM. Most medical supply companies that supply home oxygen do not have regulators that go higher than 15LPM.
If this regulator does not supply a large enough flow rate for very effective treatment, ending an attack in 15 minutes or less, we suggest the patient locate a new regulator online and purchase this regulator. Order one that fits your tanks supplied by your 02 supplier.
In addition, for best results, rather than using a standard non-rebreather mask, we suggest patients order a new mask online. These are available at clusterheadaches.com for a reasonable cost. These masks do not have any vents on the sides and provide an airtight, comfortable fit.
Best breathing techniques can vary but each individual should test out different procedures until they discover which one is best for them.
- Always keep flow rate high enough to make sure the attached bag never deflates completely but low enough to not waste extra oxygen.
- It’s best to use a regulator that goes up to 25LPM or use what is called a demand valve. This type of valve does not use a bag to collect the oxygen but allows direct flow from the tank for as deeply and quickly you want to breathe.
- Sit up straight if you are using in a seated position. This allows your lungs to expand fully and inhale as much fresh 02 as possible.
- Breathing can be done in two or more ways. Some people prefer to breath a bit slower to help relax and to help stay calm during the attack. Still breath deeply and exhale completely.
Others have the best results by breathing as quickly as possible, nearing hyperventilation. In this case its still important to breath deeply and exhaling completely. - There are many theories regarding what the process is that aborts the attack. One that seems most likely is not the increase in blood/oxygen ratio as this is very difficult to make much of an change no matter how much you inhale, but the elimination of carbon dioxide by flushing it out with pure oxygen.
- If you still have not completely eliminated the attack after 15 minutes, it is still safe to stay on the oxygen until the attack ends. There is no fear of side effects or any type of damage caused by staying on 02 for an extended period. Fighter pilots stay on pure 02 for 8 or more hours without any issues.
- If you have problems with attacks seeming to occur soon after aborting an attack with 02, you should be sure to stay on the 02 for a few minutes after the pain is completely gone.
Additional information can be found on our website www.clusterbusters.org in the resources section. Included are ordering instructions for regulators as well as finding the proper 02 mask.
Bob Wold 11-17-2018