Oxygen Treatment for Cluster Headaches
Oxygen treatment for aborting Cluster Headaches has been proven to be an effective, safe, and relatively cheap method for many sufferers. Some people do not respond to this treatment, just as some do not respond to the many drugs prescribed. There are many reasons for this, including improper usage. As with any treatment, there are risks involved.
Why does it work?
Your brain very closely monitors the amount of oxygen it receives, so it always gets the right amount. When it starts to get too much, it simply constricts the blood vessels that supply it with oxygenated blood. Because Cluster headaches are from Dilated blood vessels applying pressure the the Trigeminal Nerve, this command from the brain to constrict them thus aborting an attack typically within 5-10 minutes.
Oxygen therapy may help with the management of cluster headaches, but it does not help prevent future episodes. Typically the oxygen is delivered via a non-rebreather mask at 25-40 litres/minute, 100% O2, for 15–20 minutes. Around 70% of patients improve within 15 minutes.
More information: oxygensolutions.com.au
Equipment General Information
It is very important that this be used correctly and safely. The air we breathe is composed of approximately 79% nitrogen and 19% ambient oxygen-the other 1-2 % is rare gasses like argon, ozone, carbon monoxide (if you live in the city) , etc.
It is important to start the therapy at the very first sign of an onset of the headache. The sooner, the better. If you wait, you will suffer more.
You must have a place that has NO open flames- NO SMOKING cigarettes, NO candles, NO fire! Oxygen can saturate your clothing, bedsheets, etc. and then catch on fire when you light a match. Be very careful and wait a while before smoking.
- Oxygen supply
tank of oxygen--preferably medical grade
- A regulator that will deliver up to 15 litres per minute.
Inhaled oxygen with high-flow (10 to 15 litres per minute) 100% normobaric oxygen breathed through a mask is efficient and useful especially when contra-indications to triptans exist. The efficacy of oxygen has been recently re-examined and confirmed. There are no contra-indications or limitations for the use of oxygen. [ref]
- Non-rebreather mask
The type that covers your mouth and nose and has a bag to conserve the oxygen
A "Non-rebreather" O2 mask explanation
- Demand Valve System (optional, but HIGHLY recommended)
More expensive, but highly effective. A special valve that incorporates the use of an additional fitting on a regulator to provide an un-interrupted flow of oxygen when needed. The oxygen flow shuts off when you are not actively breathing through the mask, optimizing the tank.
cut off any elastic band that will hold the mask onto your face. you don't want to fall asleep with the mask attached, as you cpould suffocate.
The amount of time to breathe the oxygen is important, also. If you do not get relief in 15-20 minutes of treatment, you will probably not get relief for that headache by further use.
- A "bubbler" bottle
Optional - it adds moisture to the oxygen will help your sinuses and throat from dryness and irritation. If you are ordering from a catalog or medical supply place, it is called a disposable humidifier.
It is necessary to have a prescription from your GP to use oxygen. This therapy is VERY effective. Please encourage your GP to prescribe it and teach you to use it effectively.
Safety precautions with use of oxygen cylinders
- Store oxygen cylinders in a cool, ventilated room
- Do not cover cylinders with cloth or plastic
- When a cylinder is almost empty, close the valve and mark the cylinder as empty
- Do not store full and empty cylinders together
- Handle cylinders carefully to avoid dropping
- Do not permit oxygen use near an open flame
- Keep oxygen equipment and delivery point at least 3 metres from radiators or other heat sources
- Do not permit smoking near oxygen equipment
- Do not permit alcoholic solutions, oil or grease to come in contact with oxygen supply devices
- Use the correct regulator and pressure gauge
- Before connecting the regulator, open the cylinder momentarily, with the valve pointing away, to remove any dust which may be in the outlet
- Check with the State Department of Transport regarding the transport of oxygen cylinders in cars as the safety standards may vary from state to state, but always secure a cylinder carefully if transporting in a car to prevent it becoming a projectile or explosive device
- If electrical appliances, e.g. electric blankets, are in use, ensure their regular maintenance
For however lonmg it takes to get rid of the CH, keep breathign the oxygen afterwards for the same amount of time. If not, it might come back and be twice as difficult to get rid of.
Get on the Oxygen the moment you feel it coming. Drop whatever you are doing, and waste no time. The sooner you start the oxygen, the easier it will be to kill the CH.
In practice, 15 liters/minute is the minimum effective oxygen flow rate used by most successful oxygen therapy users – the really successful oxygen therapy users have oxygen regulators capable of delivering 25 liters/minute or higher. Any flow rate less than 15 liters/minute, for example at 7 to 9 liters/minute, can easily result in a build up of CO2 due to the increased physical activity associated with the cluster headache attack AND the restricted respiration rate caused by the non-rebreather mask. All this results in a situation where you cannot achieve an abort with oxygen therapy when the respiration rate is constrained by using low oxygen flow rates administered with a non-rebreather mask.
Although an oxygen flow rate of 7 to 9 liters/minute will easily result in a hemoglobin oxygen saturation at or near 100% under normal conditions, a respiration rate constrained to this flow rate by using a non-rebreather mask will result in a CO2 build up well above normal and displace or not leave room for oxygen molecules to attach to the hemoglobin in each red blood cell. In short, while you may be getting more oxygen than normal at a flow rate of 7 to 9 liters/minute, the restricted respiration rate allows CO2 in the arterial blood steam to climb above normal levels.
It gets worse… It's not the lack of oxygen that controls the rate of respiration, it's the level of CO2. During strenuous activity, CO2 builds up faster in the bloodstream than it can be expelled from the lungs at normal respiration rates. As a result, chemical receptors in the body signal an increase in respiration to reduce CO2 levels, and you start gasping for breath panting like a big dog.
On top of that, CO2 is a powerful vasodilator. As a cluster headache attack is associated with a dilation of the arteries and vascular structures around your trigeminal nerve, a buildup of CO2 above normal levels causes increased vascular dilation and that makes cluster headache attacks more painful and last longer.
CO2 is such a powerful a vasodilator that even a slight increase in CO2 above normal levels will totally negate and overpower the vasoconstriction (a cluster headache abortive mechanism) provided by breathing 100% oxygen. As CO2 levels continue to build, you start having panic attacks and become even more animated generating more CO2. It's a vicious cycle.
The only way to prevent CO2 buildup during oxygen therapy is breathe at a rate faster than normal and with a greater tidal volume than normal. This is called hyperventilation and requires a minimum oxygen flow rate of 25 liters/minute.
This page is named in honour of a warm, valuable and very knowledgeable contributor to this website, who sadly left us on February 23rd, 2013 after losing his battle with cancer.
Barry T Coles.
16 January 1949 - 23 February 2013
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